POST MENOPAUSAL BLEEDING PATTERNS IN PREDICTION OF ENDOMETRIAL CARCINOMA

Objective: To determine the demographic profile, patterns of bleeding and histopathological patterns of endometrial biopsy in women presenting with postmenopausal bleeding. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology, CAIMS, Karimnagar from October 2020 to April 2022. Material and Methods: This descriptive cross-sectional study included women of any parity and age >45 years who had spontaneous cessation of menstruation for the last one year and who presented with abnormal uterine bleeding. Premenopausal women, drug or irradiation induced, or iatrogenic menopause cases were excluded. All patients were admitted, transvaginal ultrasound done (cut off endometrial thickness >4mm) and subjected to dilatation and curettage under anesthesia and endometrial biopsies obtained. Samples were sent for histopathology and followed. Results: A total of 70 women were included. Commonest age group was 61-70 years, and was seen in 38 (54.3%) women, followed by the 52-60 years age group where 18 (25.7%) subjects were observed. Mean age was 62 ± 2.54 years. Twenty-four (35%) women were hypertensive while Type 2 Diabetes Mellitus (T2DM) was seen in 14 (20%). forty (57%) women complained of streaks of blood on the sanitary pad, and in 56 (80%) (P=0.032) there were recurrent episodes. Forty-eight (68.57%) women were multiparous. Atrophic endometrium was the most common benign histopathological pattern, seen in 18 (26%) followed by 16 (23%) chronic endometritis. Endometrial carcinoma was seen in 16 (23%). (p=0.041) Conclusion: Postmenopausal bleeding is an alarming symptom and should be thoroughly investigated with transvaginal ultrasound followed by endometrial biopsy for timely diagnosis and treatment.