A prospective observational study of histopathology of endometrium in abnormal uterine bleeding in perimenopausal and postmenopausal women.

Pragya  Khugsal; Vandana  Rajput; Chandni  Singh; Mehak  Garg

doi:10.51168/sjhrafrica.v6i12.2381

Authors

Pragya Khugsal Assistant Professor, Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences, Uttarakhand
Vandana Rajput Consultant, Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences, Uttarakhand
Chandni Singh Consultant, Vardan Hospital, Motihari, Bihar
Mehak Garg Consultant, Karan Singla Hospital, Punjab

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2381

Keywords:

Abnormal Uterine Bleeding, Endometrial Carcinoma, Histopathology, Bleeding, Postmenopausal bleeding, Endometrial Biopsy

Abstract

Background

An understanding of the varieties in the normal morphological appearance of the endometrium provides an essential background of the evaluation of endometrial pathology and early diagnosis of malignant and premalignant lesions.

Methods

Histopathological examination was done after endometrial biopsy for 340 women of age above 40 years presenting with abnormal uterine bleeding and with endometrial thickness > 4 mm on transvaginal ultrasonography, 260 of which were perimenopausal group and 80 were postmenopausal group and incidences of respective pathological outcomes in each group and their associations with specific demographic and patient comorbidities was studied.

Results

Proliferative endometrium was the most common finding among perimenopausal women (45.76%), while atrophic endometrium predominated in postmenopausal women (47.5%). Endometrial carcinoma was significantly higher in postmenopausal women (16.25%) compared to perimenopausal women (3.46%). Obesity, diabetes mellitus, and hypertension were significantly associated with malignant endometrial pathology.

Conclusion

Histopathological examination is mandatory in perimenopausal and postmenopausal abnormal uterine bleeding to detect lesions like polyps, hyperplasia, atypical hyperplasia and cancer. Obesity, history of chronic anovulation, diabetes mellitus,

hypertension are important risk factors for endometrial carcinoma.

Recommendations

Routine endometrial biopsy should be considered in perimenopausal and postmenopausal women with abnormal uterine bleeding, particularly those with metabolic risk factors.

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