XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Lanker S, Saldanha C L, Andrabi S F. Histopathological Evaluation of Abnormal Uterine Bleeding in Women of Reproductive and Perimenopausal Age Groups. Journal of Research in Applied and Basic Medical Sciences 2022; 8 (4) :221-227
URL: http://ijrabms.umsu.ac.ir/article-1-207-en.html
MD Anesthesiology & Critical Care, Lecturer, Dept. of Anesthesiology & Critical care, Govt. Medical College, Srinagar, India , andrabi123@gmail.com
Abstract:   (1009 Views)
Background & Aims:  Abnormal uterine bleeding (AUB) occurs in up to 30% of the women and is a major cause of hysterectomies. It can result from a broad spectrum of conditions ranging from physiological process to malignant lesions involving organic, systemic, and hormonal responses. The PALM component of the FIGO classification system (PALM-COEIN) deals with the structural causes, while the COEIN component deals with the non-structural causes. AUB is diagnosed by clinical examination and ultrasonography. Final diagnosis is always correlated with histopathological study. The objective of this study was clinico-histopathological evaluation of the cases of AUB, with respect to FIGO classification system in the women of reproductive and perimenopausal age group.
Materials & Methods:  Present study was a hospital-based prospective observational study conducted in the Department of Obstetrics and Gynecology of Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India. It included 100 women, with complains of abnormal uterine bleeding, in the age group of 30 to 50 years and above, who were evaluated in over a period of one year, from January 2021 to December 2021. Age, parity, menstrual cycles, duration of symptoms and recurrence (if any), contraception, obstetric history, and history suggestive of Pelvic inflammatory disease (PID) were noted. General physical, systemic, and gynecological examinations of the patients were done. The findings of blood investigations, sonography, histopathology of endometrial biopsy specimens, and hysterectomised specimens were analysed.
Results:  In our study, the maximum incidence of AUB was seen in reproductive and perimenopausal age groups between 35-40 years (38%) and 40-45 years (35%). The highest incidence of AUB was in multiparous women (44%). The most common pattern of AUB was heavy menstrual bleeding (menorrhagia) (69%). The most common type of AUB was chronic type of heavy menstrual bleeding (65%). In our study, the most common organic causes of AUB were fibroids (34%) and adenomyosis (18%). On histopathology, secretory endometrium was found in 52% cases and proliferative type in 21% of cases.
Conclusion:  Ultrasonography combined with endometrial biopsy proves to be the gold standard for diagnosis of AUB. The present study highlights the importance of endometrial biopsy and its interpretation which plays a pivotal role in the management of AUB.
Full-Text [PDF 292 kb]   (403 Downloads)    
Type of Study: orginal article | Subject: General

References
1. Jha E, Jha AK, Samuel A. Clinico histopathological evaluation of abnormal uterine bleeding in women of reproductive and perimenopausal age group. Int J Reprod Contracept Obstet Gynecol 2019;8(12):4736-41. [DOI:10.18203/2320-1770.ijrcog20195311]
2. Jagdale NG, Gawandi P, Tirankar V. A study of histopathological correlation of abnormal uterine bleeding with clinical symptoms. Medpulse Int J Obstet Gynaecol 2020; 16(2): 17-22. [DOI:10.26611/10121621]
3. Munro MG, Critchley HO, Broder MS, Fraser IS, Disorders FWGoM. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 2011;113(1):3-13. [DOI:10.1016/j.ijgo.2010.11.011] [PMID]
4. Radhika K, Gomathy E. Clinico-pathological correlation of AUB patients undergoing hysterectomy in a rural tertiary care centre. Indian J Obstet Gynecol Res2019;6(4):495-498. [DOI:10.18231/j.ijogr.2019.107]
5. Liu Z, Doan QV, Blumenthal P, Dubois RW. A systematic review evaluating health‐related quality of life, work impairment, and health‐care costs and utilization in abnormal uterine bleeding. Value Health 2007;10(3):183-94. [DOI:10.1111/j.1524-4733.2007.00168.x] [PMID]
6. Graves E. National hospital discharge survey: annual summary, 1994: US Department of Health and Human Services, Public Health Service, Centers; 1997. [Google Scholar]
7. Tanko NM, Linkov F, Bapayeva G, Ukybassova T, Kaiyrlykyzy A, Aimagambetova G, et al. Pipelle endometrial biopsy for abnormal uterine bleeding in daily clinical practice: why the approach to patients should be personalized? Journal Pers Med 2021;11(10):970. [DOI:10.3390/jpm11100970] [PMID] [PMCID]
8. Badary DM, Taleb HA, Samir HA, Abdel-Allah A. Histopathological Spectrum of Abnormal Uterine Bleeding in Upper Egypt: A Study of 676 Cases. Gynecol Obstet 2019;9(6):1-5. [URL]
9. Rastogi A. Abnormal uterine bleeding. National Health Portal India 2017. [URL]
10. Semnani FN, Abdi R, Aboobakri M. Pathological patterns of endometrial curettage samples in women referred with abnormal uterine bleeding: A descriptive study. J Surg Trauma 2015;3(3). [Google Scholar]
11. Mehrotra VG, Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, et al. Study of endometrial pathology in abnormal uterine bleeding. J Obstet Gynecol India 2011;61(4):426-30. [DOI:10.1007/s13224-011-0047-2] [PMID] [PMCID]
12. Sweet MG, Schmidt-Dalton TA, Weiss PM. Evaluation and management of abnormal uterine bleeding in premenopausal women. Am Fam Physician 2012;85(1):35-43. [PMID]
13. Katke RD, Damle RP, Dravid NV, Suryawanshi KH, Gadre AS, Bagale PS, et al. Clinicopathological spectrum of endometrial changes in perimenopausal and menopausal uterine bleeding. J Clin Diagnos Res 2013;7(12):2774-6. [PMID] [PMCID]
14. Kumar S, Farquhar CM, Lethaby A, Sowter M, Verry J, Baranyai J. An evaluation of risk factors for endometrial hyperplasia in premenopausal women with abnormal menstrual bleeding. Am J Obstet Gynecol 1999; 181:525-9. [DOI:10.1016/S0002-9378(99)70487-4] [PMID]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Journal of Research in Applied and Basic Medical Sciences

Designed & Developed by : Yektaweb