Title: Correlation between histology and bleeding pattern in a case of AUB and risk factors analysis of AUB in reproductive age group
Authors: Dr Nidhi Meena, Dr Suman Meena
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.56
Abstract
Background: Excessive and abnormal menstrual bleeding is the commonest symptom which brings a perimenopausal woman to the hospital. This age group is more amenable to serious conditions like genital cancer; hence this bleeding should be seriously evaluated to exclude the life threatening conditions by easily available investigating modalities like ultrasonography (USG) and biopsy before deciding their line of treatment.
Objective: Analysing the histomorphological pattern of endometrium in abnormal uterine bleeding, Correlation b/w histopathology and bleeding pattern in AUB and to analyse the various risk factors associated with AUB. at a tertiary care centre.
Materials and Methods: The material for the study was collected from the endometrial biopsy samples sent for histopathological examination from clinically diagnosed cases of Abnormal uterine bleeding from OPD, J.K.Lon Women hospital, GMC Kota. This was a prospective study done on patients presenting with AUB from Jan 2015 to Dec 2015 in the Department of Obstetrics & Gynaecology in collaboration with the department of Pathology of Govt. Medical College Kota, (Rajasthan). The study material included a total number of 100 specimens consisting hysterectomy specimens.
Results: Abnormal uterine bleeding was high in parous women, Grand multipara 38%, multipara 55% (P3= 34%, P2= 21%). The majority of the women (49%) presented with menorrhagia, 26% with metrorhagia, polymenorrhagia was present in 20% of cases and Postmenopausal bleeding were seen in 5% cases. There were 29% fibroid uterus, Adenomyosis (26%) and 21% were diagnosed as DUB, fibroid with adenomyosis in (13%). Postmenopausal bleeding (5%) of cases. Endometrial polyp in 3% Endometrial Carcinoma were seen in 2% cases and Monckerbergs scleroma were seen in 1 case. Endometrium was Secretory in 66%, Proliferative (10%). Atrophic endometrium (9%). Endometrial hyperplasia (7%), endometrial malignancy (2%), Endometrial polyp (3%) ,Chronic endometritis (2%) and Monckerbergs scleroma was seen in 1% cases. Multiparity (55%) and grand multiparity (38%) was the major risk factors for AUB followed by hypertension (21%), PID (19%) Diabetes (12%), Obesity (4%) and tuberculosis is found in 1% case. There is significant correlation between Parity and Bleeding pattern (Coefficient of Correlation (r) = +0.896). There is significant correlation between Endometrial histopathological finding and Bleeding pattern (Coefficient of Correlation (r) = +0.98)
Conclusion: Abnormal uterine bleeding predominantly affects women of perimenopuasal age group which needs thorough evaluation as it could be the only clinical manifestation of endometrial cancer. In our study, Organic causes were found to be the commonest cause of abnormal uterine bleeding followed by dysfunctional uterine bleeding. All these women underwent dilatation & curettage/ endometrial biopsy or hysterectomy depending on the diagnosis.
Keywords: Dysfunctional Uterine Bleeding · Leiomyoma · Adenomyosis · Endometriosis · Endometrial Hyperplasia.
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