The range of endometrial pathologies in patients with abnormal uterine bleeding at a tertiary care center in central India

Abstract

Background: Endometrial disorders are among the most common gynecological conditions globally. Abnormal uterine bleeding (AUB) refers to any irregularity in the timing, volume, or pattern of menstrual blood flow. This study investigates the histopathological spectrum of endometrial changes across various age groups in patients presenting with AUB as their primary symptom. Materials and Methods: The study analyzed 226 endometrial biopsies/specimens collected over two years from patients with AUB as the main complaint. These specimens were processed, and slides stained with hematoxylin and eosin (H&E) were examined to determine the endometrial patterns. A chi-square test assessed the relationship between age and specific endometrial pathologies. Observations and Results: Most of the 226 cases were from perimenopausal women (40–49 years), representing 57% of the total, with proliferative endometrium being the most common pattern (40.9%). About 20% of the cases were in the reproductive age group (<40 years), where typical hyperplasia was the most prevalent pattern (45.7%). Additionally, 23% of the cases involved postmenopausal women (>49 years), with endometrioid carcinoma being the most frequent pattern observed. Other endometrial patterns included disordered proliferative endometrium, endometritis, endometrial polyps, Arias–Stella reaction, and progesterone effects. Conclusion: Patients with AUB present with a wide range of endometrial patterns, from normal cyclic endometrium to malignancies. Histopathological examination remains the gold standard for diagnosing AUB, showing a significant association between endometrial lesions and age.