Spectrum of endometrial lesions in patients with abnormal uterine bleeding: A histopathological study
Keywords:
Abnormal uterine bleeding, endometrial curetting, endometrial hyperplasia, endometrial carcinoma
Abstract
Background: Abnormal uterine bleeding (AUB) is the most common menstrual problem in women of developing countries. Endometrial curettage followed by histopathological examination can be used for definitive diagnosis of AUB. This study was conducted to assess endometrial causes of AUB on histopathological examination and its association with different age groups presenting with AUB. Methods: This study was conducted at Department of Pathology, Narayana medical college and hospital, Nellore, India on 264 women presenting with AUB over a period of 1 year from January to December 2015. A statistical analysis between endometrial histopathology and age of presentation was done using chi square test.Result: Most of the patients with AUB presented in 30 -40 years age group (37.5%) with menorrhagia as the commonest bleeding pattern. The cause of AUB was determined 261 out of 264 endometrial samples as 3 specimens were inadequate for evaluation. Out of the remaining 261 cases, 223 (84.47%) cases were due to functional causes while the remaining 38 cases (14.39%) showed definite endometrial pathology (organic AUB). Endometrial causes of AUB and age of presentation showed positive association with p value <0.05.Conclusion: Endometrial curettage is recommended in women of perimenopausal and menopausal age group presenting with AUB to rule out pre-neoplastic conditions and malignancy.References
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10. Bhosle A, Fonseca M. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. Bombay Hosp J 2010;52:69-72.
11. Abdullah LS, Bondagji NS. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull 2011; 33: 1-6.
12. Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, Panicker VK. Study of endometrial pathology in abnormal uterine bleeding. Journal of obstetrics and gynaecology of India 2011;61(4):426–30.
13. Ara S, Roohi M. Abnormal uterine bleeding: Histopathological diagnosis by conventional dilatation and curettage. Prof Med J 2011;18:587-91.
14. Brenner PF. Differential diagnosis of AUB. Amer J Obstet Gynecol 1996; 175: 766-9.
15. Jairajpuri ZS, Rana S, Jetley S. Atypical uterine bleeding-histopathological audit of endometrium - A study of 638 cases. Al Ameen J Med Sci 2013; 6: 21-8.
16. Emons G, Beckmann MW, Schmidt D, Mallmann P. New WHO Classification of Endometrial Hyperplasias. Geburtshilfe und Frauenheilkunde. 2015;75(2):135-6
17. Gredmark T, Kvint S, Havel G, Mattsson LA. Histopathological findings in women with post menopausal bleeding. Br J Obstet Gynaecol 1995; 102: 133-6.
18. Baak JP, Mutter GL. EIN and WHO94. J Clin Pathol 2005;58:1-6.
19. Khan S, Hameed S, Umber A. Histopathological pattern of endometrium on diagnostic D&C in patients with abnormal uterine bleeding. Annals 2011; 17: 166-70.
2. Munro MG, Critchley HO, Fraser IS. The FIGO classification of causes of abnormal uterine bleeding in the reproductive years. Fertil Steril 2011;95:2204-8.
3. Kotdawala P, Kotdawala S, Nagar N. Evaluation of endometrium in peri-menopausal abnormal uterine bleeding. Journal of Mid-Life Health. 2013;4(1):16-21.
4. Krampl E, Bourne T, Hurlen-Solbakken H, Istre O. Transvaginal ultrasonography sonohysterography and operative hysteroscopy for the evaluation of abnormal uterine bleeding. Acta Obstet Gynecol Scand 2001;80:616-22.
5. Albers JR, Hull SK, Wesley MA. Abnormal uterine bleeding. Amer Fam Phys 2004; 69: 1915-26.
6. Muzaffar M, Akhtar KA, Yasmin S, Mahmood UR, Iqbal W and Khan MA. Menstrual irregularities with excessive blood loss: a clinico-pathological correlation. JPMA 2005 Nov;55(11):486-9.
7. Ely JW, Kennedy CM, Clark EC, Bowdler NC. Abnormal Uterine Bleeding: A Management Algorithm. J Am Board Fam Med 2006; 19: 590-602
8. Abid M, Hashmi AA, Malik B, Haroon S, Faridi N, Edhi MM et al. clinical pattern and spectrum of endometrial pathologies in patients with abnormal uterine bleeding in Pakistan: need to adopt a more conservative approach to treatment. BMC women’s health 2014, 14:132
9. Jyotsana, Manhas K, Sharma S. Role of hysteroscopy and laparoscopy in evaluation of abnormal uterine bleeding. J K Sci 2004;6:23-7.
10. Bhosle A, Fonseca M. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. Bombay Hosp J 2010;52:69-72.
11. Abdullah LS, Bondagji NS. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull 2011; 33: 1-6.
12. Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, Panicker VK. Study of endometrial pathology in abnormal uterine bleeding. Journal of obstetrics and gynaecology of India 2011;61(4):426–30.
13. Ara S, Roohi M. Abnormal uterine bleeding: Histopathological diagnosis by conventional dilatation and curettage. Prof Med J 2011;18:587-91.
14. Brenner PF. Differential diagnosis of AUB. Amer J Obstet Gynecol 1996; 175: 766-9.
15. Jairajpuri ZS, Rana S, Jetley S. Atypical uterine bleeding-histopathological audit of endometrium - A study of 638 cases. Al Ameen J Med Sci 2013; 6: 21-8.
16. Emons G, Beckmann MW, Schmidt D, Mallmann P. New WHO Classification of Endometrial Hyperplasias. Geburtshilfe und Frauenheilkunde. 2015;75(2):135-6
17. Gredmark T, Kvint S, Havel G, Mattsson LA. Histopathological findings in women with post menopausal bleeding. Br J Obstet Gynaecol 1995; 102: 133-6.
18. Baak JP, Mutter GL. EIN and WHO94. J Clin Pathol 2005;58:1-6.
19. Khan S, Hameed S, Umber A. Histopathological pattern of endometrium on diagnostic D&C in patients with abnormal uterine bleeding. Annals 2011; 17: 166-70.
Published
2016-11-06
Section
Original Article
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