Clinicopathological and hysteroscopic study of endometrium in abnormal uterine bleeding

Authors

  • P. Sandyarani Guruvelli Department of Pathology, NRIIMS, Visakhapatnam, Andhra Pradesh, India
  • Bhagyalakshmi Atla Department of Pathology, NRIIMS, Visakhapatnam, Andhra Pradesh, India
  • Uma Namballa Department of Obstetrics and Gynecology, NRIIMS, Visakhapatnam, Andhra Pradesh, India
  • Roohi Firdous Shaik Department of Pathology, NRIIMS, Visakhapatnam, Andhra Pradesh, India
  • Deepika Peddireddy Department of Pathology, NRIIMS, Visakhapatnam, Andhra Pradesh, India
  • Tharuna Shravyya Gadamsetti Department of Pathology, NRIIMS, Visakhapatnam, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20250987

Keywords:

Abnormal uterine bleeding, Endometrial biopsy, Hysteroscopy, Histopathology, Transvaginal sonography

Abstract

Background: Abnormal uterine bleeding (AUB) is defined as bleeding from uterus that is longer than usual (>7days), more than normal volume (>80ml/cycle) and varying in frequency. AUB is commonly seen in reproductive women and affects the quality of life. The study aims to compare the diagnostic accuracy of hysteroscopy correlated with histopathology in evaluation of pathology of endometrium in patients with AUB.

Methods: The study was a cross sectional observational study with samples of Dilatation and Curettage, endometrial biopsies, conducted at NRI Institute of Medical Sciences, Visakhapatnam, in the Department of Pathology over a period of 24 months from July 2022 to June 2024 with  sample size of 135 patients.

Results: Among 135 cases, the predominant age group was perimenopausal comprising of 66 cases (48.88%). According to age wise distribution common bleeding pattern was menorrhagia in both reproductive and peri menopausal age group comprising of 39 cases and 47 cases. Post-menopausal bleeding was most common bleeding pattern in   post-menopausal women comprising of 10 cases. Among the three age groups, structural causes were high comprising of 124 cases (91.85%) and non-structural causes constitute 11cases (8.14%).The commonest pattern was proliferative endometrium constituting 34.81% followed by secretory endometrium 30.37%, Hyperplasia without atypia 18.51%. Accuracy of Hysteroscopy with Histopathology was 94.44%.

Conclusions: Hysteroscopy is a safe reliable and quick procedure in the diagnosis of cases with abnormal uterine bleeding, it should not replace tissue diagnosis, which remains the gold standard.

Metrics

Metrics Loading ...

Author Biography

Uma Namballa, Department of Obstetrics and Gynecology, NRIIMS, Visakhapatnam, Andhra Pradesh, India

Professor & HOD, Department of Obstetrics and Gynaecology,

   NRI institute of Medical Sciences, Sangivalasa, Visakhapatnam,

   Andhra Pradesh

References

HiralalKonar, DC Dutta’s textbook of gynecology,10th ed. 2022.

2.Matteson KA, Boardman LA, Munro MG, Clark MA. Abnormal uterine bleeding: a review of patient-based outcome measures. Fertil Steril. 2009;92(1):205-16. DOI: https://doi.org/10.1016/j.fertnstert.2008.04.023

3.Singh P, Singh P, Chaurasia A, Dhingra V, Misra V. Expression of ERα and PR in various morphological patterns of abnormal uterine bleeding-endometrial causes in reproductive age group. J Clin Diagn Res. 2016;10(8):6-9. DOI: https://doi.org/10.7860/JCDR/2016/19565.8290

Puvitha RD, Elavasaran SM, Shylaja S. Histopathological study of endometrium in abnormal uterine bleeding an experience in a tertiary care centre of rural South India. National J of Basic Medical Sciences.2017;8(1):32-8.

Abdullah LS, Bondagji S. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull. 2011;33(4):1-6

Dijkhuizen FP, Brolmann HA, Potters AE, Bongers MY, Heinz AP. The accuracy of transvaginal ultrasonography in the diagnosis of endometrial abnormalities. Obstet Gynecol. 1996;87:345-9. DOI: https://doi.org/10.1016/0029-7844(95)00450-5

Emanuel MH, Verdel MJ, Wamsteker K, Lamemes FB. A prospective comparison of TVS and diagnostics hysteroscopy in the evaluation of patients with abnormal implications. uterine bleeding. Clinical AM J Obstet Gynaecol. 1995;172(4):547-52. DOI: https://doi.org/10.1016/0002-9378(95)90571-5

8.Taneja P, Duggal BS. Hysteroscopy: past, present and future. Med J Armed Force India. 2002;58:293-4. DOI: https://doi.org/10.1016/S0377-1237(02)80079-X

de Vries LD, Dijkhuizen FP, Mol BW, Brölmann HA, Moret E, Heintz AP. Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in premenopausal women with abnormal uterine bleeding. J Clin Ultrasound. 2000;28(5):217-23. DOI: https://doi.org/10.1002/(SICI)1097-0096(200006)28:5<217::AID-JCU2>3.3.CO;2-2

Pop-Trajkovic-Dinic S, Ljubic A, Kopitovic V, Antic V, Stamenovic S and Pjevic AT. The role of hysteroscopy in diagnosis and treatment of postmenopausal bleeding. Vojnosanit Pregl. 2013;70:747-50. DOI: https://doi.org/10.2298/VSP110405004P

Pantaleoni DC. On endoscopic examination of The cavity of the womb. Med press Circ. 1869;8:26-7.

