A Histopathological Study of Endometrium in Abnormal Uterine Bleeding: A Retrospective Study
DOI:
https://doi.org/10.61841/7442gt92Keywords:
Abnormal Uterine Bleeding, Curettage, Endometrial HyperplasiaAbstract
Background: Abnormal uterine bleeding (AUB) is a common gynecological complaint associated with considerable morbidity and significantly affects the patient’s family, personal, and social life. The study aimed to analyze the histomorphological patterns of endometrium in patients presenting with AUB and also to determine the incidence of AUB in various age groups.
Methods: This type of research is a descriptive study with a cross-sectional approach. Data was taken from medical records of the patients with a diagnosis of abnormal uterine bleeding by dilatation and curettage and then by a histopathological laboratory examination at the K.R.M.T. Wongsonegoro Hospital in Semarang, Indonesia.
Results: A total of 87 cases were analyzed. The patient’s age ranged from 19 to 68 years old. Body Mass Index (BMI) divided three groups: Normal weight: 27%; overweight: 35.6%; and obese: 36.8%. Endometrial hyperplasia was the most common histopathological finding and was seen in 29.9% of patients, followed by irregular shedding (24.13%), disorder proliferative pattern (17.24%), proliferative with glandular and stromal breakdown (9.19%), and progestin effect (6.89%). Statistical test results with a chi-square relationship between BMI and histopathological features is p = 0.290.
Conclusion: Statistical test results showed no relationship between age and BMI with histopathological results. We found that endometrial hyperplasia is the commonest cause of abnormal uterine bleeding.
Downloads
References
[1] Whitaker L, Critchley HOD. Abnormal uterine bleeding. Best Practice & Research Clinical Obstetrics & Gynecology. 2016, 34:54-65.
[2] Cheong Y, Cameron IT, Critchley HOD. Abnormal uterine bleeding. British Medical Bulletin. 2017, 2017,123:103-114.
[3] Sun Y, Wang Y, Mao L, Wen J, Bai W. Prevalence of abnormal uterine bleeding according to the new International Federation in Gynecology and Obstetrics classification in Chinese women of reproductive age. Medicine. 2018, 97:31.
[4] Pinkerton JV. Abnormal Uterine Bleeding due to Ovulatory Dysfunction (AUB-O). University of Virginia Health System. Last review: Jul 2019.
[5] Dickerson KE, Menon N, Zia A. Abnormal uterine bleeding in young women with blood disorders. Pediatr Clin North Am. 2018;65(3):543-560.
[6] Rastogi A. Abnormal uterine bleeding. National Health Portal India. 2017.
[7] Saheta A, Hariharan C, Sharma U. Abnormal uterine bleeding. Journal of dental and medical sciences. 2014; 13: 63-7.
[8] Gerald Dafe Forae, Jonathan Umezuluike Aligbe. Histopathological patterns of endometrial lesions in patients with abnormal uterine bleeding in a cosmopolitan population. Journal of Basic and Clinical Reproductive Science 2013; 2: Issue 2.
[9] Ghani NA, Abdulrazak AA, Abdullah EM. Abnormal uterine bleeding: A histopathological study. Diyala Journal of Medicine. 2013;4(1):55-60.
[10] Palmer JE, Perunovic B, Tidy JA. The obstetrician & gynecologist: review endometrial hyperplasia. United Kingdom: Royal College of Obstetricians and Gynaecologists. 2018; 10: 211-216.
[11] Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K, Voigt LF, Weiss NS. Incidence of endometrial hyperplasia. American journal of obstetrics and gynecology. 2009 Jun 1; 200(6): 678-e1.
[12] Dolanbay M, Kutuk MS, Uludag S, Bulut AN, Ozgun MT, Ozcelik B, Serin IS. Concurrent endometrial
carcinoma in hysterectomy specimens in patients with histopathological diagnosis of endometrial
hyperplasia in curettage specimens. Ginekologia Polska. 2015; 86 (10).
[13] Lacey JV, Sherman ME, Rush BB, Ronnett BM, Loffe OB, Duggan MA et al. Absolute Risk of
Endometrial Carcinoma during 20-Year Follow-Up Among Women With Endometrial Hyperplasia.
American Society of Clinical Oncology: Journal of Clinical Oncology. 2010; 28: 788-792.
[14] Allison KH, Reed SD, Voigt LF, Jordan CD, Newton KM, Garcia RL. Diagnosing Endometrial
Hyperplasia: Why is it so difficult to agree? National Institutes of Health. 2008; 32(5):691-698.
[15] Gawron I, Łoboda M, Babczyk D, Ludwin I, Basta P, Pityński K, Ludwin A. Endometrial cancer and
hyperplasia rate in women before menopause. 2017; 74(4): 139-43. PMID: 29696944.
[16] Jairajpuri Z S, Rana S, Jetley S. Atypical uterine bleeding-Histopathological audit of endometrium a study
of 638 cases. US National Library of Medicine enlisted journal. Al Ameen J Med Sci. 2013; 6 (1): 21-28.
[17] Snehkiran, Abhilashi K, Tiwary B, Sinha A, Parwina P. Clinicopathological observation of abnormal
Uterine bleeding in a peri-menopausal age female. International Journal of Clinical Obstetrics and
Gynaecology. 2019; 3(1): 136-138
[18] Braun MM, Overbeek-Wager E, Grumbo RJ. Diagnosis and management of endometrial cancer. American
Family physician. 2016 Mar 15; 93(6):468-74.
[19] Endometrial cancer. The American College of Obstetricians and Gynecologists. February 2019
[20] Sinykin MB, Goodlin RC, Barr MM. Irregular shedding of the endometrium. American Journal of
Obstetrics and Gynecology. 1956, 5(71): 990-1000.
[21] Doraiswami S, Johnson T, Panicker VK. Study of Endometrial Pathology in Abnormal Uterine Bleeding. J
Obstet. Gynaecol. India. 2011 Aug: 61(4): 426-430.
[22] Meena N, Meena S. Correlation between histology and bleeding pattern in a case of AUB and risk factors
analysis of AUB in the reproductive age group. J Med Sci Clin Res. 2017 (5): 24629-24634.
[23] Bhosle A, Fonseca M. Evaluation and histopathological correlation of abnormal uterine bleeding in
perimenopausal women. 2010. Bombay Hospital Journal; 52(1)
[24] Rizvi G, Pandey H, Pant H, Chufal SS, Pant P. Histopathological correlation of adenomyosis and leiomyoma in hysterectomy specimens as the cause of abnormal uterine bleeding in women in different age groups in the Kumaon region: A retrospective study. J Midlife Health. 2013 Jan-Mar;4(1):27-30
[25] Taran FA, Stewart EA, Brucker S. Adenomyosis: Epidemiology, risk factors, clinical phenotype, and surgical and interventional alternatives to hysterectomy. Geburtshilfe Frauenheilkd. 2013 Sep; 73(9): 924-931
[26] Schrager S. Abnormal uterine bleeding associated with hormonal contraception. American family physician. 2002 May 15; 65(10): 2073.
[27] Mazur MT, Kurman RJ. Dysfunctional uterine bleeding: diagnosis of endometrial biopsies and curettings, Springer-Verlag, New York. 1995; 89-108.
[28] Norimatsu Y, Shimizu K, Kobayashi TK, Moriya T, Kaku T, Tsukayama C, Miyake Y, Ohno E. Endometrial glandular and stromal breakdown, part 2: cytomorphology of papillary metaplastic changes. Diagnostic cytopathology. 2006 Oct; 34(10): 665-9.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 AUTHOR
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
