Histopathological Pattern of Endometrial Biopsies in Patients with Abnormal Uterine Bleeding Attending Birat Medical College Teaching Hospital

Abstract

Introduction: Abnormal uterine bleeding (AUB) is one of the commonest gynaecological problems. Etiology of AUB may be structural and functional and varies according to age group. Histological pattern of endometrial sampling along with clinical and radiological findings remains the diagnostic standard for clinical diagnosis of endometrial pathology which ultimately helps in deciding the management of the patients.
 Objectives: To determine histopathological pattern of endometrial biopsies in patients with AUB attending Birat Medical College Teaching Hospital. To determine the pattern of menstrual abnormality in patients with AUB in different age groups.
 Methodology: We conducted a prospective hospital based cross sectional study for a period of one year (1 April 2019 to March 31 2020). Histopathological findings of all endometrial biopsy samples in patients with AUB were examined. Patients were categorized into different age groups and the patterns of menstrual abnormality were also documented.
 Results: 166 patients presenting with AUB underwent endometrial biopsy. Most of them were of perimenopausal age group (42.77%). Menorrhagia was the most common presenting menstrual abnormality. Histopathological examination predominantly revealed normal cyclical endometrium. Hyperplasia was seen more frequently in patients > 40 years of age. Malignancy was diagnosed in 2.41%, all were adenocarcinoma and was seen in > 50 years age.
 Conclusion: AUB is a common gynaeco-pathological problem with varied clinical presentation and multiple causes. Functional endometrial changes account for the highest histological pattern. However hyperplasia and malignancy are important cause of AUB in perimenopausal and post menopausal age group's women.

Endometrial Pathology in abnormal uterine bleeding (AUB) & role of different techniques of endometrial sampling in evaluation of AUB : A cross sectional study

“…In our study as per table2, functional endometrium with proliferative and secretary changes were noted in 53 cases (35.4%) and 24 cases (16%)respectively while Kafle et al (7) in a study of 166 samples noted proliferative and secretary changes in 42.97% and 14.46% cases. Brahmaiah J et al (8) in study of 210 samples noted proliferativeand secretary changes in 31.3% and 11.43% cases respectively.…”

“…Brahmaiah J et al (8) in study of 210 samples noted proliferativeand secretary changes in 31.3% and 11.43% cases respectively. Endometrial hyperplasia without atypia was seen in 18 cases(12%) cases and with atypia was seen in 7 cases (4.66%) in our study while Kafle et al (7) noted hyperplasia of endometrium without atypia in 7.23% cases and atypical hyperplasia in 3.01% cases. Brahmaiah J et al (8) noted endometrial hyperplasia in 20% cases with no specification of features such as atypia or without atypia.…”

“…Age group 31-40 years 53 cases (35.3%) underwent endometrial sampling and histological changes were mostly benign such as proliferative(23),secretary (11)pill endometrium(2)endometrial hyperplasia without atypia (4), with atypia(2) chronic endometritis and endometrial polyp 3 cases each and inadequate sample in 2 cases. Age group 41-50 contributed to maximum number 60 cases (40%) and endometrial changes were Proliferative (22),secretary (12),endometrial hyperplasia without atypia (7),with atypia(3),carcinoma endometrium (1) ,other changes were chronic endometritis (6),pill endometrium(1),Polyp (2).Age group 51-60 contributed 22 cases 14% of cases and histopathological changes were noted as proliferative (6),disordered proliferative(1), Atrophic endometrium (3)and chronic endometritis 2 cases each, endometrial hyperplasia without atypia (6) with atypia(2),carcinoma endometrium(1),inadequate sample(1) other changes were benign. Age group 61-70 total 8 cases (5.2%) underwent endometrial sampling and pathological changes were endometrial carcinoma(3), atrophic endometrium (3) and endometrial polyp (1),inadequate sample for reporting (1).…”

Histopathological pattern of endometrial biopsies in patients with abnormal uterine bleeding in a tertiary referral hospital in Jordan

“…AUB usually peaks in the 4th-5th decade as the physiologic phenomenon of menopausal transition takes place. 12 , 13 Anovulatory cycles in women approaching menopause begin with the loss of ovarian follicular activity and manifest as menstrual irregularities. 14 This diagnosis is reached after excluding all the possible causes, including an endometrial biopsy to exclude structural lesions.…”

Histopathological pattern of endometrial biopsy in abnormal uterine bleeding

“…2,3 AUB usually peaks in the 4th-5th decade as the physiologic phenomenon of menopausal transition takes place. 4,5 It can be caused by a wide variety of systemic diseases such as endocrine disorders or drugs. On the other hand, it may be related to pregnancy, anovulation, fibroids, polyps, adenomyosis or neoplasia.…”