Correlation of Endometrial Thickness and Histopathological Study in Patients of Abnormal Uterine Bleeding (AUB) in Perimenopausal Age

Introduction: Menstrual irregularity and abnormal heavy menstruation accounts for up to 35% of women attending Gynecology department. The histopathological evaluation of endometrial curettage yields various results ranging from physiological to pathological lesions and helps for an early diagnosis of endometrial carcinoma which carries a risk of 5-10% in perimenopausal women. Aims and Objectives: To assess the correlation of endometrial thickness and histopathological study in abnormal uterine bleeding of perimenopausal women and its contribution in the clinical diagnosis and management. Materials and Methods: This cross-sectional study was conducted at the M.K.C.G. Medical College Hospital Berhampur (Odisha), India from September 2019 to September 2021. Perimenopausal women with AUB were first examined clinically to rule out other gynecological abnormalities and followed by relevant hematological investigations. TVS was done in all patients for measuring endometrial thickness followed by endometrial biopsy for HP study and hysterectomy was done if required. Analysis was done by MS-Excel sheet after results were tabulated. Results: Out of 250 women, 33.2% women were found to have adenomyosis as commonest pathology, 38% presented as heavy menstrual bleeding as the commonest form of AUB. Endometrial thickness (ET) was more than 8 mm in majority of women (55.6%) who were subjected to endometrial biopsy. Biopsy revealed 32% had proliferative pattern as commonest form and 13.6% had endometrial hyperplasia. Out of the 145 women, who had undergone hysterectomy adenomyosis came out as the commonest pathology (42.8%) and 4.1% as carcinoma endometrium. Conclusion: ET more than 8 mm is most often associated with abnormal histopathology. Endometrial biopsy should be employed whenever indicated to obtain a tissue diagnosis to exclude endometrial cancer.