Clinicopathological Profile and Diagnostic Concordance of Abnormal Uterine Bleeding in Women Aged after 40 Years: A Hospital-Based Cross-Sectional Study in Bangladesh

Background: Abnormal uterine bleeding (AUB) in women aged after 40 years is a common gynecological problem and is frequently associated with underlying structural pathology, including leiomyoma, adenomyosis, endometrial hyperplasia and malignancy. In this age group, the risk of endometrial carcinoma increases, necessitating accurate and timely diagnosis through a combination of clinical, radiological and histopathological evaluation. Objective: To evaluate the clinicopathological profile of AUB and assess diagnostic concordance between clinical, ultrasonographic and histopathological findings in women aged after 40 years in a tertiary care setting in Bangladesh. Study Design: This hospital-based retrospective cross-sectional study was conducted at Sir Salimullah Medical College & Mitford Hospital, Dhaka, over 6 months (May–October 2014). Fifty women aged more than 40 years with AUB who underwent hysterectomy were included. Clinical features, ultrasonographic findings including endometrial thickness, and histopathological diagnoses were analyzed. Diagnostic agreement was assessed using Cohen’s kappa (κ), and associations were evaluated using the chi-square test (P < .05). Results: The mean age was 45.8 ± 4.6 years, with most patients aged 41–45 years (56%). Menorrhagia (64%) and anemia (92%) were common. Fibroid uterus was the leading clinical diagnosis (46%) and was confirmed in 48% on histopathology. Adenomyosis was detected in 8% clinically, 10% on USG, and 18% on histopathology. It showed histopathology Proliferative endometrium (44%) and carcinoma (4%) were observed. Diagnostic agreement was strong (κ = 0.82), with significant association between endometrial thickness and histopathology (p < 0.001); carcinoma occurred at ≥20 mm. Conclusion: AUB in women aged after 40 years is commonly associated with significant structural pathology and malignancy risk. The strong correlation between clinical, radiological, and histopathological findings in this Bangladesh-based population reinforces the reliability of a multimodal diagnostic approach, enhancing diagnostic precision and informing appropriate clinical decision-making. Article Details Section This work is licensed under a Creative Commons Attribution 4.0 International License. This journal provides immediate open access to its content under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Authors retain copyright and grant the journal the right of first publication. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. License details: https://creativecommons.org/licenses/by/4.0/ How to Cite

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