Histopathological evaluation of endometrium in pre and postmenopausal uterine bleeding

Abstract

Introduction: Abnormal uterine bleeding is most common gynecological presentation in pre and postmenopausal women caused by benign and malignant lesions and infections. Histopathological examination is the gold standard in diagnosing exact cause of this bleeding. Objectives: 1) To detect pattern of endometrium in women having abnormal uterine bleeding in pre and postmenopausal age group. 2) To detect incidence of carcinoma endometrium in this age group. Methods: A retrospective study was conducted of 250 patients more than 40 years of age group presented with abnormal uterine bleeding from January 2011 to June 2014 attending R. D. Gardi medical college hospital Ujjain (M. P). Histopathology reports of Endometrium were analysed and results were tabulated. Results: Maximum incidence of AUB was found in the age group of 40-42 years premenopausal (38.42%) and 50-52 years in postmenopausal women (43.3%). Menorrhagia was most common bleeding pattern found in proliferative (28.5%) and secretary (28.5%) profile. Postmenopausal bleeding was common in atrophic endometrial profiles (41%) and malignant lesions (100%). Proliferative pattern was most common in age group of 50-54 years (30.3%), secretary in 45-49 years (30.3%), atrophic endometrium in age group 65-69 years (100%), polyp in 60-64years (25%), endometritis (8.9%) in 45-49 years, irregular shedding (21.6%) in 40-44 age group, simple hyperplasia (19.6%) in 45-49 years, endometrial carcinoma (11.7%) in age group of 55-59 years. Conclusion: Sampling of endometrium is a must in all women over the age of 40 years presenting with AUB for exact diagnosis of benign and malignant lesions. Key words: Abnormal uterine bleeding, Premenopausal and postmenopausal bleeding