scholarly journals Histopathological evaluation of endometrial tissue in patients of abnormal uterine bleeding

Author(s):  
Zothansangi . ◽  
Vanremmawii . ◽  
Naveen P.

Background: Abnormal uterine bleeding (AUB) is one of the commonest complaints in the gynecology OPD. It is also one of the most common reason for hysterectomy among Mizo women. Endometrial biopsy is a gold standard and first step for diagnosis of AUB in a low resource setting like the North-east states of India. The aim of the study was to evaluate the histopathology of endometrium for proper management of AUB cases.Methods: This was a prospective study done to evaluate the histopathology of all the cases of AUB who attended gynaecology OPD, from the year 2018 to 2020. This study comprised of 668 AUB cases and material of the study was endometrial tissue of the cases of Abnormal uterine bleeding collected by dilatation and curettage, and sent for histopathological study to the department of pathology.Results: Most of the abnormal uterine bleeding patients was in the age group of 40 to 49 years, and the most common histopathological finding was proliferative endometrium, 35.5% followed by disordered proliferation, 21%. 14 cases of carcinoma endometrium were found among the age group above 40 years.Conclusions: The research evident that all the women above 40 years old need to undergo screening, keeping in mind the higher risk of carcinoma in the older age group of women.

Author(s):  
Ushadevi Gopalan ◽  
Sathiyakala Rajendiran ◽  
Karnaboopathy Ranganathan

Background: Abnormal uterine bleeding is a major gynaecological problem accounting for 33% of Gynaec outpatients. The cause of the bleeding is established in only 50-60% of the cases. The aim of this study was to evaluate the various histopathological patterns in the endometrial biopsy of patients presenting with abnormal uterine bleeding and to determine the specific pathology in the different age groups.Methods: This was a prospective study done in a tertiary care teaching hospital for a period of 2 years. Total of 905 patients with abnormal uterine bleeding were included in the study and they were subjected to a Dilatation and Curettage. Histopathological examination of the endometrial biopsy was done and the various histopathological patterns identified and classified.Results: The age of patients ranged from 24-74 years. 54.7% were in the age group 40-49 years followed by 23.4% in the age group 30-39 years. The most frequent findings were proliferative findings in 47.3% followed by secretory endometrium in 16.1 % patients. Proliferative endometrium was more common in the age group 40-49 years as also disordered proliferation, secretory endometrium, cystoglandular hyperplasia and endometrial hyperplasia.Conclusions: Endometrial curettings and biopsy is an important diagnostic procedure for assessing all cases of abnormal uterine bleeding and to plan for successful management.


2021 ◽  
Vol 12 (9) ◽  
pp. 84-87
Author(s):  
Nabanita Chakraborty ◽  
Rajasri Chunder ◽  
Barnali Mukherjee ◽  
Soham Chakraborty

Background: Menopause is an important event in women’s life and it marks the end of a woman`s reproductive life. Perimenopause is the interval in which a woman`s body makes a natural shift from regular cycles of ovulation & menstruation to irregular cycles and various forms of abnormal uterine bleeding. Dysfunctional uterine bleeding (DUB) is a very frequent complaint from women in the perimenopausal age group. The histological diagnosis of DUB and its proper management is very essential in this age group. Aims and Objective: Primary aim of our study was to identify the spectrum of histological changes that occur in the endometrium in perimenopausal age group and to identify the demographic pattern of each histological change. Materials and Methods: Fifty-two specimens of endometrial biopsy obtained from the patients in the perimenopausal age group of 40-50 years attending the Gynaecology and Obstetrics department were studied. Results: 71.15% cases of DUB was diagnosed amongst the 52 endometrial biopsy specimens in perimenopausal age group and Secretory endometrium is most common histological pattern. Conclusion: This study reflects a spectrum of endometrial histology present during perimenopausal age. This study has  also highlighted the correlation of endometrial histology with final diagnoses of the patients, and this may help in diagnosis and treatment of gynaecological diseases of this specific age group in future.


Author(s):  
Jessy Varghese ◽  
Jeyashambavi J. ◽  
Deepa S.

Background: Abnormal uterine bleeding is one of the most common complaint that reproductive age women bring to their clinicians. Causes are varied and study of endometrium by dilatation and curettage with histopathological examination is an important aspect of treating patients with Abnormal uterine bleeding (AUB). The present study was done for evaluation of the histopathology of the endometrium for identifying endometrial causes of AUB.Methods: A prospective study was conducted over a period of one year from July 2017 to July 2018 in the department of Obstetrics and Gynaecology in collaboration with the department of Pathology at Aarupadai Veedu Medical College, Puducherry. A complete clinical history, complete clinical examination, laboratory investigations, pelvic scan and endometrial biopsy were done to diagnose causes of AUB.Results: A total of 152 cases are included. The age of the patients having AUB was ranging from 21 to 70 years. AUB was more common the age group in the age group 41-50 years (49%) followed by 31-40 years (36%). Majority were multiparous (74%). Menorrhagia (61%) was the commonest presentation. Majority of the cases showed a disordered proliferative endometrial pattern (34.2%), followed by secretory pattern (25%). 9.8% had polyp and 1.3% showed simple hyperplasia and 0.62% revealed complex hyperplasia without atypia and carcinoma endometrium.Conclusions: Abnormal uterine bleeding was more common in the perimenopausal age group and majority had disordered proliferative endometrium and secretory changes. Endometrial sampling followed by histopathological examination helps us to diagnose the underlying pathology and will help in treating the patients appropriately including ruling out premalignant and malignant conditions of the uterus.


