Histopathological spectrum of endometrium in abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) interferes with the quality of life of an otherwise healthy woman. Until the pathology underlying menorrhagia is, accurately diagnosed, proper therapy is hardly possible. The objective of the study was to analyze different histopathological patterns of endometrium in AUB and observe the incidence of various pathologies in different age groups and their relation to parity.Methods: This two-year prospective studywas done in the department of pathology in atertiary care centre, which included 250 cases of clinically diagnosed AUB patients were evaluated. Histopathological examination of endometrial biopsies and hysterectomy specimens were done, followed by clinical correlation.Results: Out of 250 cases of AUB, Premenopausal bleeding was seen in 216 cases (86.4%) and 34 cases (13.6%) had postmenopausal bleeding. The commonest finding observed in the study was proliferative phase endometrium (37.2%), followed by secretory endometrium (34%) and endometrial hyperplasia (16%). Disordered proliferative endometrium was seen in 2.4% of patients. Endometrial carcinoma was seen in 4 (1.6%) cases. Endometrial hyperplasia was seen mostly in the age group 41-50 years (27 cases). Two cases of endometrial carcinomas were presented after age 60 years.Conclusions: Our study revealed the highest incidence of AUB in the perimenopausal age group (41-50 years). Hence a thorough histopathological workup and clinical correlation are mandatory in cases of abnormal uterine bleeding