DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20194306

Endometrial pathology in abnormal uterine bleeding

Indu Rajagopal, Beena Mary Thomas, Vidyadhar N.K. Rama Rao

Abstract


Background: Abnormal uterine bleeding (AUB) is a common presenting symptom in gynecological outpatient department. Endometrial sampling could be used as the first diagnostic step in AUB. Aim of our study was to evaluate the endometrial causes of AUB and to observe the incidence of various pathology in different age groups.

Methods: A study was conducted on 167 patients who presented with AUB, during the period from July 2015- January 2017.All endometrial curettage and hysterectomy specimens received in the Department of Pathology, Kannur Medical College during  this  period  were included.

Results: Maximum numbers of patients were in the perimenopausal age group and normal cycling endometrium was the commonest pattern observed (41.3%).Abnormal patterns noted were hyperplasia without atypia (20.9%), disordered proliferative pattern (16.1%) and endometrial carcinoma (1.7%).

Conclusion: Histopathological examination of endometrium showed wide spectrum of lesions from normal endometrium to malignancy. Accurate analysis of endometrial sampling is important in the management of AUB.


Keywords


Abnormal uterine bleeding, Endometrium, Histopathology

Full Text:

PDF

References


Bhatta S, Sinha AK. Histopathological study of endometrium in abnormal uterine bleeding. J Pathol Nepal. 2012;2(4):297-300.

Saraswathi D, Thanka J, Shalinee R, Aarthi R, Jaya V, Kumar PV. Study of Endometrial Pathology in Abnormal Uterine Bleeding. J Obstetr Gynecol India. 2011 July; 61(4):426-30.

Sajitha K, Padma SK, Shetty KJ, Prasad KHL, Permi HS, Hegde P. Study of histopathological patterns of endometrium in abnormal uterine bleeding. CHRISMED J Health Res. 2014;1(2):76-81.

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

Sharma A, Dogra Y. Trends of AUB in tertiary centre of Shimla hills. J Midlife Health. 2013;4(1):67-8.

Fraser IS, Critchley HO, Munro MG, Broder M. Can we achieve international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding? Hum Reprod. 2007 Mar;22(3):635-43.

Albers JR, Hull SK, Wesley RM. Abnormal uterine bleeding. Am Fam Physician. 2004 Apr 15;69(8):1915-26.

Litta P, Merlin F, Saccardi C, Pozzan C, Sacco G, Fracas M, et al. Role of hysteroscopy with endometrial biopsy to rule out endometrial cancer in postmenopausal women with abnormal uterine bleeding. Maturitas. 2005 Feb 14;50(2):117-23.

G. Dallenbach-Hellweg. Histopathology of the endometrium. 4th Ed. New York: Springer-Verlag. 1993.

Silverberg SG. Problems in the differential diagnosis of endometrial hyperplasia and carcinoma. Mod Pathol. 2000 Mar;13(3):309-27.

Bashir H, Bhat N, Khuroo MS, Reshi R, Nazeir MJ, Qureshi MZ. Clinicopathological study of endometrium in patients with AUB. International Journal of Current Pharmaceutical Review and Research 2015 December; 7(22):67-73.

Vaidya S, Lakhey M, Vaidhya SA, Sharma PK, Hirachand S, Lama S, et al .Histopathological patterns of AUB in endometrial biopsies. Nepal Med Coll J. 2013 Mar;15(1):74-7.

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

Shilpa, Subramanya. Study of endometrial pathology in abnormal uterine bleeding. Int J Scient Res. August 2014;3(8):490-2.

Parmar J, Desai D. Study of endometrial pathology in abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2013 Jun; 2(2):182-5.

Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of untreated hyperplasia in 170 patients. Cancer 1985 Jul 15;56(2):403-12.

Lacey JV, Ioffe OB, Ronnett BM, Rush BB, Richesson DA, Chatterjee N, et al. Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan. Br J Cancer. 2008 Jan 15;98(1):45-53.

Chamlian DL, Taylor HB. Endometrial hyperplasia in young women. Obstet Gynecol. 1970 Nov;36(5):659-66.

Kumari S, Anuradha M. Endometrial patterns in abnormal uterine bleeding: a retrospective study. Int J Reproduction, Contraception, Obstetrics and Gynecol. Oct 2017 Nov;6(11):4966-70.

Dangal G. A study of endometrium of patients with abnormal uterine bleeding at Chitwan Valley. Kathmandu Uni Medi J. November 2002; 1(2):110-2.