Results :
Table 1 shows most of our patients are para 3 or more96 cases (64%)
cases and most patients 82 cases (54.6%) belong to lower socio economic
class.
Table 1 and Table 2 shows age groupwise spectrum of endometrial
pathologies in patients with AUB. In age group 21-30 years 7cases(4.5%)
underwent endometrial sampling and histological features in this age
group were mainly benign changes such as proliferative and pill
endometrium 2 cases each, secretary change, chronic endometritis, polyp
one case each. Age group 31-40 years 53 cases (35.3%) underwent
endometrial sampling and histological changes were mostly benign such as
proliferative(23),secretary(11)pill endometrium(2)endometrial
hyperplasia without atypia (4), with atypia(2) chronic endometritis and
endometrial polyp 3 cases each and inadequate sample in 2 cases. Age
group 41-50 contributed to maximum number 60 cases (40%) and
endometrial changes were Proliferative(22),secretary(12),endometrial
hyperplasia without atypia (7),with atypia(3),carcinoma endometrium (1)
,other changes were chronic endometritis (6),pill
endometrium(1),Polyp(2).Age group 51-60 contributed 22 cases 14% of
cases and histopathological changes were noted as
proliferative(6),disordered proliferative(1), Atrophic endometrium
(3)and chronic endometritis 2 cases each, endometrial hyperplasia
without atypia(6) with atypia(2),carcinoma endometrium(1),inadequate
sample(1) other changes were benign. Age group 61-70 total 8 cases
(5.2%) underwent endometrial sampling and pathological changes were
endometrial carcinoma(3), atrophic endometrium (3) and endometrial polyp
(1),inadequate sample for reporting(1). Repeat endometrial sampling was
done in cases after inadequate sample it is reported as chronic
endometritis in one case and atrophic endometrium in 2 cases in this age
group.
Table 3 shows commonest clinical presentation as heavy menstrual
bleeding HMB with normal duration 96 cases (64%), followed by heavy and
prolonged bleeding in 23 cases (15.3 %), Post menopausal bleeding 23
cases (15.3%), Intermenstrual bleeding(IMB) was presentation in 8 cases
5.4%.
Table 4 shows out of 150 patients out 71 patients subjected to pipelle
biopsy only 69 cases sample was obtained while 2 cases technical failure
was noted. 34 patients endometrial sample was obtained by traditional
dilatation and curettage technique while 47 cases underwent hysteroscopy
along with endometrial biopsy and additional 3 cases who consented for
repeat sampling by hysteroscopy due to inadequate sample for reporting
also underwent hysteroscopy. Inadequate sample was noted in 4 cases in
pipelle group and in 3 cases in D & c group . One Uterine perforation
was noted in patients undergoing dilatation and curettage. Pipelle
biopsy was found to be more feasible for outpatient procedure however
dilatation and curettage and hysteroscopy with biopsy were less feasible
in our setting