Aim: To study the histopathological patterns, to categorise the causes of bleeding according to age group
and to correlate it with the thyroid profile and with the thickness of endometrium.
Materials and Methods: Strategies:It is a review study directed by the branch of pathology in our institute.
An aggregate of 80 cases were taken from the age gathering of 18-60 years. Histopathological patterns were
recorded from the endometrial biopsy along with the biochemical and radiological records.
Results: The commonest age group presented with AUB was 40-49 years which shows the perimenopausal
period. Most of the histopathological pattern showed normal cyclic endometrium with (42.5%) of
proliferative phase followed by(23.7%) of secretory phase. Higher incidence of AUB was seen in the
euthyroid cases (65%). ET > 15mm was mostly related towards endometrial hyperplasia.
Conclusion: Endometrial biopsies helpin analyzing the diverse causes of abnormal menstrual bleeding.

Keywords: Bleeding, Endometrium.

/pdf/a-reterospective-study-on-the-endometrial-biopsy-of-aub-59mlkrphah.pdf

A reterospective study on the endometrial biopsy of AUB correlated to thyroid abnormalities and endometrial thickness

Abnormal uterine bleeding (AUB) is defined as any change in the frequency of menstruation, duration of flow or amount of loss. Menstrual disturbances and different endometrial pattern may accompany and precede thyroid dysfunction. The objective of the study was to correlate thyroid profile with endometrial biopsy in cases of AUB. This study was conducted on 74 patients who presented with AUB, had undergone TFT and endometrial biopsy/hysterectomy. Among 74 patients, thyroid disorders were identified in 26 patients. Maximum number of patients with AUB belonged to the category of hypothyroidism (27%) and 8.1% of cases had hyperthyroidism. In the present study 29 (39.1%) had proliferative endometrium, followed by secretory pattern in 21 (28.4%) patients. Hormone induced changes was seen in 3 (4.1%) patients. Disordered proliferative endometrium and endometrial hyperplasia was observed in 6 patients (8.1%) each. Malignant lesion was not common and it comprised of only 1.4% cases. AUB is frequently seen in patients with thyroid dysfunction. Thyroid function test is a cost effective, easily available test and can detect a possibly curable cause of AUB and avoid unnecessary intervention like hormonal treatment and hysterectomy. AUB due to endometrial cause is an age related pathology. Histopathological examination of endometrial biopsy is a major diagnostic tool in evaluation of AUB. It helps the physician to plan therapy for successful management of AUB. Corresponding author Dr. Shraddha Koirala, Lecturer, Department of Pathology, Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, Nepal, Email: shraddhaa46@gmail.com Orcid No: https://orcid.org/0000-0001-5155-8184 DOI: https://doi.org/10.3126/nmcj.v23i4.42227

Correlation of Abnormal Uterine Bleeding (AUB) with Thyroid Profile and Endometrial Biopsy

Introduction: Abnormal uterine bleeding is a challenging gynecological problem caused by various endometrial pathologies and is a major clinical problem among women in peri and postmenopausal age groups. The problem is common worldwide but causes may vary from one region to another.
Aims and Objectives: The main objective was to evaluate pathological spectrum of different endometrial lesions in abnormal uterine bleeding and to correlate with clinical history and diagnosis.
Materials and Methods: The study was a prospective study done from August 2017 to July 2019. The specimens received from endometrial biopsy were included in the study. All the specimens were fixed in formalin and processed through paraffin wax embedding method. Sections were cut at 3-5 micrometer thickness and stained by Hematoxylin and Eosin (H&E) stain and were examined under light microscope. 
Result: A total no. of 247 cases were studied. Out of these, 57 cases were of Proliferative endometrium, 33 cases of Secretory endometrium, 34 cases of simple hyperplasia without atypia, 11 cases of cystic glandular hyperplasia, 17 cases of complex hyperplasia with atypia, 09 cases of menstrual phase endometrium, 07 cases of irregular shedding, 06 cases of endometrial polyp and anovulatory cycle, 04 cases of endometritis, 03 cases each of simple hyperplasia with atypia, progesterone exposed endometrium and inadequate secretory phase, 02 cases each of complex hyperplasia without atypia, atrophic endometrium, products of conception and inadequate proliferative phase and 01 case each of stromal hyperplasia. 45 samples were inadequate. Maximum cases of abnormal uterine bleeding were seen between 31-40 years of age.
Interpretation and Conclusion: Abnormal uterine bleeding is one of the commonest condition for which patients seek advice in the gynecological outpatient department. Analysis of histopathology of endometrium in abnormal uterine bleeding helps in management of patients and to know th

https://www.jdpo.org/journal-article-file/13339

Cliniopathological profile in women with abnormal uterine bleeding

/pdf/histopathological-profile-of-abnormal-uterine-bleeding-a-two-3cjtetaw4h.pdf

Histopathological profile of abnormal uterine bleeding- a two-year singleinstitutional study

