A CLINICOPATHOLOGICAL STUDY OF THE ENDOMETRIUM-DECIPHERING PATTERNS OF ABNORMAL UTERINE BLEEDING

Abstract

Objective: Abnormal uterine bleeding (AUB) can be defined as any bleeding that varies from the duration, frequency and amount of blood flow in a normal menstrual cycle. In India, the prevalence of AUB in India is reported to be 17.9% with greater than one third of patients presenting with to the outpatient department with AUB. The endometrium is a hormone-sensitive and dynamic tissue and its histomorphological study along with clinical correlation is important in deciphering causes of AUB; to provide comprehensive patient care. This study aimed to analyze the histopathology of the endometrium and evaluate causes of abnormal uterine bleeding in conjunction with clinical findings.

Methods: This was a prospective study performed over a period of 2 y (2016-2018). The study comprised of 60 participants who came to the gynecology OPD with complaints of AUB. The relevant clinical information obtained and tabulated. Endometrial samples and hysterectomy specimens received in our pathology department were histopathologically analyzed and diagnosed.

Results: The age of the patients diagnosed ranged from 25-70 y and was maximally seen between 40-50 y (n=25, 41.67%). The most common clinical complaint was heavy menstrual bleeding (menorrhagia) (n=40, 66.67%). Histopathologically, endometrial hyperplasia was the most common pattern observed (n=20, 33.33%). In cases of anovulatory endometrium (n=18, 30%) the most common pattern was disordered proliferative endometrium (n=10, 16.67%).10 cases of endometrioid endometrial adenocarcinoma (16.67%).

Conclusion: Histopathological study of the endometrium, coupled with adequate clinical history is of utmost importance in eliciting the cause of AUB, with subsequent patient management.