1970 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
R Baral ◽  
S Pudasaini

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16


Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 


2014 ◽  
Vol 4 (8) ◽  
pp. 635-638
Author(s):  
N Katuwal ◽  
G Gurung ◽  
A Rana ◽  
A Jha

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding when there is absence of organic disease of the genital tract. The objective of this study was to find out the clinical and pathological aspect of women presenting with dysfunctional uterine bleeding.Materials and Methods: A descriptive study was conducted over a period of one year from April 14th 2010 to April 13th 2011 in the Department of Obstetrics and Gynaecology and Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A complete history, clinical examination, pelvic scan, hormonal status if required and endometrial biopsy were done to diagnose dysfunctional uterine bleeding.Results: A total of 120 cases were included. The age of the patients diagnosed dysfunctional uterine bleeding were ranging from 24 -63 years. Dysfunctional uterine bleeding was most common in the age group 40-44 yrs (30%) followed by 45-49 yrs (27.5%). Menorrhagia (41.7%) was the most common presenting sign. Majority histopathology of endometrium revealed anovulatory pattern (61.7%) followed by ovulatory (38.3%). Of the cases with an anovulatory pattern 48.6% was proliferative endometrium, 33.8% disordered proliferative endometrium, 6.8%atrophic, 5.4% weakly proliferative and 2.7% each of simple hyperplasia without atypia and complex hyperplasia with atypia. All cases with ovulatory pattern showed secretory endometrium.Conclusion: Dysfunctional uterine bleeding was the most common in the perimenopausal age group and chiefly in the form of an anovulatory endometrium. . Histopathological evaluation of endometrium helps exclude the local causes and establishes the diagnosis of dysfunctional uterine bleeding, its types, and clinical correlation to histopathological findings and finally helps to determine the mode of management.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11500 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 635-638


2016 ◽  
Vol 4 (2) ◽  
pp. 72
Author(s):  
Archana Tiwari ◽  
Narinder Kaur ◽  
Sushila Jain ◽  
Ramji Rai ◽  
Surendra Kumar Jain

Introduction: Endometrial specimen for abnormal uterine bleeding (AUB) is the one of the commonest specimens received in histopathology laboratory. Histopathological characteristics of endometrial tissues, as assessed by light microscopy, remains the diagnostic standard for the management of AUB. The objective of study is to find out the histopathological pattern of endometrium in AUB in the light of clinical details.   Methods: This was a prospective observational study carried out in the department of Pathology, Lumbini Medical College Teaching Hospital for a period of two years from June 2014 to May 2016. Formalin fixed endometrial specimens were processed, paraffin embedded, sectioned at 3-4 µm, stained with hematoxylin and eosin, and studied under light microscopy along with their demographics. Data were collected, entered and analyzed using SPSS version 20.   Results: The study included 100 cases of endometrial biopsy specimens with clinical diagnosis of AUB. Menstrual disturbances was found in wide age range between 17-75 years with the mean age of 45 (SD=13.36) years. Menorrhagia was the commonest (n=60, 60%) clinical presentation. Most (n=85; 85 %) endometrium had non-neoplastic lesions. Among them, normal endometrial patterns were commonest (n=50, 50 %). Neoplastic lesions (n=15, 15%) were distributed in all menstruation status with majority in postmenopause (n=7, 7%) and included malignant cases (n=5, 5%) among others.   Conclusion: Post-menopausal bleeding was common presentation among women with malignant and premalignant disease which was present in 15% of the cases together. Timely evaluation of AUB  by histopathology can be life saving with early tissue diagnosis and management.


Author(s):  
Malarvizhi Loganathan ◽  
Meera Krishnakumar

Background: This study was undertaken to study the endometrial histology in patients presenting with abnormal uterine bleeding in the absence of palpable pelvic pathology, which helps in choosing the right modality of treatment in a particular age group with a specific histological change. The study of endometrium in dysfunctional uterine bleeding was undertaken to correlate clinical presentations with histopathological studies and to correlate the distribution of histopathological findings in various age groups.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology at Govt. Dharmapuri Medical College and Hospital during the period 01.07.2017 to 31.05.2018. Patients presenting to Govt. Dharmapuri Medical College and Hospital with abnormal uterine bleeding form the material of this study. Cases have been selected by using purposive sampling technique.Results: An ovulatory cycles were more common than ovulatory cycles in all age group. However, in patients with menorrhagia and polymenorrhagia majority had secretory endometrium (ovulatory cycles).Conclusions: Majority of the patients were found in the reproduction age group with the maximum percentage in multiparous women. Menorrhagia was the commonest mode of presentation in all age group. Most of the patients with proliferative and secretory endometrium had normal sized uterus and normal looking endometrium.


2019 ◽  
Vol 17 (2) ◽  
pp. 52-54
Author(s):  
Durga BC ◽  
Nirmala Sharma

Abnormal uterine bleeding is the third most common clinical presentation in gynecology OPD. Histopathological evaluation of the endometrial tissue plays a significant role in diagnosis and management of Abnormal Uterine Bleeding. Aim: To find out cause of abnormal uterine bleeding with the help of histopathological report of endometrial biopsy. Methodology: This is retrospective observational study done at NGMC from ( 1st June 2018 to -30th June 2019) of 100 patients endometrial biopsy sent for histopathological evaluation and diagnosis reports were correlated with age and bleeding pattern and patients were managed accordingly. Result: A total of 100 endometrial specimens submitted with clinical diagnosis of Abnormal Uterine Bleeding were studied. Patients age group ranged from 18 – 65 yrs and most of them were seen in the age group of 41–50 yrs (43%).The commonest complaint was menorrhagia i.e. 48% .The commonest endometrial pattern observed in the study was, proliferative phase endometrium (38%). Conclusion: Endometrial biopsy is one of the most useful diagnostic tools to find out cause of uterine bleeding in AUB cases and also helps in management of AUB patient.  


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