A Histopathological Study of Endometrial Biopsy Samples in Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) is the most common health issue in women, defined as any bleeding pattern that differs in frequency, duration, and amount. Endometrial sampling and its histopathological examination is the first-line test in patients presenting with AUB. The aim of this study was to analyze the histopathological patterns of endometrium in women with AUB and to find the predominant histopathologic pattern in the different age groups of women with AUB.

The study was conducted at the Indira Gandhi Medical College and Research Institute, Puducherry, from January 2019 to December 2020. Endometrial biopsies of patients with AUB, in whom gestational causes were ruled out, were included in this study.

Out of the 160 cases analyzed, the maximum number of biopsies were from the age group of 41-50 years; the majority of patients presented with complaints of menorrhagia. The bleeding pattern was significantly associated with age groups (p=0.00). Of 160 cases, 104 cases were related to functional causes. The association of functional and organic causes with age group was not significant (p=0.67 and p=0.99, respectively). The most common histological pattern was the normal cyclical pattern showing proliferative (56) and secretory phase (30) in 86 cases. Of 42 cases of endometrial hyperplasia, 9 cases had atypical hyperplasia. The endometrial polyp was the other common organic lesion observed. Only two cases of endometrial carcinoma were reported during the present study period.

Although a regular cyclical pattern is observed commonly, endometrial sampling should be considered in the peri- and post-menopausal age groups wherein the incidence of endometrial hyperplasia and endometrial carcinoma is more common.