HISTOPATHOLOGICAL PATTERN OF ENDOMETRIAL BIOPSIES IN PATIENTS WITH ABNORMAL UTERINE BLEEDING

Abstract

Objectives:
To evaluate the histopathological patterns of endometrial biopsies in patients presenting with abnormal uterine bleeding (AUB) and to determine their distribution across different age groups.

Methodology:
This descriptive cross-sectional study was conducted at a tertiary care hospital of Rawalpindi and included 150 patients with AUB selected through non-probability consecutive sampling. Women of reproductive, perimenopausal, and postmenopausal age groups were included, while those with bleeding disorders, hormonal therapy, or known malignancy were excluded. Clinical data were collected using a structured proforma. Endometrial samples were obtained via dilatation and curettage or pipelle biopsy, processed, and examined histopathologically. Qualitative variables included histopathological patterns, while quantitative variables included age, parity, and duration of symptoms. Data were analyzed using statistical software.

Results:
The mean age was 42.6 ± 10.8 years, with most patients in the perimenopausal group. Multiparity was common, and the mean duration of symptoms was 7.4 ± 3.2 months. Menorrhagia was the most frequent complaint. Proliferative endometrium (30%) was the most common histopathological finding, followed by secretory endometrium (20%) and endometrial hyperplasia. Disordered proliferative endometrium and endometritis were also observed, while atrophic endometrium and carcinoma were mainly seen in older women. Functional patterns predominated in younger patients, whereas hyperplasia and malignancy were more frequent in perimenopausal and postmenopausal groups.

Conclusion:
Endometrial biopsy is an essential diagnostic tool in AUB, enabling early detection of premalignant and malignant lesions. Age and symptom duration are important predictors of pathology.