Endometrial Pathology in abnormal uterine bleeding (AUB) & role of
different techniques of endometrial sampling in evaluation of AUB : A
cross sectional study
Abstract
Objectives: Primary: 1. To Analyze prevalence of
various endometrial pathologies among patients presenting with abnormal
uterine bleeding. Secondary : 1. To study age wise distribution
of various endometrial pathologies. 2. To study age wise clinical
presentation (symptomatology) in patients with AUB. 3. To assess the
feasibility and compare different techniques of collecting endometrial
sample. Design and setting: A single center prospective cross
sectional study at teaching institute Population/Sample : 150 females
from 18-70 years presenting with abnormal uterine bleeding. Endometrial
sample was obtained either by OPD Pipelle brush or Surgical Dilatation
and Curettage method or hysteroscopy. Outcome measures : Endometrial
sampling methods used, Endometrial Pathology, Age groups wise clinical
and pathological correlation, Feasibility of technique used. Statistical
Analysis was done by using Epi-Info-7 software. Results
:Commonest age group presenting with AUB was 41-50 (40%) years ,64 %
were para 3 or more, Proliferative and secretary changes, 53(35.3%) and
24(16%) cases while endometrial hyperplasia without atypia 18 (12%)
cases and with atypia7cases(4.7% ),endometrial carcinoma 5 cases(3.3%)
while endometrial polyp was seen in 8 cases(5.3% ). Heavy menstrual
bleeding with normal duration was commonest presentation in 64%.
Endometrial sampling technical failure was seen in 2 cases with pipelle
biopsy while in 7 cases inadequate sample was obtained with pipelle and
dilatation and curettage. Uterine perforation was seen in one case which
was managed conservatively. Conclusion: Technical failure and
inadequate sample needs to be addressed considering background high risk
factors, TVS imaging and repeat sample and use of hysteroscopy may be
offered case to case basis.