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Category: Volume 07 Issue 12 December 2019
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Title: Histopathological Spectrum of Endometrium in Perimenopausal and Postmenopausal Women in a Tertiary Care Center

Authors: Dr P.S.Mulay, Dr Soundararajan Rama, Dr S.A. Deshpande

 DOI: https://dx.doi.org/10.18535/jmscr/v7i12.23

Abstract

Introduction: The endometrium is uniquely endowed throughout the female reproductive lifespan with complex of periodic proliferation, differentiation, breakdown and regeneration. Virtually every woman will at some point in her lifetime experiences episodes of bleeding that are perceived as abnormal2. Sampling of endometrium should be considered in all women over the age of 40 years with abnormal bleeding in order to diagnose benign and malignant conditions that are very often found among postmenopausal women.

Aims And Objectives

  1. To determine various histological patterns of endometrium in peri and postmenopausal women.
  2. To analyse the causes of abnormal vaginal bleeding after histopathological examination in peri and postmenopausal women.
  3. To correlate between clinical and histopathological findings of endometrium in peri and post menopausal women.

Materials and Methods: This 18 months study was done in Department of Pathology, Dr SCGMC  Nanded from january2017-june2018 which included D&C, Endometrial biopsies, curettage  and resected specimens of  uterus. Histopathological spectrum of endometrium in 340 Female patients in the perimenopausal group (45 + 5 years) and postmenopausal group (50 years and above) with symptoms of bleeding were studied.

Results: Maximum incidence was found in the age group of 41-50 years perimenopausal (64.7%). Menorrhagia was most common bleeding pattern found in 67.65%. Postmenopausal bleeding was common in atrophic endometrial profiles (47.5%). Among the perimenopausal women, the most common pattern was Proliferative endometrium (58.64%) and the commonest pathology was Simple endometrial hyperplasia (5.0%). Among the postmenopausal women, the most common pattern was Atrophic endometrium (47.5%) and the commonest pathology was Simple endometrial hyperplasia (5.0%). Out of 5 malignant cases,4 cases were found to be endometrial adenocarcinoma  and 1 case was found to be endometrial stromal sarcoma. 

Conclusion: Sampling of endometrium should be considered in all women over the age of 40 years with abnormal bleeding in order to diagnose benign and malignant conditions and also to decide the mode of treatment to be given.

Keywords: Abnormal uterine bleeding, Perimenopausal and postmenopausal bleeding.

References

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Corresponding Author

Dr Soundararajan Rama

Assistant Professor, Dept. of Pathology, Dr SCGMC Nanded