Histo-Pathological Study of Endometrium in Dysfunctional Uterine Bleeding- A Study of 400 Cases

Abstract

Introduction: Dysfunctional uterine bleeding (DUB) is a common problem in women in the 30-50 years age group. The incidence increases as age advances till menopause. The pathophysiology is not fully understood and it is complex. It accounts for above one third of all gynaecological consultations carried out for abnormal uterine bleeding. Objectives: To study correlation of different clinical presentation and clinical findings with histopathology of endometrium in cases of Dysfunctional Uterine Bleeding (DUB). Results: A one year retrospective study of DUB cases was conducted in Department of Pathology, B.J. Medical College, Ahmedabad. 400 cases were studied which were clinically diagnosed as DUB with exclusion of structural lesions by radiological investigations and proven histologically. Dilatation and curettage (D & C) was the commonest mode by which endometrium was obtained (79% cases). Largest numbers of patients were in 31-40 years (48%) with mean age being 38.7 years. The most common clinical presentation was menorrhagia (76.5%) followed by Metrorrhagia (13.5%). In present series proliferative phase was most common and found in 39.75% cases. Hyperplasia was seen in 22% cases. Atypical hyperplasia was a rare finding (4.55%). Conclusion: The patient who presents with DUB and a history of menstrual cycle irregularity warrants an endometrial biopsy, regardless of age. A higher degree of suspicion, based on clinical findings and associated risk factors, precise histological typing of lesions and to rule out organic causes is essential in the management of DUB.