Histopathological interpretation of endometrium in abnormal uterine bleeding.

ABSTRACT

Background: Abnormal uterine bleeding is one of the most frequent problems in life of an adult female. Accurate analysis of endometrium & localization of intrauterine lesion is the goal to effective management & better outcome of problem. Aims & Objective: To evaluate various histopathological features in D & C and/or hysterectomy in patients presenting with abnormal uterine bleeding and to find the efficacy of D & C as a better, cost effective and minimally invasive tool for screening in patients with AUB. Materials and Methods: The present study was conducted in Department of Pathology, tertiary care hospital, Ahmedabad, Gujarat, India over a period of one and half years. A total 320 patients aged 20 years & above, presenting with AUB were included. Endometrial samples were analysed, histopathological changes identified and classified. Results: Age of patients ranged from 21 to 70 years mean age being 42.6 ± 6.9 years, maximum patients (53.4%) belonged to 41-50 years of age group. Most common histopathological pattern was normal cyclical endometrium (47.3%) followed by endometrial hyperplasia (42.9%). Endometrial hyperplasia was most common (57.1%) in perimenopausal age group (41-50 years). The diagnostic accuracy of D &C was found to be 93.4%; amongst all histopathological patterns it was maximum for complex hyperplasia (typical and atypical) and simple atypical hyperplasia. Conclusion: Endometrial causes of AUB are age related therefore it is specially recommended in women of perimenopausal age group to rule out preneoplastic and neoplastic etiology. D & C is an accurate, minimally invasive outdoor procedure for detecting endometrial pathology especially hyperplasia.