Evaluation of endometrium in peri-menopausal women in case of abnormal uterine bleeding

Introduction: Abnormal uterine bleeding should include all abnormalities of menstruation like hypermenorrhea as well as hypomenorrhea. Abnormal bleeding is synonymous only with excessive menstruation. Abnormal uterine bleeding (AUB) is one of the most common conditions for which women consult their gynaecologists. Material and methods: This was a retrospective study done in Dhiraj Hospital over a period of six month on patients presenting with AUB. Patients were selected based on clinical details. The study material included a total no. of 60 patients which were inclusive of endometrial samples. Patients with isolated endometrial causes of abnormal uterine bleeding were included for this study and those with pregnancy, profusely bleeding per vaginum, anemic patients were excluded. All specimens were transported in 10% formalin to the pathology laboratory. The gross morphology was recorded. Microscopic examination was done by two pathologist so as to reduce inter observer findings. The data collected for this study was statistically analyzed using chi-square test. Results: In the present study, maximum age occurrence was between 40-49 years, the youngest patient in this study was 22 year old and the oldest was 54 year. Majority of the patients presented with menorrhagia (50%) followed by post- menopausal bleeding (28.3%). There were 8 cases (13.3%) with polymenorrhagia and 5 patients (8.3%) with metrorrhagia. 36 (60%) normal cases were reported. The diagnosis of 9 (15%) cases of endometrial polyps and endometrial hyperplasia were 10 (16.6%) among them 2 (20%) was hyperplasia with atypia and 8 (80%) were hyperplasia without atypia, atrophic endometrium was present in 2 cases (3.3%), endometritis in 3 cases (5%). Histopathology correctly diagnosed all cases. Conclusion: Histopathological examination after Dilatation and curettage is necessary tool for ruling out the organic pathology in uterus in those patients where history, systemic and pelvic examination reveals no pathology. Dilatation and curettage findings of organic pathology like TB, endometrial carcinoma, endometrial polyp etc. will rule out at the given cases AUB. Presence of organic pathology tells the case is of AUB. Further it helps in differentiating in ovulatory and an-ovulatory cycle and therefore guides the clinician and hormonal management.