Authors: Ismat Jahan, Ratu Rumana, Najnin Munni, Tasnuva Akter, Humayra ZU.
Introduction: Abnormal Uterine Bleeding is a common problem encountered by women of all age groups, responsible for around 20-30% visits to out- patient department in reproductive age group. The International Federation of Gynaecology and Obstetrics working group on menstrual disorders has developed a classification system-PALM COEIN for causes of AUB in non-pregnant women of reproductive age.
Aim of the Study: To evaluate the correlation of histopathological findings with clinical & sonographic findings.
Material & Methods: This was a cross sectional observational study, conducted in the Department of Obstetrics & Gynaecology, BIRDEM Hospital, Dhaka from 1st July 2015 to July 2017.One hundred patients of age range between 35-45 years who were clinically diagnosed as AUB & underwent total abdominal hysterectomy in BIRDEM Hospital.
Results: A total of 100 cases were analyzed. Patients’ age ranged from 35-45 years.The most common presenting symptom was heavy menstrual bleeding (62%). Most of the patients (60%) were initially treated medically before undergoing hysterectomy. In few patients (14%) hysterectomy was done as first treatment as the bleeding was severe. Endometrial proliferative pattern was the most common histopathological finding and was seen in 64% patients. Atypical endometrial hyperplasia in 5% patients, secretory endometrium in 15% and atrophic endometrium were seen in 4% patients each & Cystic hyperplasia in 7% patients. After exclusion of organic pathology (according to FIGO classification: PALM) through histopathological findings, diagnosis of AUB due to Nonstructural pathology like ovulatory dysfunction, Endometrial pathology was confirmed in 45% of cases.
Conclusion: Histopathological examination of endometrium should be done generously in women presenting with AUB especially after the age of 40 years to rule out malignant pathology
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