Publication:

Clinicopathological evaluation of abnormal uterine bleeding in peri menopausal women

Background Abnormal uterine bleeding (AUB) is a frequently encountered gynaecological complaint in perimenopausal women and also the most common cause of hysterectomy in their age group. The current study was carried out to evaluate various presentations of perimenopausal Abnormal uterine bleeding and to correlate with histopathological examination of the dilation and curettage (D&C) sample of endometrium.

Methods A cross-sectional study was conducted from 2022 to 2024 at a tertiary care hospital in Imphal, among 190 abnormal uterine bleeding cases. Data were collected in a predesigned proforma and analysed using SPSS Version 21.0. Descriptive statistics were used to express the findings. Ethical approval was obtained and informed consent was taken.

Results The mean age of the study subjects or participants was 45.67±5.58 years. The majority of the cases were aged 41-50 years, Hinduism dominated, educated up to 12th class, self-employed, and living in a joint family. Heavy uterine bleeding was the common presentation. The USG findings were 80.5% sensitive and 100% specific to diagnose leiomyomas; in adenomyosis, USG is more sensitive (100%) and specific (100%). Clinically, leiomyoma was the most common suspected cause of AUB; radiologically, 50% of leiomyomas and post-hysterectomy histopathological findings showed that 62.1% were leiomyoma, among which 98.9% were proliferative. Only 21% were adenomyosis. The endometrial pattern was 63.7% proliferative, 21.6% secretory, 14.7% disordered proliferative.

Conclusions The abnormal uterine bleeding was common in middle-aged women and heavy bleeding was the common presentation. The proliferative leiomyomas are the major causes for AUB followed by adenomyosis.