Abstract
Introduction
Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology out-patient department. Endometrial sampling could be effectively used as the first diagnostic step in AUB, although at times, its interpretation could be quite challenging to the practicing pathologists. This study was done to evaluate histopathology of endometrium for identifying the endometrial causes of AUB. We also tried to observe the incidence of various pathology in different age groups presenting with abnormal uterine bleeding.
Material and Methods
This was a study done at Sri Ramachandra Medical College and Research Institute, Chennai, India on 620 patients who presented with AUB from June 2005–June 2006. Out of which 409 cases of isolated endometrial lesions diagnosed on histopathology were selected for the final analyses. A statistical analysis between age of presentation and specific endometrial causes was done using χ2 test.
Results
The most common age group presenting with AUB was 41–50 years (33.5%). The commonest pattern in these patients was normal cycling endometrium (28.4%). The commonest pathology irrespective of the age group was disordered proliferative pattern (20.5%). Other causes identified were complications of pregnancy (22.7%), benign endometrial polyp (11.2%), endometrial hyperplasias (6.1%), carcinomas (4.4%) and chronic endometritis (4.2%). Endometrial causes of AUB and age pattern was statistically significant with P value <0.05.
Conclusion
There is an age specific association of endometrial lesions. In perimenopausal women AUB is most commonly dysfunctional in origin and in reproductive age group, one should first rule out complications of pregnancy. The incidence of disordered proliferative pattern was significantly high in this study, suggesting an early presentation of these patients.
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References
Brenner PF. Differential diagnosis of AUB. Am J Obstet Gynecol. 1996;175:766–9.
Albers JR, Hull SK, Wesley RM. Abnormal uterine bleeding. Am Fam Phys. 2004;69:1915–26.
Litta P, Merlin F, Saccardi C, et al. Role of hysteroscopy with endometrial biopsy to rule out endometrial cancer in post menopausal women with abnormal uterine bleeding. Maturitas. 2005;50:117–23.
Dahlenbach-Hellweg G. Histopathology of endometrium. 4th ed. New York: Springer-Verlag; 1993.
Emans SJ, Woods ER, Flagg NT, et al. Genital findings in sexually abused, symptomatic and asymptomatic girls. Paediatrics. 1987;79:778–85.
Shankar M, Lee CA, Sabin CA, et al. Von Willebrand disease in women with menorrhagia: a systematic review. BJOG. 2004;111:734–40.
Kilbourn CL, Richards CS. Abnormal uterine bleeding, diagnostic considerations, management options. Postgrad Med. 2001;109:137–50.
Yusuf NW, Nadeem R, Yusuf AW, et al. Dysfunctional uterine bleeding. A retrospective clinicopathological study over 2 years. Pak J Obstet Gynaecol. 1996;9:27–30.
Muzaffar M, Akhtar KAK, Yasmin S, et al. Menstrual irregularities with excessive blood loss: a clinico-pathologic correlation. J Pak Med Assoc. 2005;55:486–9.
Steven SG. Problems in the differential diagnosis of endometrial hyperplasia and carcinoma. Mod Pathol. 2000;13:309–27.
Nam-Hoon C, Chan-II P, In-Joon C. Clinicopathologic study of the endometrium. Dysfunctional uterine bleeding. Korean J Pathol. 1989;23:65–74.
Gredmark T, Kvint S, Havel G, et al. Histopathological findings in women with postmenopausal bleeding. B J Obstet Gynaecol. 1998;102:133–6.
Hileeto D, Fadare O, Martel M, et al. Age dependent association of endometrial polyps with increased risk of cancer involvement. World J Surg Oncol. 2005;3:8.
Escoffery CT, Blake GO, Sargenat LA. Histopathological findings in women with postmenopausal bleeding in Jamaica. West Indian Med J. 2002;51:232–5.
Dangal G. A study of endometrium of patients with abnormal uterine bleeding at chitwan valley. Kathmandu Univ Med J. 2003;1:110–2.
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Doraiswami, S., Johnson, T., Rao, S. et al. Study of Endometrial Pathology in Abnormal Uterine Bleeding. J Obstet Gynecol India 61, 426–430 (2011). https://doi.org/10.1007/s13224-011-0047-2
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DOI: https://doi.org/10.1007/s13224-011-0047-2