Endometrial Pathology in abnormal uterine bleeding (AUB) & role of different techniques of endometrial sampling in evaluation of AUB : A cross sectional study

Objectives: Primary: 1. To Analyze prevalence of various endometrial pathologies among patients presenting with abnormal uterine bleeding. Secondary : 1. To study age wise distribution of various endometrial pathologies. 2. To study age wise clinical presentation (symptomatology) in patients with AUB. 3. To assess the feasibility and compare different techniques of collecting endometrial sample. Design and setting: A single center prospective cross sectional study at teaching institute Population/Sample : 150 females from 18-70 years presenting with abnormal uterine bleeding. Endometrial sample was obtained either by OPD Pipelle brush or Surgical Dilatation and Curettage method or hysteroscopy. Outcome measures : Endometrial sampling methods used, Endometrial Pathology, Age groups wise clinical and pathological correlation, Feasibility of technique used. Statistical Analysis was done by using Epi-Info-7 software. Results : Commonest age group presenting with AUB was 41-50 (40%) years ,64 % were para 3 or more, Proliferative and secretary changes, 53(35.3%) and 24(16%) cases while endometrial hyperplasia without atypia 18 (12%) cases and with atypia7cases(4.7% ),endometrial carcinoma 5 cases(3.3%) while endometrial polyp was seen in 8 cases(5.3% ). Heavy menstrual bleeding with normal duration was commonest presentation in 64%. Endometrial sampling technical failure was seen in 2 cases with pipelle biopsy while in 7 cases inadequate sample was obtained with pipelle and dilatation and curettage. Uterine perforation was seen in one case which was managed conservatively. Conclusion: T echnical failure and inadequate sample needs to be addressed considering background high risk factors, TVS imaging and repeat sample and use of hysteroscopy may be offered case to case basis.