Histopathological Patterns of Endometrial Biopsies and Their Clinical Association in Abnormal Uterine Bleeding Cases from Bihar

Background: Abnormal uterine bleeding (AUB) is one of the most frequent complaints among women of reproductive and peri-menopausal age, often indicating underlying endometrial pathology. Histopathological examination of endometrial tissue remains the cornerstone in diagnosing the cause of AUB and guiding management. The pattern of histological changes in endometrial biopsies can vary with age, hormonal status, and associated systemic or gynecological conditions. Understanding regional patterns of endometrial pathology and their clinical correlation is essential for timely and accurate diagnosis, especially in resource-limited settings like Bihar. Objectives:  To evaluate the spectrum of histopathological patterns seen in endometrial biopsies from patients presenting with abnormal uterine bleeding.  To correlate the histological findings with clinical parameters such as age, menstrual history, and presenting symptoms.  To identify the most common causes of AUB in different age groups. Materials and Methods: This retrospective observational study was conducted in the Department of Pathology at Netaji Subhas Medical College and Hospital, Patna, Bihar, over a period of 12 months. A total of 186 endometrial biopsy samples from women presenting with AUB were retrieved and reviewed. Clinical details were obtained from patient records. Biopsy specimens were fixed in 10% formalin, processed, and stained with hematoxylin and eosin. Histopathological findings were categorized into normal cyclic endometrium, hyperplasia, atrophy, chronic endometritis, disordered proliferative endometrium, and malignancy. Data were analyzed using SPSS version 26.0, and correlation between clinical and histological parameters was studied. Results: The most common age group presenting with AUB was 41–50 years. Proliferative phase endometrium was the most frequent histological finding, followed by secretory phase and endometrial hyperplasia. Disordered proliferative endometrium and chronic endometritis were common in perimenopausal age, while atrophic endometrium and malignancies were more frequently seen in postmenopausal women. A significant clinico-pathological correlation was observed, emphasizing the diagnostic role of biopsy in management of AUB. Conclusion: Histopathological examination of endometrial biopsies remains a reliable and cost-effective tool in evaluating abnormal uterine bleeding. The study highlights age-specific patterns of endometrial pathology in AUB cases and reinforces the importance of timely biopsy for appropriate clinical management. Clinico-pathological correlation enhances diagnostic accuracy and improves therapeutic outcomes.