Endometrial patterns in abnormal uterine bleeding: a retrospective study
Keywords:Abnormal uterine bleeding, Dilatation and curettage, Endometrium, Histopathology
Background: Abnormal uterine bleeding (AUB) is a common reason for women of all ages to consult their gynecologist and is one of the most common debilitating menstrual problems ending up in hysterectomy in developing countries. The aim of the present study was to determine the clinical spectrum and frequency of pathologies in endometrial biopsy of patients with AUB in our population. We also tried to observe the incidence of various pathologies in different age groups presenting with abnormal uterine bleeding.
Methods: The study was conducted in SRM Medical College Hospital and Research Centre, Tamil Nadu over a period of eight months. This was a retrospective study done on 217 patients presenting with abnormal uterine bleeding who underwent endometrial sampling in our hospital. The pattern of endometrial changes were studied and classified.
Results: Age of the patients in our study ranged from 25 years to 68 years with maximum in the age group of 41-50 years. The commonest clinical feature was menorrhagia followed by metrorrhagia. Evaluation of the endometrium revealed various histopathological patterns like proliferative endometrium, secretory endometrium, disordered proliferative endometrium, pill endometrium, shedding endometrium, simple hyperplasia, complex hyperplasia, atrophic endometrium, endometrial polyp, carcinoma endometrium etc.The incidence of malignancy was 1.84%.
Conclusions: Histopathological examination of the endometrium showed a wide spectrum of pathological changes ranging from normal endometrium to malignancy thus emphasizing the importance of endometrial sampling as an important diagnostic tool in the management of abnormal uterine bleeding. Accurate analysis of endometrial samplings is the key to effective therapy and optimal outcome.
Sedhai LB, Shrestha A. Abnormal uterine bleeding; its prevalence, causes and management in Chitwan. J Chitwan Med Coll. 2012;1(2):36-38.
Abid M, Hashmi AA, Malik B, Haroon S, Faridi N, Edhi MM, Khan M. Clinical pattern and spectrum of endometrial pathologies in patients with abnormal uterine bleeding in Pakistan: need to adopt a more conservative approach to treatment. BMC Women's Health. 2014 Nov 5;14(1):132.
Fraser IS, Critchley HO, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. InSeminars Reproductive Medicine. 2011;29(05):383-390).
Vaidya S, Lakhey M, Vaidya Amatya S, Sharma P K, Hirachand S, Lama S et al. Histopathological pattern of abnormal uterine bleeding in endometrial biopsies. Nepal Med Coll J. 2013;15(1):74-77.
Agrawal S, Mathur A, Vaishnav K. Histopathological study of endometrium in abnormal uterine bleeding women of all age groups in Western Rajasthan (400 cases). Int J Basic Appl Sci. 2014;4(3):15-18.
Salvi A, Mital P, Hooja N, Batar A, Soni P, Beniwal R. Spectrum of endometrial histopathology in women presenting with abnormal uterine bleeding. Sch J App Med Sci. 2015;3(1A):1-4.
Khare A, Bansal R, Sharma S, Elhence P, Makkar N, Tyagi Y. Morphological spectrum of Endometrium in patients presenting with dysfunctional uterine bleeding. People’s J Scient Res. 2012;5(2):13-16.
Afghan S, Yasmeen A. Abnormal Uterine Bleeding (AUB) A Clinicopathological Study of 150 cases. Ann Pak Inst Med Sci. 2013;9(4):201-4.
Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, Panicker VK. Study of endometrial pathology in abnormal uterine bleeding. J Obstet Gynaecol India 2011;61(4):426-430.
Yusuf NW, Nadeem R, Yusuf AW. Dysfunctional uterine bleeding. A retrospective clinicopathological study over 2 years. Pak J Obstet Gynecol. 1996;9:27-30.
Muzaffar M, Akhtar KAK, Yasmin S, Mahmood-Ur-Rehman, Iqbal W, Khan MA. Menstrual irregularities with excessive blood loss: a clinico-pathologic correlation. J Pak Med Assoc. 2005;55:486-9.
Bashir H, Bhat N, Khuroo MS, Reshi R, Nazeir MJ, Qureshi MZ. Clinicopathological study of endometrium in patients with abnormal uterine bleeding. Int J Cur Res Rev. 2015 Nov 15;7(22):67.
Baral R, Pudasaini S. Histopathological pattern of endometrial samples in abnormal uterine bleeding. J Pathol Nepal. 2011;1(1):13-6.
Mirza T, Akram S, Mirza A, Aziz S, Mirza T, Mustansar T. Histopathological pattern of abnormal uterine bleeding in endometrial biopsies. J Basic Appl Sci. 2012;8:114-7.
Anwer M, Imdad SK, Jamal Q. Histpathological correlation of endometrial curettage with abnormal uterine bleeding pattern. J Surg Pak 2004;9(2):21-4.
Mogal N. Diagnostic value of endometrial curettage in abnormal uterine bleeding-a histopathological study. J Pak Med Assoc. 1997;47(12):295-9.
Abdullah LS, Bondagji NS. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull. 2011;33(4):1-6.
Jairajpuri ZS, Rana S, Jetley S. Atypical uterine bleeding-Histopathological audit of endometrium A study of 638 cases. Al Ameen J Med Sci. 2013;6(1):21-8.
Prajapati R, Daveshwar MR. A clinic-pathological correlation of endometrial pattern in patients with abnormal uterine bleeding (Aub). Int J Res Med. 2015;4(2):128-32.