Menstrual irregularities with excessive blood loss: a clinico-pathological correlation.

OBJECTIVE To evaluate various histo-pathological features in endometrial curettings of patients complaining of menstrual irregularities with excessive blood loss and correlating them with clinical presentations. METHODS A total of 260 endometrial curettings were obtained by Dilatation and Curettage done at the Department of Gynecology and Obstetrics, Railway Hospital, Rawalpindi. All the preserved specimens were processed under standard conditions at the Pathology Department, Islamic International Medical College (IIMC). The sections were studied after staining with Haematoxylin and Eosin stain. RESULTS The patients presented with menorrhagia in 51.9%, metrorrhagia in 35.4%, polymenorrhoea in 9.2% and polymenorrhagia in 3.5% cases. History of hormonal intake was observed in 0.66% patients. Menstrual disorders were most common in 41-50 years age group accounting for 48% cases. Pathology was diagnosed in 40% of endometrial biopsies. The endometrial lesions included endometrial hyperplasia (24.7%), chronic nonspecific endometritis (13%), endometrial polyp (1.2%), pill pattern endometrium (2.3%) atrophic endometrium (0.8%) menopausal pattern endometrium, squamous metaplasia, squamous cell carcinoma and chorioncarcinoma (0.4% each). CONCLUSION The dilatation and curettage was found to be an appropriate approach with a good diagnostic yield. Fortunately frequency of endometrial malignancy appeared to be very low. Endometrial hyperplasia was the leading causes of excessive menstrual bleeding.