Title: Histopathological Spectrum of Endometrial Lesions in Women Presenting with Atypical Uterine Bleeding: Two Year Study
Authors: Jahnavi Marachapu, Swati Vij
DOI: https://dx.doi.org/10.18535/jmscr/v11i3.30
Abstract
Background: Abnormal uterine bleeding (AUB) is a prevalent symptom experienced by patients of all ages in the O&G outpatient department, which can negatively impact the quality of life of an otherwise healthy woman. Proper treatment is challenging until an accurate diagnosis of the underlying pathology is made. AUB can be caused by a range of factors that differ across age groups. Conducting a histopathological examination of endometrial biopsy and curettage samples can effectively diagnose the cause of AUB at an early stage.
Materials and Methods: In this study, a retrospective analysis was performed on a cohort of patients who presented with abnormal uterine bleeding (AUB). The study was conducted between 2021 and 2022, and D&C material endometrial biopsy and curettage specimens were collected in the Pathology Department. All specimens were processed and stained with the H&E stain, and any changes in the endometrial samples were recorded. The patients were classified into three groups based on their age: reproductive age (17-40 years), perimenopausal (up to 50 years), and postmenopausal (above 50 years).
Results: A total of 200 specimens of endometrial biopsies and D&C materials, were collected of which 20 cases were excluded due to inadequate tissue sampling. The most common age group affected is the reproductive age group of patients presenting with complaints of AUB frequently observed in the age17- 40years, which constitute86 cases (47.78%), followed by perimenopausal age group with 72 cases (40.00%) and postmenopausal group with 22 cases (12.22%).The most common histopathological finding in this study was a normal menstrual pattern (45.56 %). The commonest finding observed in the study was secretory phase endometrium (25.00%), followed by proliferative phase endometrium (20.56%).Two cases of endometrial carcinomas were presented after the age 50 years. pregnancy related complications (PRC) were prevalent, In reproductive age and endometrial polyp was common in perimenopausal age groups after excluding functional causes. In post-menopausal age, atrophic endometrium was the commonest finding.
Conclusion: Pregnancy related complications are a common cause of abnormal uterine bleeding in women of reproductive age. However, it is important to perform a thorough histopathological workup and consider clinical factors to rule out endometrial hyperplasia or carcinoma, which are more common in perimenopausal and postmenopausal women. This study aimed to investigate the most common endometrial causes of AUB among different age groups, including reproductive, perimenopausal, and postmenopausal women, in our hospital.
