A Study on Histopathological Patterns of Endometrium in Different Types of Abnormal Uterine Bleeding Among Peri And Postmenopausal Women

Introduction: Abnormal uterine bleeding (AUB) is considered as one of the most common problems both to the patient and the gynecologist. Until the pathology underlying atypical uterine bleeding is accurately diagnosed, proper therapy is hardly possible. The objectives of the study were to determine the types and frequencies of pathologies in endometrial curettings of abnormal uterine bleeding & compare different endometrial pathologies in different types of abnormal uterine bleeding in peri and postmenopausal patients. Methods: This is a retrospective study, conducted in the Department of Pathology, in a tertiary care teaching hospital, Kolkata from November 2014 to October 2015. All cases of AUB in the peri and postmenopausal patients with a probable endometrial cause were included in the study. Results: A total of 156 cases were analyzed. AUB was most prevalent in the perimenopausal age group. The most common presenting complaint was menorrhagia (43%). Histopathological diagnosis was not possible in 5 cases with inadequate sample material. Non-organic causes of the endometrium comprised 80.1% of total while in the rest (19.9%) definite organic pathology was found. Among the nonorganic causes secretory endometrium(42.9%) and in the organic group polyp(43.3%) was found to be commonest. Malignancy comprises 23.3% and hyperplasia constitutes 30% of total organic causes. Conclusion: Histopathological diagnosis of hyperplasia and malignancy is maximum in the patients presented with menometrorrhagia followed by postmenopausal bleeding. Hereby Histopathological evaluation of endometrial samples is especially indicated in peri and postmenopausal women to rule out neoplastic and preneoplastic conditions.