Clinicopathological evaluation of patients with postmenopausal bleeding in a tertiary care center

Abstract

Postmenopausal bleeding (PMB) is frequent finding in 5-10% of women in gynaecology clinic. About 10% of these patients have primary or secondary malignancy. PMB requires complete assessment to ensure the absence of malignancy and to identify and treat high risk patients such as those with endometrial hyperplasia.The aim of this study is to investigate the clinical significance and endometrial pathology in patients with PMB.A retrospective study on postmenopausal women visiting a tertiary care center between 2016 January to 2017 December was taken up for study. About 80 patients with PMB were selected and these patients were evaluated by pelvic USG, Endometrial biopsy and Endometrial histopathology.Maximum patients with PMB belonged to age group of 46-50 years (31.25%). 57.5% were multiparous (parity>2). About 53.75% had PMB 1 to 5 years after menopause. Endometrial thickness (ET) was > 4mm in 86.25%. Majority had ET between 5-10mm (58.75%). Histopathological analysis of endometrial curettings showed Proliferative phase in 35%, disordered proliferative phase in 17.5%, Atrophic Endometrium in 13.75% and endometrial carcinoma in 11.25%.Postmenopausal bleeding is an important symptom which requires evaluation to eliminate possibility of malignancy. Transvaginal sonography (TVS) is the first mode of investigation for PMB but Histopathology of Endometrium serves as gold standard for definitive diagnosis.