Endometrial pathologies in abnormal uterine bleeding: prevalence, patterns, and perspectives: A cross sectional study

Abnormal uterine bleeding (AUB) is a common gynecological challenge, stemming from various endometrial pathologies. This study aims to assess their prevalence, age distribution, symptomatology correlation, and compare sampling techniques.
This prospective cross-sectional study was conducted at a single teaching institute, involving 150 female participants aged between 18 and 70 years who presented with AUB. Endometrial samples were collected using one of three OPD Pipelle brush, surgical dilatation and curettage (D&C), or hysteroscopy.
The study found 41-50-year-olds most affected by AUB (40%), with 64% having given birth three or more times. Proliferative and secretory changes were common (35.3% and 16% respectively). Endometrial hyperplasia without atypia occurred in 12% and with atypia in 4.7%. Endometrial carcinoma was in 3.3% and polyps in 5.3% of cases. Heavy menstrual bleeding with normal duration affected 64%. Technical challenges included sampling failure in 2 pipelle biopsies and 7 D&C cases. Inadequate samples were obtained in 2 pipelle biopsy and 5 D&C cases. Uterine perforation occurred once, managed conservatively.
Our study underscores the burden of endometrial pathologies in AUB patients with predominant proliferative and secretory changes. Sampling challenges, particularly with pipelle biopsy and D&C, emphasize the need for refining methods and exploring alternatives like transvaginal sonography and hysteroscopy to enhance diagnostic accuracy and patient outcomes in AUB management.