Abnormal uterine bleeding: A study of its clinical spectrum and incidence of histopathological patterns of endometrium as a function of age with parity

Nidhi Golecha, Varsha Porwal
In: Indian Journal of Obstetrics and Gynecology Research · 2018 · vol. 5(3) , pp. 339–343 · doi:10.18231/2394-2754.2018.0078 · W3127391979
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This study analyzed 300 women with abnormal uterine bleeding, finding the perimenopausal age group most affected and categorizing histopathological patterns like proliferative endometrium and polyps by age and parity.

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This single-center study evaluated the clinical spectrum of abnormal uterine bleeding (AUB) and the incidence of histopathological endometrial patterns across age groups and parity in 300 women aged 20 to 70 years. The authors reported that menorrhagia was the most common bleeding pattern and that proliferative and secretory endometrial phases were the leading histopathologic findings, with additional diagnoses including polyps, hyperplasia, metaplasia, endometritis, and a small proportion of adenocarcinoma; the main caveat explicitly noted was that dilatation and curettage may miss organic lesions such as leiomyoma and adenomyosis. The paper also concluded that AUB causes vary by age, with the perimenopausal group most frequently represented. Relevance to endometriosis: the study mentions adenomyosis as an organic lesion that can be missed, though it focuses on endometrial histopathology in AUB rather than endometriosis or adenomyosis directly.

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Abstract

Introduction: Abnormal uterine bleeding (AUB) is a common complaint affecting majority of pre and postmenopausal women. Endometirum is a dynamic tissue and is affected by a wide range of histopathological lesions. The causes of AUB is a function of age. Aim and Objective: to study the histopathological pattern in cases of AUB in reference age, parity and bleeding pattern. Patients were categorized into reproductive (50 years). Materials and Methods: A total of three hundred patients presenting with AUB are included in this study. Observation and Results: In this study patient ranged from 20 to 70 years and the mean age of the cohort was 43.46±8.07. Major parity category noted in the cohort was para-2 in 89 patients (29.67%). Major bleeding pattern observed in the cohort was menorrhagia (32.33%); followed by metrorrhagia (19.67%), menometrorrhagia (16.33%), postmenopausal bleeding (12.67%), polymenorrhoea (9.67%), polymenorrhagia (5%) and continuous bleeding (1%). Histopathological pattern observed in AUB patients was proliferative phase endometrium (31.33%), secretory phase endometrium (21.67%), menstrual endometrium (1.33%). atrophic endometrium (6%), disordered proliferation (3.33%), mixed pattern (1%), polyp (10.67%), metaplasia (9.67%), hyperplasia (8.67%), endometritis (2.67%), adenocarcinoma (1.67%) and insufficient (2%). Conclusion: The causes of AUB are function of age; perimenopausal age group is the most common affected. Dilatation & Curettage is cost effective, useful procedure but organic lesions such as leiomyoma and adenomyosis can be missed. AUB is a common disorder affecting females and is a challenge to the treating gynaecologist. Keywords: Endometrium, Premenopausal, Postmenopausal, Hyperplasia, Polyp.
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Introduction

Abnormal uterine bleeding (AUB) is a common complaint affecting majority of pre and postmenopausal women. Endometirum is a dynamic tissue and is affected by a wide range of histopathological lesions. The causes of AUB is a function of age. Aim and Objective: to study the histopathological pattern in cases of AUB in reference age, parity and bleeding pattern. Patients were categorized into reproductive (50 years).

Materials and methods

A total of three hundred patients presenting with AUB are included in this study. Observation and Results: In this study patient ranged from 20 to 70 years and the mean age of the cohort was 43.46±8.07. Major parity category noted in the cohort was para-2 in 89 patients (29.67%). Major bleeding pattern observed in the cohort was menorrhagia (32.33%); followed by metrorrhagia (19.67%), menometrorrhagia (16.33%), postmenopausal bleeding (12.67%), polymenorrhoea (9.67%), polymenorrhagia (5%) and continuous bleeding (1%). Histopathological pattern observed in AUB patients was proliferative phase endometrium (31.33%), secretory phase endometrium (21.67%), menstrual endometrium (1.33%). atrophic endometrium (6%), disordered proliferation (3.33%), mixed pattern (1%), polyp (10.67%), metaplasia (9.67%), hyperplasia (8.67%), endometritis (2.67%), adenocarcinoma (1.67%) and insufficient (2%).

Conclusion

The causes of AUB are function of age; perimenopausal age group is the most common affected. Dilatation & Curettage is cost effective, useful procedure but organic lesions such as leiomyoma and adenomyosis can be missed. AUB is a common disorder affecting females and is a challenge to the treating gynaecologist.

Keywords

Endometrium, Premenopausal, Postmenopausal, Hyperplasia, Polyp. How to Cite This Article Vancouver Golecha N, Porwal V. Abnormal uterine bleeding: A study of its clinical spectrum and incidence of histopathological patterns of endometrium as a function of age with parity [Internet]. Indian J Obstet Gynecol Res. 2018 [cited 2026 Jun 14];5(3):339-343. Available from: https://doi.org/10.18231/2394-2754.2018.0078 APA Golecha, N., Porwal, V. (2018). Abnormal uterine bleeding: A study of its clinical spectrum and incidence of histopathological patterns of endometrium as a function of age with parity. Indian Journal of Obstetrics and Gynecology Research, 5(3), 339-343. https://doi.org/10.18231/2394-2754.2018.0078 MLA Golecha, Nidhi, Porwal, Varsha. "Abnormal uterine bleeding: A study of its clinical spectrum and incidence of histopathological patterns of endometrium as a function of age with parity." Indian J Obstet Gynecol Res, vol. 5, no. 3, 2018, pp. 339-343. https://doi.org/10.18231/2394-2754.2018.0078 Chicago Golecha, N., Porwal, V.. "Abnormal uterine bleeding: A study of its clinical spectrum and incidence of histopathological patterns of endometrium as a function of age with parity." Indian J Obstet Gynecol Res 5, no. 3 (2018): 339-343. https://doi.org/10.18231/2394-2754.2018.0078

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