HISTOPATHOLOGICAL ANALYSIS OF ENDOMETRIAL BIOPSIES FROM WOMEN WITH ABNORMAL UTERINE BLEEDING

Background: Hysterectomy is the most common gynaecological procedure performed worldwide. Abdominal hysterectomy remains the most common approach though recently there has been preference towards laparoscopic hysterectomy. Fibroid uterus is the most common indication for hysterectomy followed by pelvic organ prolapse, benign ovarian tumour and abnormal uterine bleeding. The objective of this study was to analyse the indication, outcome and correlate the clinical indication with the histopathological diagnosis.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, B. P. Koirala Institute of Health Sciences, from January 2017 to December 2019. This is a descriptive analysis of the patients who had undergone abdominal hysterectomy during the study period.Results: A total of 801 patients underwent abdominal hysterectomy and the most common indication was fibroid uterus (n=391, 48.81%), followed by abnormal uterine bleeding. The total complication rate was 3.24% (n=26) and we had one (0.1%) mortality. Histopathological analysis of the specimen revealed leiomyoma (54.43%) as the most common finding. The clinical indication and histopathological diagnosis matched in 373 (86.94%) patients.Conclusions: Abdominal hysterectomy is the most common approach and it is associated with risk of complications, so the indication for hysterectomy should be adequately evaluated. With the improvement in the different organ-preserving options, hysterectomy in benign disease should only be opted when all the other conservative options fails.

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Thyroid disorders in women with abnormal uterine bleeding: a tertiary hospital based cross sectional study from Puducherry, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181350 ◽

2018 ◽

Vol 7 (4) ◽

pp. 1532

Author(s):

Rini Ezhil ◽

Nivedita K. ◽

Fatima Shanthini N.

Keyword(s):

Thyroid Dysfunction ◽

Transvaginal Ultrasound ◽

Abnormal Uterine Bleeding ◽

Cross Sectional Study ◽

Uterine Bleeding ◽

Histopathological Analysis ◽

Thyroid Disorder ◽

Sectional Study ◽

Cross Sectional ◽

Study Participants

Background: The most common complaint with which women present for gynecological consultation is abnormal uterine bleeding which may be due to varied etiology. Among non-structural causes for AUB, endocrinological disorders like thyroid dysfunction is very common. Thyroid dysfunction is often overlooked, and unnecessary hormonal or surgical interventions are performed in patients with AUB.Methods: This is a hospital based cross sectional study carried out in Sri Manakula Vinayagar Medical College and Hospital, Puducherry between January 2017 to June 2017 for a period of 6 months and the participants were 200 women attending gynecological OPD with complaints of abnormal uterine bleeding. After obtaining a written informed consent from the participants a detailed history and complete examination including a thorough gynecological examination was performed. A transvaginal ultrasound examination to note for any structural causes for AUB was performed. Thyroid function test (FT3, FT4, TSH) was performed in all study participants and they were then categorized into euthyroid, hypothyroid, hyperthyroid, subclinical hypo or hyperthyroid based on the results. After preliminary preparation all participants were subjected for an endometrial biopsy in the outpatient department and the tissue obtained was sent for histopathological analysis. All the information was tabulated and analyzed using SPSS 22 version with descriptive and inferential statistics (chi square test). A p value of < 0.05 was considered as statistically significant.Results: Heavy menstrual bleeding was the most common menstrual abnormality found in 85% of the study participants.77% had structural causes for AUB whereas 23% had non-structural causes. 79.5% of the patients with AUB were euthyroid whereas 20.5% had some form of thyroid dysfunction. Subclinical hypothyroidism was the most common thyroid dysfunction (15.5%) in this study followed by hypothyroidism (3.5%). Only 1.5% of patients had hyperthyroidism. In the present study no, significant association was found between any particular thyroid dysfunction and specific menstrual pattern or endometrial pattern in histopathology.Conclusions: Testing and treating for thyroid disorder would prove to be cost effective in patients with AUB particularly with nonstructural causes as it would avoid many costly interventions done for AUB.

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Pipelle Endometrial Biopsy vs Dilatation and Curettage to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding

The Journal of South Asian Federation of Menopause Societies ◽

10.5005/jp-journals-10032-1120 ◽

2017 ◽

Vol 5 (2) ◽

pp. 123-128

Author(s):

Nikhitha Chandrashekar ◽

Jyothi GS ◽

Prasanna Shetty

Keyword(s):

