Abnormal uterine bleeding: a study of menstrual patterns and histopathological patterns in perimenopausal females

Authors

  • Mahima Jain Department of Obstetrics & Gynecology, PDU Medical College, Rajkot, Gujarat, India
  • Nilesh Gorania Department of Obstetrics & Gynecology, PDU Medical College, Rajkot, Gujarat, India

Keywords:

Abnormal uterine bleeding, Perimenopausal females, Histopathological diagnosis

Abstract

Background: In gynecology out-patient department there is a large group of patients especially in perimenopausal age group who present with various menstrual disorders. These can be as such caused due to various etiologies, which need to be investigated as line of management is thereupon decided. This study is undertaken to know the various abnormal uterine bleeding in perimenopausal women, and their histopathological pattern.

Methods: This study is done at PDU medical college hospital, Rajkot, Gujarat which is a tertiary care centre. A retrospective analysis of 268 cases clinically presenting with abnormal uterine bleeding is done. They are further posted for dilatation & curettage after thorough investigation to rule out other pathologies. The endometrial samplings from the D& C material are collected and sent for histopathological assessment. The data is recorded and further analysed. Women between 40-55 years age group are included in this study. Women with diagnosed pelvic pathology, endocrinal cause and bleeding tendencies are excluded from the study.

Results: In our study almost all menstrual disorders are found, commonest being menorrhagia in 42.16%. Other patterns reported are metrorrhagia in 3.35%, oligomenorrhea in 14.80%, polymenorrhea and polymenorrhagia in 5.22% and 5.59% cases. Post-menopausal bleeding is found in one case. The histopathological diagnoses reported in this study are proliferative and secretory phase in 26.49% and 19.77% respectively. Other endometrial hyperplasias reported are Swiss cheese in 1.86%, simple cystic hyperplasia in 12.31%, complex hyperplasia with or without atypia in 7% and 4.10% respectively. Malignancy is found in 2 cases.

Conclusions: From this study it is well established that endometrial sampling from D&C material still remains the gold standard in diagnosis of various endometrial pathologies in low resource set-up. Thereby the further line of management can also be decided for a rational approach in the treatment of perimenopausal women with abnormal uterine bleeding. 

References

Khare R, Bansal S, Sharma P, Elhence N, Makkar N, Tyagi Y. Morphological spectrum of Endometrium in patients presenting with DUB. Peoples’ J Sci Res. 2012 Jul;5(2):13-6.

Rajshri P. Damle, N. V. Dravid, Kishor H. Suryawanshi, Arundhati S. Gadre, Priya S. Bagale, Neelam Ahire. Clinicopathological spectrum of endometrial changes in perimenopausal and post-menopausal abnormal uterine bleeding: a 2 years study, J Clin Diagn Res. 2013 Dec;7(12):2774-6.

Zeeba S. Jairajpuri, S. Rana, S. Jetley. Atypical uterine bleeding - histopathological audit of endometrium: a study of 638 cases. Al Ameen J Med Sci. 2013;6(1):21-8.

Vaidya S, Latchey M, Vaidya S, Sharma PK, Hirachand S, Lama S, et al. Histopathological pattern of abnormal uterine bleeding in endometrial biopsies. Nepal Med Coll J. 2013;15(1):74-7.

Dutta DC. Abnormal menstrual bleeding. In: Dutta DC, eds. Text Book of Gynecology. 4th ed. New Delhi, India: Jaypee Brothers Medical Publishers; 2007: 175-177.

Layla S. Abdullah, Nabeel S. Bondagji. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull. 2011 Dec;33(4):1-6.

Riaz S, Ibrar F, Dawood NS, Jabeen A. Endometrial pathology by endometrial curettage in menorrhagia in perimenopausal age group. J Ayul Med Coll Abbottabad. 2010;22(3):161-4.

Downloads

Published

2017-02-03

Issue

Section

Original Research Articles