Endometrial Evaluation by Histopathology in Abnormal Uterine Bleeding in Perimenopausal and Postmenopausal Patients

Abstract

Introduction: Abnormal Uterine Bleeding (AUB) is an important symptom of both benign and serious gynaecological diseases. Abnormal perimenopausal or postmenopausal bleeding is associated with endometrial carcinoma in approximately 10% of cases. The present study is designed to study the histopathological results of the endometrial biopsy in women with abnormal perimenopausal and postmenopausal uterine bleeding. Aims and Objectives: To study, the various histopathological patterns of endometrium, in patients with abnormal uterine bleeding, those are in perimenopausal and postmenopausal age group. Materials and Methods: In all 100 patients were selected for the study after satisfying the specific inclusion and exclusion criteria. They underwent detailed history taking including the pattern of bleeding associated with general, systemic, and pelvic examination. They were subjected to routine laboratory investigations and pelvic ultrasound examination. Endometrial biopsy was done irrespective of endometrial thickness. Endometrial biopsy was done in OPD without anaesthesia. Biopsy was performed using a manual vacuum aspiration syringe, and the material collected was sent for histopathological examination. Endometrium was also obtained from patients undergoing diagnostic or therapeutic dilatation and curettage. Analysis of Histopathology report was done and results were obtained. Results: Most predominant findings of histopathological examination were the … •Proliferative Endometrium in 29% •Simple hyperplasia without atypia 28% •Secretory 20% •Followed by other patterns Conclusion: Study of endometrial histopathology in perimenopausal and postmenopausal women with abnormal uterine bleeding is helpful to diagnose hyperplasia and carcinoma of endometrium.

Histopathological evaluation of endometrial biopsies and curetting’s in abnormal uterine bleeding

“…As the risk of endometrial carcinoma increases with age, the American College of Obstetricians and Gynecologists recommends endometrial evaluation in women aged 35 years and older who have abnormal uterine bleeding [2,6]. Endometrial carcinoma thus is commonly seen in the peri-and post menopausal age group [13,14] and post menopausal bleeding in women receiving hormone therapy for more than 12 months definitely needs endometrial study to rule out carcinoma. The incidence of carcinoma is low in our study like Doraiswamy et al and Rupal Shah et al probably because of early detection, but higher in other studies -Divya and Sajita et al…”

Correlation Between Endometrial Thickness By Ultrasonography and Histopathology in Abnormal Uterine Bleeding

“…Perimenopause is the phase, preceding the onset of menopause, generally occurring around 40 years of age during which the regular menstrual cycle of a woman changes from normal cycles to a pattern of irregular cycles. [1] Menopausal transition includes a period of about 4-5 years before menopause, sometimes even several months, characterized by varying degrees of somatic and psychological changes that reflect the changes in the ovarian cycle. [1] In some women, the most significant symptom is an irregular menstrual period, which must be carefully evaluated to determine whether it is the consequence of low oestrogen levels or an associated pathology.…”

“…[1] Menopausal transition includes a period of about 4-5 years before menopause, sometimes even several months, characterized by varying degrees of somatic and psychological changes that reflect the changes in the ovarian cycle. [1] In some women, the most significant symptom is an irregular menstrual period, which must be carefully evaluated to determine whether it is the consequence of low oestrogen levels or an associated pathology. [1] Abnormal uterine bleeding (AUB) is one of the most common and challenging problems presenting to the gynaecologist.…”

A Study of Histological Patterns of Endometrium in Abnormal Uterine Bleeding

“…[10] In our study, endometrial carcinoma was found in a 63-year-old lady who presented with postmenopausal bleeding. It has been reported in 2.48% of all patients with AUB by Vaidya et al and 2.0% by Desai et al [15,1] Endometrial carcinoma mostly occurs in elderly women (Sixth and seventh decade) with 90% of patients presenting with vaginal bleeding or discharge as a presenting complaint. [1] CONCLUSION Endometrial histopathology in abnormal uterine bleeding is an important tool to diagnose various endometrial patterns ranging from proliferative, secretory, simple and complex hyperplasia with/without atypia, disordered proliferation and atrophic endometrium, including pathologic conditions of uterus including hyperplasia and carcinoma of endometrium, especially in perimenopausal and postmenopausal bleeding.…”

“…[1] AUB in reproductive age women is defined as bleeding at abnormal or unexpected times or by excessive flow at the time of an expected menses. The aetiology of abnormal genital bleeding encompasses a wide range of disorders that can be secondary to anatomic changes of female genital tract, infection, endocrinologic disorders, malignancies, systemic illness.…”