Predictive Value ◽

Endometrial Hyperplasia ◽

Tertiary Care ◽

Abnormal Uterine Bleeding ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

Histopathological Analysis ◽

Care Hospital ◽

Dilatation And Curettage ◽

Risk Of Cancer

ABSTRACT Aim The objective of this study was to assess the adequacy of the sample aspirated in order to make a definite diagnosis of endometrial disease in abnormal uterine bleeding (AUB) and to draw comparisons between the histopathological findings of Pipelle endometrial aspiration biopsy and dilatation and curettage (D&C). Materials and methods Pipelle endometrial biopsy and D&C samples were collected from 100 patients with AUB in the Department of the Obstetrics and Gynecology and sent to the Department of Pathology of a tertiary care hospital for adequacy of the sample and for histopathological analysis. Results The Pipelle sample was adequate in 73% of the cases and inadequate in 27% compared with D&C, which showed 85% and 15%, respectively. About 53% of cases were comparable between D&C and Pipelle and 37% were discordant. For endometrial hyperplasia using Pipelle aspirator, the sensitivity was 58.8%, specificity was 91.6%, positive predictive value (PPV) was 58.8%, negative predictive value (NPV) was 91.6%, and concordance was 86%. For detection of endometrial carcinoma using Pipelle, the sensitivity was 50%, specificity was 99%, PPV was 50%, NPV was 99%, and concordance rate was 98%. Conclusion It is more convenient and cost-effective for patients to undergo pipelle biopsy to confirm normalcy and rule out endometrial hyperplasia rather than undergoing D&C initially. Out of the 27% of inadequate samples, 14.8% had fibroids and 11.1% had polyps, thus showing that tumors localized to a polyp or a small area of endometrium went undetected with Pipelle. Clinical significance Due to the high specificity and NPV and low sensitivity and PPV in diagnosing endometrial lesions and carcinomas, pipelle is suitable for women with a low risk of cancer. In cases where the diagnosis is hyperplasia on Pipelle, the patients are advised to undergo hysteroscopic-guided D&C following pipelle to confirm the diagnosis. This is also applicable for cases of polyps and fibroids. How to cite this article Chandrashekar N, Jyothi GS, Shetty P. Pipelle Endometrial Biopsy vs Dilatation and Curettage to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc 2017;5(2):123-128.

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“STUDY OF ENDOMETRIAL PATHOLOGY IN ABNORMAL UTERINE BLEEDING”

10.36106/gjra/6700142 ◽

2021 ◽

pp. 1-3

Author(s):

Neelima Verma ◽

Suman Lata Verma ◽

Divya Shukla

Keyword(s):

Early Diagnosis ◽

Endometrial Hyperplasia ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Histopathological Analysis ◽

Common Symptom ◽

Proliferative Phase ◽

Number Of Patients ◽

Endometrial Hyperplasia With Atypia ◽

Cystic Type

CONTEXT - Histopathological analysis of endometrial samples in various forms of abnormal uterine bleeding in adjunction with clinical history of patient to identify underlying cause of bleeding. This also helps in early diagnosis of premalignant and malignant lesions leading to their proper follow up and improved prognosis. AIMS - Histopathological analysis of causes of abnormal uterine bleeding with their clinical correlation. SETTINGS AND DESIGN -A prospective observational study MATERIAL AND METHODS - This study was done in department of pathology, GSVM medical college, Kanpur. This was a prospective study from year 2017-2018. A total of 300 cases were studied. Specimen received were xed in 10% formalin, processed and sections of 3-4 micron were prepared, stained with H and E. Histopathological examination was done. RESULTS - It was observed that the highest number of patients were between 41-50 years of age. (44.33%). Menorrhagia is the most common symptom accounting for 135 (45%) patients followed by metrorrhagia accounting for 135 (45%) patients and hypomenoorhea is the least common complaint. It was observed that there were signicantly higher number of patients with proliferative phase – 68 (22.67%) and in endometrial hyperplasia 35 (33.66%) patients. The least common cause were endometrial polyp, seen in 4 (1.33%) patients, gestational endometrium and gestational trophoblastic tumor accounted for 2 ( 0.67%) patients. In patients who presented with metrorrhagia, secretory phase endometrium was the most common histopathological nding accounting for 34.62% followed by proliferative phase. In cases of endometrial hyperplasia, 28 (80%) cases were simple cystic type, 5 ( 14.29%) cases were of simple endometrial hyperplasia with atypia and complex endometrial hyperplasia with atypia was found in 2(5.71%) cases. Among cases of endometrial hyperplasia, 28 (80%) cases were simple cystic type, 5 ( 14.29%) cases were of simple endometrial hyperplasia with atypia and complex endometrial hyperplasia with atypia was found in 2(5.71%) cases. Endometrial carcinoma is commonest complain in 51-60 years and >60 years age group. CONCLUSION - Histopathological analysis of AUB causes helps in identifying the cause and early diagnosis of premalignant and malignant cases.

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Histopathological analysis of hysterectomy specimens: one year study

Journal of Pathology of Nepal ◽

10.3126/jpn.v7i1.16942 ◽

2017 ◽

Vol 7 (1) ◽

pp. 1084-1086

Author(s):

R Baral ◽

P Sherpa ◽

D Gautam

Keyword(s):

Abnormal Uterine Bleeding ◽

Life Time ◽

Uterine Bleeding ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Endometrioid Adenocarcinoma ◽

Database Analysis ◽

Histopathological Features ◽

One Year

Backgound: The uterus is prone to develop several non-neoplastic and neoplastic conditions during the life time of a woman. The aim of this study is to study the histopathological features of varied uterine lesions, their profile and distribution of different lesions in relation of age.Materials and Methods: This is a histopathological database analysis of hysterectomy specimen of one year 2011/12 in Patan Hospital. The variables studied were age and histopathological diagnosis. SPSS version 16 was used as an analytical tool.Results: A total of 3576 histopathology samples were received in this period. There were 1173 gynaecology samples during this period out of which 22% (261 cases) were that of hysterectomy. Histopathology diagnosis showed Leiomyoma in 48.6% (127 cases), Adenomyosis was seen in 10.3% (27 cases), Endometrioid Adenocarcinoma was seen in 1.14% (3 cases).Conclusion: A large number of hysterectomy specimens had no significant findings. However, adenomyosis, leiomyomya and adenocarcinoma are also found which may be the cause of abnormal uterine bleeding.

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