DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160384

Study of histopathological pattern of endometrium in abnormal uterine bleeding and its management

Alpana Singh, P. V. Ramana Bai

Abstract


Background: Abnormal uterine bleeding is one of the most common and challenging problems presenting as an enigma to the gynecologist regardless of the age of the women.  Histopathological evaluation of endometrium plays a significant and pivotal role in the diagnosis and management of endometrial causes of Abnormal Uterine Bleeding. The main aim was to study the frequency of different histopathological patterns of endometrium in patients with abnormal uterine bleeding across different age groups, know the endometrial causes of abnormal uterine bleeding and its managements.

Methods: This study was conducted on 300 patients from March 2014 to February 2015 in the department of Obstetrics and Gynaecology in a reputed teaching hospital and research centre in South India. Demographic indices were collected and recorded. Endometrial samples were sent for histopathological examinations and different endometrial patterns were noted.

Results: Abnormal Uterine Bleeding (AUB) presented mostly in the 41-50 years age spectrum (48.6%) and most of the patients were multipara. The main presenting complaint among our patients was menorrhagia (42%) followed by polymenorrhagia (15%), menometrorrhagia (10.6%) ,continuous vaginal bleeding (9.6%), Polymenorrhea (9.3%), postmenopausal bleeding (8.6%) and metrorrhagia (4.6%).The commonest histopathological  pattern in abnormal uterine bleeding was  normal physiological phases of menstrual cycle - proliferative and secretary endometrium (37% and 30%  respectively). Endometrial hyperplasia was the most common endometrial pathology observed (22.6%).

Conclusions: Endometrial evaluation in abnormal uterine bleeding in different age groups helps in the management, especially in the perimenopausal and postmenopausal age groups to rule out premalignant conditions and malignancy.


Keywords


Abnormal uterine bleeding, Multipara, Menorrhagia, Endometrial carcinoma

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References


The ESHRE Capri workshop group. Endometrial bleeding. Human reproduction update. 2007;13(5):421-31.

Ozdemir S, Celik C, Gezginc K Kıreşi D, Esen H. Evaluation of endometrial thickness with transvaginal ultrasonography & histopathology in premenopausal women with abnormal vaginal bleeding.Arch Gynecol Obstet. 2010;282(4):395-9.

Mary GS, Tarin AS, Patrice MW. Evaluation and management of abnormal uterine bleeding in premenopausal women. Am Fam Physician. 2012;85(1):35-43.

Munro MG, Critchley HO, BroderMS, Fraser IS; FIGO Working Group on Menstrual Disorders. FIGO classification system for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113(1);3-13.

Brenner PF. Differential diagnosis of AUB. Am J Obstet Gynecol. 1996;175:766-9.

Albers JR, Hull SK, Wesley RM. Abnormal uterine bleeding. Am Fam Phys. 2004;69:1915-26.

Litta P, Merlin F, Saccardi C, Pozzan C, Sacco G, Fracas M. Role of hysteroscopy with endometrial biopsy to rule out endometrial cancer in postmenopausal women with abnormal uterine bleeding . Marturitas. 2005;50(2):117-23.

Yusuf NW, Nadeem R, Yusuf AW, Rahman R. Dysfunctional uterine bleeding a retrospective clinicopathological study over 2 years. Pak J. Obstet Gynaecol. 1996;9:27-30.

Muzaffar M, Akhtar KA, Yasmin S, Mahmood-Ur-Rehman, Iqbal W, Khan MA. Menstrual irregularities with excessive blood loss A clinicopathological correlation. J Pak Med Assoc. 2005;55(11):486-9.

Wahda MT, Manal TA, Safwan I. Histopathological Interpretation of Abnormal Uterine Bleeding After the Age of 40 Year. The Iraqi Postgraduate Medical Journal. 2010;9:274-82.

Moghal N. Diagnostic value of endometrial curettage in abnormal uterine bleeding- a histopathological study. J Pak Med Assoc. 1997;47:295-9.

Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, Panicker VK. Study of endometrial pathology in Abnormal uterine bleeding. J Obstet Gynecol India. 2011;61:426-30.

Afgan S, Yasmeen A. Abnormal uterine bleeding a clinicopathological study of 150 cases. Ann Pak Inst Med Sci. 2013;9(4):201-4.

Stead LG, Stead SM, Kaufman MS, Jeane Simmons Holmes JS, Schachel PP. First Aid For the Obstetrics and Gynaecology. Clerkship McGraw –Hill Companies, 2002:167-231.