Panda A, parulekar SV, gupta A. Diagnostic Hysteroscopy in abnormal uterine Bleeding and its histopathological correlation. J Obst Gyn India. 1999;175:74-6.

Gianninoto A, Morana C, Campione C.Diagnostic hysteroscopy in aub. Five years’ experience. minerva ginecol. 2003;55(1):57-61.

Vantrotsenburg M, Wieser F, Naegle F.Diagnostic hysteroscopy for the investigation of abnormal uterine bleeding in Premenopausal patients. Contrib gynecol Obstet. 2000;20:21-6. DOI: https://doi.org/10.1159/000060284

Kekelci S, Kaya M, Alan M diagnostic value of Hysterocopy in aub compared to pathology Report. Iranian J of Reprod Med. 2007;5(2):61-4.

Aziz N. Study Of “Histopathological pattern of endometrium in abnormal uterine bleeding in the age group 40-60 years”: a study of 500 cases. IJMSCI. 2014;1(10):67.

Swathi GR, Nataraja MK, Shetty SS. A comparative study of hysteroscopy and transvaginal ultrasonography in diagnosis of endometrial pathology in abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2020;9:1772-8.

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;61(4):426-30. DOI: https://doi.org/10.1007/s13224-011-0047-2

Themthingla Zimik, Deepa Longjam, Sushila Devi L. A study of histopathological spectrum of endometrial lesions in Abnormal uterine bleeding with analysis of expression pattern of ER, PR and KI-67.Paripex – Indian J Res. 2020;9(6):78.

Khatik N, Tiwari A, Yadav K. Histopathological evaluation of endometrium and its clinical correlation in patients of abnormal uterine bleeding. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020;9(10):4169. DOI: https://doi.org/10.18203/2320-1770.ijrcog20204308

Yv S, Jain P. Abnormal uterine bleeding: a clinicohisto pathological analysis. International J of Reproduction, Contraception, Obstetrics and Gynecol. 2017;3(3):656–61. DOI: https://doi.org/10.5455/2320-1770.ijrcog20140954

El-khayat W, Sleet M E, Mahdi E Y. Comparative study of transvaginal Sonography and hysteroscopy for the detection of pathological endometrial lesions in women with perimenopausal bleeding. Middle East Fertility Society J. 2011;16:77–82 DOI: https://doi.org/10.1016/j.mefs.2010.09.007

Swathi GR, Nataraja MK, Shetty SS. A comparative study of hysteroscopy and transvaginal ultrasonography in diagnosis of endometrial pathology in abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2020;9:1772-8. DOI: https://doi.org/10.18203/2320-1770.ijrcog20201553

Reddy S, Jayaprakash S, Venkatesh S. Comparative study of the diagnostic accuracy of transvaginal sonography vs hysteroscopy in abnormal uterine bleeding. J South Asian Feder Menopause Soc. 2020;8(1):30–3. DOI: https://doi.org/10.5005/jp-journals-10032-1201

Gadge A, Acharya N, Shukla S, Phatak S, Comparative Study of Transvaginal Sonography and Hysteroscopy for the Detection of Endometrial Lesions in Women with Abnormal Uterine Bleeding in Perimenopausal Age Group. J South Asian Feder Obst Gynae. 2018;10(3):155-60. DOI: https://doi.org/10.5005/jp-journals-10006-1580

Twinkle, Khan A, Nigar A, Singh K, Gupta B, Khan MFF. An analytical study of hysteroscopic evaluation in patients with abnormal uterine bleeding and its correlation with histopathology. Indian J Obstet Gynecol Res. 2023;10(4):426-32. DOI: https://doi.org/10.18231/j.ijogr.2023.082

Downloads

Published

2025-03-29

How to Cite

Guruvelli, P. S., Atla, B., Namballa, U., Shaik, R. F., Peddireddy, D., & Gadamsetti, T. S. (2025). Clinicopathological and hysteroscopic study of endometrium in abnormal uterine bleeding. International Journal of Research in Medical Sciences, 13(4), 1594–1601. https://doi.org/10.18203/2320-6012.ijrms20250987

Issue

Section

Original Research Articles