Histopathological Spectrum of Endometrial Lesions in Abnormal Uterine Bleeding: A Cross-Sectional Study in a Tertiary Care Hospital

Abstract

Background: Abnormal uterine bleeding (AUB) is a frequent gynecological complaint with a wide spectrum of underlying causes. Histopathological examination of endometrial tissue plays a vital role in diagnosing these conditions, especially in peri- and postmenopausal women.

Objective: To evaluate the histopathological patterns of endometrial lesions in patients presenting with AUB and correlate them with age and clinical features.

Methods: This cross-sectional study included 162 cases of endometrial samples from women presenting with AUB. Samples were processed and examined histologically. Data were analyzed by age distribution, histological diagnosis, and menopausal status. Statistical significance was calculated using the chi-square test.

Results: The most common histopathological finding was proliferative endometrium (32.1%), followed by secretory endometrium (22.2%), endometrial hyperplasia (20.3%), and endometrial carcinoma (6.8%). Hyperplasia and malignancy were more common in women aged >45 years (p < 0.01). Postmenopausal bleeding was most frequently associated with atrophic endometrium and carcinoma.

Conclusion: Histopathological evaluation is essential for definitive diagnosis in AUB, particularly in peri- and postmenopausal women where the risk of malignancy is higher. Routine endometrial sampling is advocated in this population for early detection and management.

Keywords: Abnormal uterine bleeding, Endometrium, Histopathology, Endometrial carcinoma, Hyperplasia