Study of endometrial pathology in abnormal uterine bleeding
Keywords:Abnormal uterine bleeding, Endometrium
Background: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology outpatient department. Endometrial sampling could be effectively used as a first diagnostic step in AUB, although at times, its interpretation could be quite challenging to the practicing obstetrician. This study was done to evaluate histopathology of endometrium for identifying endometrial causes of AUB. We observed the incidence of various pathology in different age groups presenting with abnormal uterine bleeding & with respect to it were offered pharmacological management.
Methods: This was a study done at S B K S Medical Institute & Research Centre, Vadodara, India on 155 patients who presented with AUB from February 2010-2012, these were the cases of isolated endometrial pathology diagnosed on histopathology were selected for analyses. A statistical analysis between age of presentation and specific endometrial causes was done using chi - square test.
Results: The most common age group presenting with AUB was 30- 40 yrs. The commonest pattern in these patients was normal cycling endometrium (32.65%).The commonest pathology irrespective of the age group was disordered proliferative endometrium (33.33%). Other causes identified were pregnancy associated conditions (0.08%), benign endometrial polyp (10.78%), endometrial hyperplasia without atypia (0.05%), chronic endometritis (0.03%), endometrial hyperplasia with atypia (0.04%). Endometrial causes of AUB and age pattern was statistically significant with p value < 0.05.
Conclusions: There is an age specific association of endometrial lesions. In perimenopausal women AUB is most commonly dysfunctional in origin and in reproductive age group, one should rule out pregnancy associated conditions. The incidence of disordered proliferative pattern was significantly high in this study, suggesting an early presentation of these patients & procuring success with pharmacological management.