The illusion of varied presentations flagstoningclinicohistopathological aspects of abnormal uterine bleeding in north eastern tertiary care hospital–a three year study

Maj (Dr) Ragini Thapa; Capt (Dr) Priti Mishra

Volume : VIII, Issue : VI, June - 2018

The illusion of varied presentations flagstoningclinicohistopathological aspects of abnormal uterine bleeding in north eastern tertiary care hospital–a three year study

Maj Dr Ragini Thapa, Capt Dr Priti Mishra

Abstract :

Introduction: Abnormal uterine bleeding (AUB) is a common gynecological problem associated with considerablemorbidity and significantly affects the patients.Histopathological evaluation of the endometrial samples plays a crucial role in the diagnosis of abnormaluterine bleeding.The studyis aimed to analyze the histopathologicaltriagesofendometrium in patients presenting with AUB and also to determine the incidence of AUB in various age groups.

Methods: This is a retrospective study, conducted in the Department of pathology and Obstetrics and Gynaecology, in a secondary care military hospital,shillong, India from May 2015 to May 2018. Endometrial biopsies and curettingsof patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 120 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years Data wasentered in microsoft excel and managed in statistical package for the social sciences (SPSS) version 16.

Results: A total of 120 cases were analysed. Patients’ age ranged from 18–70 years. AUB was most common amongtheperimenopausal females (41–50years). The most common presenting symptom was heavy menstrual bleeding(53%). Dilatation and curettage (D&C) was performed in all cases and 96 underwent hysterectomy as final resort.Endometrial proliferative pattern was the most common histopathological finding and was seen in 27% patients,followed by endometrial hyperplasia in 13.5% patients, secretory endometrium (12.7%) and disordered proliferativeendometrium were seen in 10.9% patients each. Malignancy was suspected in 1.7% of cases and complex hyperplasia with atypia / endometrialcarcinoma was the most common lesion.

Conclusions: Endometrial sampling is especially indicated in women above the age of 35 years to rule outmalignancy and preneoplasia. It has been elicitatedthat among the females with no pathology, normal physiological patterns withproliferative, secretory, and menstrual changes take place. The most common endometrial pathology in this studywas endometrial proliferation.Endometrialevaluationis specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB,to rule out a possibility of any preneoplastic/borderline suspected condition or malignancy