Endometrial histopathological changes in women with abnormal uterine bleeding in Kirkuk City : a clinicopathological study

Abstract EN

Background : abnormal uterine bleeding is defined as any excessive, erratic, or irregular bleeding that does not correspond with the amount, duration or frequency of blood flow of a normal menstrual cycle .It is considered one of the most common and challenging problems presenting to the gynecologist regardless of the age the women ; it occurs in 9-14 % of women between menarche and menopause, significantly impacting quality of life and imposing financial burden.

Aim : to determine the types and frequencies of various types of histopathological changes of the endometrium in patients with abnormal uterine bleeding in Kirkuk city.

Methods : in this study a total number of 525 endometrial biopsies obtained by dilatation and curettage from patients with abnormal uterine bleeding between 18-68 years old attending to Azadi teaching hospital, Kirkuk general hospital & a private clinic over a period of 26months.

Results : most of our patients were in the age group 41-50 years and most of our patients were grand multiparous and of normal weight.

the main presenting complaint among our patients was menorrhagia (42.7 %).

Dysfunctional causes accounted for majority of the cases (61.3 %), In which proliferative endometrium was the commonest seen in 159 cases.

Organic causes of abnormal uterine bleeding constitutes (38.7 %), the commonest histopathological finding in this category was endometrial hyperplasia which was found in (60.1 %) of cases.

Age specific comparative analysis of organic causes of abnormal uterine bleeding revealed that endometrial hyperplasia was commonest in premenopausal women in the age group 41-50 year (48.5 %) followed by premenopausal women 31-40 year (36.8 %), while all the cases with endometrial carcinoma was found in postmenopausal women in the age groups 51-60 year and > 60 year 5 and 9 cases respectively.

Conclusion : in this study Obesity & nulliparity are important risk factors of endometrial hyperplasia and carcinoma, Menorrhagia was the commonest clinical features of abnormal uterine bleeding and dysfunctional causes constituents the majority of cases and endometrial hyperplasia was the commonest histopathological changes in abnormal uterine bleeding however endometrial carcinoma was more common at postmenopausal age groups.