A Retrospective Study of Endometrial Patterns in Patients Presenting with Abnormal Uterine Bleeding at A Tertiary Care Center

Background: Abnormal uterine bleeding (AUB) is a frequent gynaecological issue among women of all ages amongst the most important causes of morbidity. Histopathological evaluation of the endometrium is important for determining the cause of the problem, particularly for the identification of ill-defined and malignant conditions. The aim is to evaluate the spectrum of endometrial histopathology in patients with AUB. Design: Translational research involving comparison of specimens obtained in a cohort of patients with AUB. Methods: Translational research comparing specimens obtained in a cohort of patients with AUB. The objective is to assess the distribution of different endometrial patterns, to correlate this endometrial pattern with the different age groups and to assess the frequency of premalignant and malignant lesions. Material and Methods: Retrospective observational study was carried out in the department of Pathology, Dr. RajendraGode Medical College and Hospital for three years from March 2023 to March 2026. Two hundred patients were included, who presented with AUB and underwent an endometrial biopsy. Hospital charts and histopathology reports were used to obtain data. Endometrial patterns were classified and the statistical analysis with descriptive and inferential methods was done. Results: Most of the patients were in the perimenopausal age group (41-50 years). Most frequently presented symptom was menorrhagia. Histopathological examination showed proliferating endometrium (30%), disordered proliferating endometrium (20%) and secretory endometrium (15%) were the most frequently occurring conditions. In 11% of cases there was endometrial hyperplasia, most often without atypia, and in 6% endometrial carcinoma of which most were in postmenopausal women. However, most AUB cases were functional and pathological lesions were noted to increase with age. Conclusion: AUB is most common in perimenopausal women, and is often linked to functional changes in the endometrium. In older age groups, however, there is a large number of cases that have premalignant as well as malignant lesions. Endometrial sampling is essential in the diagnosis for early detection and suitable management of AUB.

Keywords: Abnormal uterine bleeding, Endometrial patterns, Histopathology; Endometrial hyperplasia; Endometrial carcinoma; Perimenopausal bleeding.