FREQUENCY OF ENDOMETRIAL TISSUE PATTERN AMONG WOMEN WITH ABNORMAL UTERINE BLEEDING

Abstract

Background: Abnormal uterine bleeding (AUB) is one of the most frequently encountered gynecological complaints, especially in peri- and post-menopausal women. Accurate diagnosis of its underlying causes is crucial to guide appropriate management. While imaging and clinical evaluation provide initial direction, histopathological examination remains the gold standard for identifying endometrial abnormalities. In many local settings, particularly within resource-limited regions, data on endometrial histological patterns in AUB remains sparse. This study was designed to address this gap.

Objective: To evaluate the frequency of different histopathological patterns in endometrial tissue samples from women presenting with AUB in a tertiary care setting.

Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, CMH Kohat, from 5th February 2024 to 4th August 2024. A total of 203 women aged 40 to 80 years diagnosed with AUB were enrolled using non-probability consecutive sampling. Patients with pregnancy, bleeding diathesis, or intrauterine devices were excluded. Under general anesthesia, dilation and curettage were performed and endometrial tissue was obtained for histopathological analysis. Data on demographics and clinical parameters were recorded and analyzed using SPSS version 26. Frequencies, percentages, means, and standard deviations were computed; chi-square tests were applied for inferential analysis with a significance level set at p ≤ 0.05.

Results: The mean age of participants was 55.07 ± 11.33 years; 112 (55.2%) were older than 60 years, and 113 (55.7%) were post-menopausal. The most common histopathological finding was endometrial hyperplasia in 67 patients (33.0%), followed by endometrial polyps in 48 (23.6%) and secretory/disordered proliferative endometrium in 55 (27.1%). Endometrial carcinoma and atrophic endometrium were each found in 40 cases (19.7%).

Conclusion: Endometrial hyperplasia was the predominant histopathological finding among women with AUB, while endometrial carcinoma, though less frequent, highlights the need for timely biopsy and diagnosis in post-menopausal bleeding.