Clinicopathological Spectrum of Endometrial Changes in abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) is a very common gynecological condition that affects all age groups. One third of patients attending gynecology OPD present with complaints of abnormal uterine bleeding. The importance of endometrial biopsy or curettage done to obtain material for histopathological evaluation, to aid in diagnosis and further management, cannot be overemphasized especially in perimenopausal females who are at a risk of developing malignancy. This study was conducted to determine the clinico-histopathological pattern of the abnormal uterine bleeding. This was a retrospective study conducted at a tertiary care hospital in South India in April 2014. The data was obtained from the medical records department from May 2012 to November 2013. A total of 324 endometrial biopsies patients with abnormal uterine bleeding were analyzed. The cause of AUB could be determined in 285 patients and the remaining 39 biopsy specimens were inadequate for evaluation. Among 285 cases, 232 (81.4%) were due to functional causes as no organic pathology was found, while the remaining 53 cases (18.5%) showed definite endometrial pathology. Peri-menopausal (40-50 years) was the most common age group and most of the cases were para <2. Most common menstrual disorder was menorrhagia followed by menometrorrhagia. Most common etiological factor for abnormal uterine bleeding was dysfunctional uterine bleeding followed by Fibromyoma and Adenomyosis. Most common endometrial pattern in peri menopausal age group was proliferative followed by secretory and in post menopausal women, atrophic endometrium followed by proliferative and endometrial carcinoma. The histopathological study of endometrium in abnormal uterine bleeding above the age of 40years plays an important role in diagnosing various etiopathological factors and helps in determining the mode of management.