Abstract :
Introduction: Abnormal uterine bleeding (AUB) usually occurs in peri or postmenopausal age group.
Causes of AUB according acronym (PALM-COEIN) by FIGO (2011). They are–polyp, adenomyosis,
leiomyoma, malignancy and hyperplasia, coagulopathy, Ovulatory dysfunction, endometrial, iatrogenic
and not yet classified.
Diagnosis was made by clinical examination, ultrasonography and confirmed by histopathology.
Management can be medical, minor procedures D and C, ablative procedure and hysterectomy.
Objectives: To find out the incidence and distribution of various uterine pathology in hysterectomy
specimens with related to different age groups, parity and clinical features.
Materials and Methods: A prospective study was conducted in the department of Obstetrics and
Gynecology at R.L. Jalappa hospital attached to Sri Devaraj Urs Medical college, Kolar over a period of
one year i.e June 2017 to May 2018. AUB cases (90) were examined. History taken about age, parity,
clinical symptoms, duration and amount of blood loss. Information about gynaecological complaints,
medical diseases, hormonal, operative treatment, general examination, systemic examination done and
diagnosis made. Blood investigations, Pap smear and pelvic sonography done. Endometrial sampling
sent for Histopathology. Hysterectomy specimens sent for Histopathology examination. Final diagnosis
compared with clinical, ultrasonography and HPR.
Results: Most of the patients belonging to the age group of 41-50 years and were multiparous.
Common symptoms were heavy menustral bleeding HMB 48.89%. Indications was fibroid uterus 46.67%.
Endometrial biopsy was proliferative endometrium 44.44%. Histopathological study specimen showed
leiomyoma (40%). Fibroid diagnostic accuracy by clinical and Sonography methods are 85.7% and
92.3%. Endometrial patterns was proliferative simple endometrial hyperplasia in perimenopausal group
and complex hyperplasia in postmenopausal group.
Conclusion: Maximum patients were multiparous belonging to perimenopausal age. Common AUB
symptom was HMB and diagnosis was leiomyoma which was confirmed by USG and histopathology.
Hysterectomy remains definite treatment in AUB patients.
Keyword :
Heavy menstrual bleeding, Abnormal uterine bleeding, Hysterectomy, Histopathology study, Fibroid, Adenomyosis, Dysmenorrhea.