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Indian Journal of Pathology: Research and Practice

Volume  8, Issue 4, July-August 2019, Pages 371-380
 

Original Article

Clinico-Histopathological Study of Endometrium in Dysfunctional Uterine Bleeding : A Study of 950 Endometrial Biopsies

Neha Garg1, Neil Sharma2

1Senior Demonstrator, Department of Biochemistry 2Assistant Professor, Department of Pathology, Goverment Medical College, Bharatpur, Rajasthan 321001, India.

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.8419.2

Abstract

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding in the absence of organic disease of the genital tract. It is present with considerable morbidity and affects the patient’s personal, family and social life. Objective: The aim of the study was to analyze the histopathological patterns of endometrium in patients presenting with DUB and also to correlate histopathological patterns of DUB with clinical presentation, age, parity and bleeding patterns in women clinically diagnosed as DUB. Material and Methods: In this study a total number of 950 endometrial biopsies were included from patients with dysfunctional uterine bleeding submitted to the department of Pathology, GMCH, Udaipur from July 2014 to October 2016 and clinical history of the patients was taken. The endometrial samples included biopsies and hysterectomy specimens which were fixed in 10% formalin for 12-24 hours and the entire tissue was taken for routine processing. Slides were examined and histopathological diagnosis was made.Results:The age of the patients in the present study ranged from 20-56 years. Maximum number of cases were seen in age group 41-50 years (38.7%). Menorrhagia was the most commonest presenting symptom accounting for 55.4% of cases followed by menometrorrhagia (16.7%) and the least being oligomenorrhoea (4.9%). The incidence of DUB was found to be highest in multipara (72.4%) followed by 13.9% in grandmultipara and least in nullipara (4.2%). Maximum number of patients presented with symptoms for a duration of 1-6 months accounting for 56%. Proliferative endometrium (59.2%) was the dominant histopathological finding in DUB patients followed by secretory endometrium (22.2%). Among 950 patients, endometrial hyperplasia was seen in 41 patients (4.3%) and endometrial carcinoma in 7 patients only (0.7%). Conclusion: The present study revealed that proliferative and secretory endometrium are the most common endometrial histopathological patterns in endometrial samples obtained for dysfunctional uterine bleeding in our region. Histopathological evaluation of endometrium helps to exclude the local causes and establishes the diagnosis of DUB, its types, clinical correlation to histopathological findings and finally helps to determine the mode of management.

 


Keywords : Dysfunctional uterine bleeding; Endometrium; histopathological pattern.
Corresponding Author : Neil Sharma