Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women

Abstract

Objectives: To study the causes of abnormal uterine bleeding in perimenopausal women and to correlate their clinical evaluation with ultrasonographic and histopathological examination. Method: This is a retrospective study of 100 perimenopausal women with complaint of abnormal bleeding in the age group ranging from 40 years till 1 year within the menopause, who underwent hysterectomy at Lok Nayak Hospital. The age, parity, menstrual complaints of these patients were noted and clinical diagnosis and ultrasonography were analysed. Finally, histopathology report of the hysterectomy specimen was correlated with the clinical profile of the patient and ultrasonographic findings. Results: Maximum frequency of abnormal uterine bleeding was seen in the age group 40 45 years. Most of the patients were para 3. Menorrhagia was the commonest complaint and fibroid uterus was responsible for abnormal uterine bleeding in 53% of women. Out of 39 women labelled clinically as dysfunctional uterine bleeding, 8 patients were diagnosed with fibroid uterus on ultrasound and in rest of the 31 patients, no organic cause was found. Out of these 31 patients, 4 patients were diagnosed to have adenomyosis on histopathology and in rest, no gross pathology was detected. Suspected malignancy in all the 3 patients was confirmed on histopathology. Simple endometrial hyperplasia without atypia was present in 19% patients. Conclusion: Clinical, radiological and pathological evaluation correlated well to diagnose fibroids, however clinically as well as ultrasound proved to be of little help in diagnosing adenomyosis.