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Evaluation of endometrial histopathological patterns in abnormal uterine bleeding: A study of 1545 cases

Chandrashekhar Chhatrasal, Gaurav Shelgaonkar, Kulkarni C V, Shikha Ghanghoria, Ashok Yadav, Poorva Aggarwal.

Abstract
Background: Abnormal uterine bleeding (AUB) is quite common gynecological complaint associated with considerable morbidity and significantly affects the patientís family, personal, and social life. The aim of the study was to analyze the histomorphological patterns of endometrium in patients presenting with AUB and their frequencies.

Objectives: Our study aimed at determining the types and frequencies of endometrial pathologies in patients presenting with AUB at our hospital which caters largely to women of low socioeconomic status.

Materials and Methods: This is a retrospective study conducted in the Department of Pathology, in a Tertiary Care Teaching Hospital, Indore from January 2012 to December 2016. All cases of AUB with a probable endometrial cause were included in the study. Data were entered in Microsoft Excel and analysis was done in the form of percentage, proportion, and represented as tables where necessary.

Results: A total of 1545 cases were analyzed. Patientsí age ranged from 23 to 78 years. AUB was most the prevalent in the perimenopausal age group. The most common presenting complaint was menorrhagia (45.5%). Endometrial hyperplasia was the most common histopathological finding and was seen in 25.3% patients with simple hyperplasia without atypia being the predominant pattern (22.6%), followed by secretory endometrium in 24.1% patients, irregular ripening of endometrium in 19.5% patients, and proliferative phase pattern in 7.6% patients. Malignancy was detected in 2.0% of cases, and endometrial carcinoma with 1.8% was the most common lesion.

Conclusion: Histopathological evaluation of endometrial samples is, especially, indicated in women with AUB to rule out malignancy and preneoplasia. Among the patients with no organic pathology, normal physiological patterns with proliferative, secretory, and menstrual changes were observed. The most common endometrial pathology was endometrial hyperplasia. The rise in cases of irregular ripening of endometrium is associated with abnormal hormonal effects.

Key words: Abnormal Uterine Bleeding; Dilatation and Curettage; Endometrium; Histological Pattern


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