Endometrial biopsies and curettage in abnormal uterine bleeding: Histopathological evaluation

Author(s): Dr. Harsha Gajjar1, Dr. Rugvi Patel2, Mahla Shrideviben Gamanbhai3, Patel Prachi Hitendrakumar4
1Assistant Professor, Department of Pathology, Narendra Modi Medical College, Ahmedabad, Gujarat.
2Senior Resident, Department of Pathology, Narendra Modi Medical College, Ahmedabad, Gujarat.
3Second Year Resident, Department of Pathology, Narendra Modi Medical College, Ahmedabad, Gujarat.
4First Year Resident, Department of Pathology, Narendra Modi Medical College, Ahmedabad, Gujarat.
Copyright © Dr. Harsha Gajjar, Dr. Rugvi Patel, Mahla Shrideviben Gamanbhai, Patel Prachi Hitendrakumar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Aim: The most typical menstrual issue is abnormal uterine bleeding (AUB), which affects women of all ages and is also indicative of a significant underlying illness. The gold standard for determining the causes of AUB is still endometrial biopsy and subsequent histological analysis. In order to assess and determine the most prevalent patterns of endometrial histological findings and their prevalence in women of various age groups presenting with AUB in MRMCW, this study was conducted.
Material and Methods: This observational study was conducted in conjunction with the Department of Obstetrics \& Gynaecology at the Tertiary Care Institute of India for Women over a period of one and a half years on cases of abnormal uterine bleeding that underwent endometrial sampling (endometrial curettage and biopsy). A total of 200 premenstrual endometrial samples were included in the study material. Endometrial biopsy or sedation-assisted dilatation and curettage were both used to collect endometrial samples. Based on the architecture and cytologic features, hyperplasia was divided into benign (non-atypical) endometrial hyperplasia and atypical endometrial hyperplasia/endometrioid intraepithelial neoplasia (EIN).
Results: The most frequent observation was normal cyclical patterns with proliferative and secretory phase in 114 cases (57%) overall. 41 patients (20.5%) were found to have hyperplasia, of whom 3 had atypical endometrial hyperplasia. Pregnancy complications were observed in 10 (5%) cases, with abortion being the most common cause. Ectopic gestation, partial moles, and complete moles were all contributing factors.
Conclusion: The current study demonstrates that the most typical histological pattern of endometrium for AUB in perimenopausal women in our region is endometrial hyperplasia. The etiology and appearance of AUB, as well as the ensuing endometrial pathology, vary depending on the age group, just as endometrial physiology does with age and reproductive activity.

Keywords: Abnormal uterine bleeding; Ectopic gestation; Endometrial biopsy; Endometrial hyperplasia.