Morphological Spectrum of Endometrium in Dysfunctional Uterine Bleeding

Introduction: Dysfunctional uterine bleeding (DUB) is defined as increased abnormal endometrial bleeding unrelated to any anatomic lesions/ organic pathology of the genital tract [1]. It is a common problem in woman of reproductive age and about 20% of women affected will seek consultation [2]. Objectives: 1.To study morphological features of endometrium in DUB. 2.To correlate with age, parity and bleeding pattern in women clinically diagnosed as DUB. Methodology: Study was conducted for a period of two years (January 2014 to December 2015) in department of Pathology, Shri Nijalingappa Medical College, Bagalkot. Endometrial samples were obtained from endometrial biopsy or from dilatation and curettage (D & C) and studied with routine haematoxylin & eosin slides. Results: A total of 284 samples were received. Maximum incidence of DUB was found in age group 41-50 years (37.32%), followed by 31-40 years (35.56%) in multiparous (71.83%) women presenting with menorrhagia (71.83%). Endometrial hyperplasia was the predominant lesion seen in 46.47%, of which simple hyperplasia without atypia were 32.74%, complex hyperplasia without atypia in 7.40%, simple hyperplasia with atypia in 2.11% and complex hyperplasia with atypia in 4.22%. Proliferative endometrium was seen in 19.71%, secretory endometrium in 10.21%, disordered proliferative phase in 4.93%, irregular ripening in 8.80%, irregular shedding in 1.75%, atrophic endometrium in 2.46%, while 5.62% samples were considered inadequate. Conclusion: No age was exempted from DUB and highest incidence was noted in 3 and 4 decades with menorrhagia as the commonest bleeding pattern occurring in multiparous women and microscopically endometrial hyperplasia was most commonly found.