Introduction: Abnormal uterine bleeding (AUB) is a common complaint in postmenopausal and perimenopausal women, caused by a range of disorders, including structural and systemic diseases. The evaluation of endometrial thickness (ET) via radiological methods, followed by a histopathological examination of the endometrium, is useful for proper diagnosis. Among systemic diseases, thyroid dysfunction, specifically hypothyroidism and hyperthyroidism, contribute significantly to AUB cases. Materials and methods: This descriptive cross-sectional study was conducted at Sri Aurobindo Medical College, Indore, Madhya Pradesh, India, over a period of 16 months, from May 2021 to September 2022. Patients presenting with abnormal uterine bleeding and undergoing thyroid function tests (TFTs), ultrasonography, and endometrial biopsy/hysterectomy at the gynecological outpatient department were included. Hospital records were used to obtain clinical details and investigation results. Endometrial thickness and thyroid status were recorded, and descriptive statistics were used to analyze the collected data. Results: This study included 150 patients with abnormal uterine bleeding, with a mean age of 44 years and 80.6% of patients in the premenopausal age group. A total of 48% of patients had a deranged thyroid profile, with hypothyroidism being more common (91.6%). Structural causes of AUB were identified in 81.3% of cases, with adenomyosis (33.65%), concomitant adenomyosis and leiomyoma (31.5%), and leiomyoma (14.8%) being the most common. Endometrial polyps (4.6%) and endometrial carcinoma (0.6%) were also observed and were consistent with the final histopathology. The remaining 18 patients had no structural causes and were categorized as cases of dysfunctional uterine bleeding (DUB). Increased ET was more commonly observed in postmenopausal patients (4.3%) compared to premenopausal patients (0.7%) among those with AUB, while the reverse was true for patients with DUB. Increased ET was commonly associated with hypothyroidism in both groups. Histopathological examination of endometrial biopsies/hysterectomy specimens revealed additional findings in some patients, including hyperplasia of the endometrium with (0.7%) and without atypia (4%), leading to a more accurate diagnosis. Conclusion: AUB is a prevalent condition affecting women in both pre-menopausal and postmenopausal stages, frequently caused by structural anomalies. However, thyroid dysfunction, especially hypothyroidism, is also a significant contributing factor. As such, thyroid function tests (TFTs) are an effective and economical means of identifying potential underlying causes of AUB. Hypothyroidism is frequently associated with increased endometrial thickness, and histopathological examination remains the gold standard for determining the precise cause of AUB.

/pdf/endometrial-histopathology-in-abnormal-uterine-bleeding-and-3vpptf0h.pdf

Endometrial Histopathology in Abnormal Uterine Bleeding and Its Relation With Thyroid Profile and Endometrial Thickness

Background: Abnormal uterine bleeding is the cause for many disturbances in women who are in the reproductive age group. Frequent and prolonged periods will lead to morbidity, social embarrassment, diminished quality of life and compromise of the sexual life. Methods: It is a hospital based cross sectional study conducted in the department of pathology, Andhra medical college. A total of 270 patients in the age group of 18 to 45 years were included in this study. Endometrial samples were obtained and histopathological examinations were conducted. All the clinical details and investigation reports were collected. Results: The age group of patients in this study ranged from 18 to 45 years. Maximum numbers of cases (169) were in the age group of 36 to 45 years (62.6%). Most of the patients were multipara (244 cases, 90.37%) and most common presenting complaint was heavy menstrual bleeding (198 cases, 73.3%). Majority of the patients were euthyroid (247 cases, 91.5%). Normal cyclical endometrium was found to be the commonest histopathological pattern with proliferative endometrium in 45.56% and secretory endometrium in 32.59% cases. Leiomyomas were found to be the commonest cause of abnormal uterine bleeding (15.56%). Bulky / enlarged uterus (77%) and type-IV (hyperechoic) endometrium, depicting the secretory endometrial pattern (36.66%) was the most common finding on transvaginal sonography (TVS). Conclusions: Histopathological examination is the gold standard for studying the pattern of endometrium in various causes of abnormal uterine bleeding.

Parvathi Gorla

Papers

Histopathology of endometrium in abnormal uterine bleeding, in correlation with thyroid profile and ultrasonography findings -