Correlation of new menstrual symptom abnormalities (FIGO 2018) with endometrial histopathology in cases of abnormal uterine bleeding

Abstract

ObjectiveTo find the correlation between new symptom classes of menstrual abnormalities (FIGO 2018) and endometrial histology. MethodsThis hospital based cross sectional study was conducted in 225 married women aged between 20 and 75 years of age over a period of one year in a tertiary care teaching hospital. The women presenting with any menstrual abnormality for 3 months or more duration were included in the study after institutional ethical clearance and informed consent. Transvaginal sonography was done to exclude structural causes like uterine fibroids, endometrial polyps and adenomyosis. All patients with endometrial thickness above 4 mm underwent endometrial aspiration for histological diagnosis. Data was analysed on SPSS 21 version. ResultsThe mean age was 39.73 years and majority (83%) were parous women. The most common menstrual abnormality was heavy menstrual bleeding (29.3%) followed by post-menopausal bleeding (19.6%). The most common histological abnormality (44.9%) was proliferative endometrium not in phase with menstrual cycle followed by simple hyperplasia (6.7%). The menstrual symptoms of amenorrhoea and scanty menstrual bleeding, both had significant association (p = 0.001 & p < 0.001) with tubercular endometritis. Heavy menstrual bleeding had significant association (p = 0.025) with ovulatory dysfunction and postmenopausal bleeding (p < 0.001) had significant association with endometrial hyperplasia and carcinoma. ConclusionAmong all the symptoms of menstrual abnormalities, amenorrhoea, scanty menstrual bleeding, heavy menstrual bleeding and postmenopausal bleeding are significantly associated with endometrial pathology in the absence of any organic lesions.