Histopathological spectrum of endometrium in abnormal uterine bleeding

Simridhi Bindroo, Monika Garg, Tajinder Kaur


Background: Abnormal uterine bleeding (AUB) interferes with the quality of life of an otherwise healthy woman. Until the pathology underlying menorrhagia is, accurately diagnosed, proper therapy is hardly possible. The objective of the study was to analyze different histopathological patterns of endometrium in AUB and observe the incidence of various pathologies in different age groups and their relation to parity.

Methods: This two-year prospective studywas done in the department of pathology in atertiary care centre, which included 250 cases of clinically diagnosed AUB patients were evaluated. Histopathological examination of endometrial biopsies and hysterectomy specimens were done, followed by clinical correlation.

Results: Out of 250 cases of AUB, Premenopausal bleeding was seen in 216 cases (86.4%) and 34 cases (13.6%) had postmenopausal bleeding. The commonest finding observed in the study was proliferative phase endometrium (37.2%), followed by secretory endometrium (34%) and endometrial hyperplasia (16%). Disordered proliferative endometrium was seen in 2.4% of patients. Endometrial carcinoma was seen in 4 (1.6%) cases. Endometrial hyperplasia was seen mostly in the age group 41-50 years (27 cases). Two cases of endometrial carcinomas were presented after age 60 years.

Conclusions: Our study revealed the highest incidence of AUB in the perimenopausal age group (41-50 years). Hence a thorough histopathological workup and clinical correlation are mandatory in cases of abnormal uterine bleeding.


Endometrium, Hyperplasia, Hysterectomy, Menopause, Menorrhagia, Uterine hemorrhage

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Sedhai LB, Shrestha A. Abnormal uterine bleeding; its prevalence, causes and management in Chitwan. J Chitwan Med Coll. 2012;1(2):36-8.

Al-Neaimy WMT, Ahmed MT, Al-Jawadi SI. Histopathological Interpretation of Abnormal Uterine Bleeding After the Age of 40 Year. Iraqi Postgrad Med J. 2010;9(3):274-82.

Sajitha K, Padma SK, Shetty KJ, Kishan Prasad HL, Permi HS, Hegde P. Study of histopathological patterns of endometrium in abnormal uterine bleeding. Chrismed J Health Res. 2014;1(2):76-81.

Bolde SA, Pudale SS, Pandit GA, Matkari PP. Histopathological study of endometrium in cases of abnormal uterine bleeding. Int J Res Med Sci. 2017 Jan 26;2(4):1378--81.

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

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 Aug;61(4):426-30.

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.

Khan S, Hameed S, Umber A. Histopathological Pattern of Endometrium on Diagnostic D & C in Patients with Abnormal Uterine Bleeding. Ann King Edw Med Univ. 2011;17(2):166.

Patil SG, Bhute SB, Inamdar SA, Acharya NS, Shrivastava DS. Role of Diagnostic Hysteroscopy in Abnormal Uterine Bleeding and its Histopathologic Correlation. J Gynecol Endosc Surg. 2009;1(2):98-104.

Corniţescu FI, Tănase F, Simionescu C, Iliescu D. Clinical, histopathological and therapeutic considerations in non-neoplastic abnormal uterine bleeding in menopause transition. Rom J Morphol Embryol. 2011;52(3):759-65.

Perveen S, Perveen S. Endometrium histology in abnormal uterine bleeding. Med Channel. 2011;17(4):68-70.

Gon S, Kundu T, Mallick D, Ghosh G. A Study on histopathological patterns of endometrium in different types of abnormal uterine bleeding among peri and postmenopausal women. IOSR J Dent Med Sci. 2016 Sep;15(09):106-11.

Abdullah LS, Bondagji NS. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull. 2011 Dec;33(4):195-8.

Sajeetha KR, Anuradha M. Endometrial patterns in abnormal uterine bleeding: a retrospective study. Int J Reprod Contracept Obstet Gynecol. 2017 Oct 28;6(11):4966-70.

Bhatta S, Sinha AK. Histopathological study of endometrium in abnormal uterine bleeding. J Pathol Nepal. 2012 Sep 25;2(4):297-300.

Ashraf-Ganjoei T, Behtash N, Shariat M, Mosavi A. Low grade endometrial stromal sarcoma of uterine corpus, a clinico-pathological and survey study in 14 cases. World J Surg Oncol. 2006 Aug 9;4:50.

Sandeepa S, Jayaprakash HT, Ashwini MC. Abnormal uterine bleeding: Histopathological patterns of endometrium in elderly. Indian J Pathol Oncol. 2016;3(4):662-4.