A study on correlation between bleeding pattern and histopathological findings of endometrium among perimenopausal women

Authors

  • Radha Nair Department of Obstetrics & Gynaecology, Kerala Medical College, Mangod, Cherupulassery, Palakkad, Kerala, India
  • Mallikarjuna M. Department of Obstetrics & Gynaecology, Mount Zion Medical College, Chayalode, Adoor, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20151225

Keywords:

Abnormal uterine bleeding, Perimenopausal, Histopathological examination

Abstract

Background: During climacteric, ovarian activity declines. Initially, ovulation fails, no corpus luteum forms, and no progesterone are secreted by the ovary. Therefore the premenopausal menstrual cycles are shortened, often anovulatory and irregular. The irregularity in menstrual cycle during perimenopause can be due to anovulation or to irregular maturation of follicles.

Methods: The endometrial samples (endometrial curettage/ biopsy and hysterectomy specimens) sent to pathology laboratory were analyzed. These specimens are fixed in 10% formalin and gross morphology was recorded. Endometrial samples were totally embedded and representative bits are taken from hysterectomy specimens. These bits were placed in cassettes and kept in fixative and processed in the automatic tissue processor. Paraffin tissue blocks were prepared and 3-4 micrometer thick sections were cut and stained with routine haematoxylin and eosin. A detailed histological study was carried out and the findings were noted.

Results: Among total study subjects, 62% of patient’s endometrium was in proliferative phase, 26% of patient’s endometrium was in secretory phase, 6% of patient’s endometrium was in cystoglandular hyperplasia. Dysplasia with atypical changes was found in 2% of patients. Adenomatous polyp was found in 2% of patients. Simple hyperplasia was found in 2% of patients.

Conclusions: Patients with abnormal uterine bleeding should always be subjected to histopathological investigation.

References

Tavassoli FA, Devilee P. Pathology and genetics of tumours of the breast and female genital organs. Lyon France: IARC. Tumours of the uterine corpus. In: WHO classifications of tumours. 2003: 221-232.

Rosai RJ, Ackerman’s surgical pathology. New Delhi: Elseiver, A division of Reed Elsevier, India Private limited. Female reproductive system – Uterus – corpus. In: Rosai J Ed. 2004;4(9):1569-635.

Awwad JT, Toth TL, Schiff I. Abnormal Uterine Bleeding in the Perimenopause. International Journal of Fertility & Menopausal Studies. 1993;38(5):261-9.

Speroff L, Fritz MA. In: Clinical gynaecologic endocrinology and infertility. 7th edition. Jaypee Brothers Med Publishers (P) Ltd; 2005. Menopause and the peri-menopausal transition. 2005;621-88.

Padubidri VG, Daftary SN. Howkins and Bourne Shaw’s Textbook of Gynaecology. Noida: Elsevier, A division of Reed Elsevier India Private Limited; 2008. Perimenopause, Menopause, Premature Menopause and Post-menopausal Bleeding. In: Padubidri VG, Daftary SN. 2008;14:52-62.

Kumar A, Mittal S. Endometrial sampling: How? & why? Obs and Gynae Today. 2007;12(6):284-7.

Gusberg SB, Kaplan AL. Precursors of Corpus Cancer-4, Adenomatous Hyperplasia as stage 0 Carcinoma of Endometrium, American Journal of Obstetrics and Gynaecology. 1963;87(5):662-76.

Khan S, Sadia H, Umber A. Histopathological Pattern of Endometrium on Diagnostic D&C in patients with Abnormal Uterine Bleeding. Annals. 2011;17(2):166-70.

Sanyal MK, Sanyal S, Bhattacherjee KK, RoyChoudhuri NN. Clinicopathological study of endometrium: A review of three thousand ninehundred twenty cases in different gynaecologicalabnormalities. J Obstet Gynaecol India. 1981;31(5):816-21.

Azim P, Khan MM, Sharif N, Khattak EG. Evaluation of abnormal uterine bleeding on endometrial biopsies. Isra Medical J. 2011;3(3):84-8.

Mirza T, Akram S, Mirza A, Aziz S, Mirza T, Mustansar T. Histopathological Pattern of Abnormal Uterine Bleeding in Endometrial Biopsies. J Basic and Applied Sciences. 2012;8:114-7.

Al-Neaimy WMT, Ahmed MT, Al-Jawadi SI. Histopathological Interpretation of Abnormal uterine bleeding after the age of 40 year. The Iraqi postgraduate medical journal. 2010;9(3):274-82.

Downloads

Published

2017-02-19

Issue

Section

Original Research Articles