The role of histopathology, endometrium thickness and obstetric history in abnormal uterine bleeding

Abstract

AimTo evaluate the clinical manifestations of abnormal uterine bleeding (AUB), ultrasonography findings and compare with histopathological results. MethodA total of 404 women with AUB were classified as; Group I: 18-39 years, Group II: 40-50 years, Group III: >50 years old. Age, parity, bleeding pattern, menstrual history, laboratory results, ultrasonogra-phy and histopathological findings were evaluated. ResultsAlmost half pre-sented with AUB were in the premenopausal group [196 (48.51%)], followed by 150(37.13%) postmenopausal group and 58(14.36%) reproductive age group. The most common bleeding pattern was menometrorrhagia followed by metrorrhagia. Endometrial pathologies were observed in 306 (75.74%) and normal menstrual pattern in 98 (24.26%) participants of AUB. Endome-trium cancer was seen in 7 (1.7%) women. In the reproductive period most common pathology was hormonal imbalance pattern. Endometrial polyp was the dominant pathology in premenopausal and postmenopausal age groups. All malignancy cases were in the postmenopausal age group. Malignancy was in 4(19.04%) women who gave birth < 3 and in 1(4.76%) who had ≥3 children. Four women with vaginal delivery had malignancy whereas no ma-lignancy was seen in women with only cesarean history. Among 109 women who had endometrial thickness <4mm, 15(13.76%) had irregular endometrial proliferation and polyp, 1 (0.92%) had endometrioid CA. Of 295 women who had endometrial thickness >4mm, 30 (10.17%) had endometrial hyperplasia, 6(2.03%) had endometrium cancer. ConclusionTransvaginal ultrasonogra-phy can be used as diagnostic method to evaluate endometrial thickness and differentiate uterine pathologies. However in the case of recurrent uterine bleeding, endometrial sampling should be performed disregarding ultraso-nography findings.

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