Histopathological patterns in endometrial biopsy associated with abnormal uterine bleeding

Abstract

Abnormal uterine bleeding is one of the most common gyenocological problems that affects women worldwide. We studied patterns of endometrial biopsy pathology in abnormal uterine bleeding in a tertiary care hospital in a metropolitan city. Retrospective study of 518 cases of endometrial samples were studied in patients presenting with abnormal uterine bleeding. Clinical data and endometrial biopsy findings were recorded. The age of the patients
varied, ranging from 18 years to 70 years. Maximum number of patients presented in the age group 40-49 years (49.2%), followed by 30-39 years (34.9%). The patients presented most commonly as menorrhagia (48.6%). Cyclical pattern was the most common finding on endometrial biopsy including secretory (33.4%) followed by proliferative pattern (31.3%), gestational causes (9.8%), endometrial hyperplasia (7.1%) chronic endometritis (4.0%), endometrial polyp (3.0%), irregular endometrium (4.2%), malignancy (1.7%) and atrophic endometrium (0.6%). Endometrial hyperplasias and malignancy were more frequently seen in patients presenting ≥40 yrs of age. Pregnancy associated causes of abnormal bleeding were more common in patients of reproductive age group i.e. <40yrs. Endometrial biopsy is the usual investigation performed in abnormal uterine bleeding and it can help to determine the etiology and decide the management in these cases. Patients in reproductive age group may have an underlying pregnancy associated cause of abnormal bleeding. Endometrial hyperplasia and malignancy must be excluded in patients presenting at or above 40 yrs of age.