EVALUATION AND HISTOPATHOLOGICAL CORRELATION OF ABNORMAL UTERINE BLEEDING DURING THE MENOPAUSAL TRANSITION AT A TERTIARY CARE HOSPITAL IN NORTH COASTAL ANDHRA PRADESH

Abstract

Background: The study evaluates abnormal uterine bleeding (AUB) during the menopausal transition in women at a tertiary care hospital in North Coastal Andhra Pradesh, highlighting its clinical presentation and histopathological correlation. AUB is prevalent during this transitional period due to fluctuating hormonal levels, leading to various bleeding patterns, such as heavy, prolonged, and irregular bleeding. The FIGO PALM-COEIN system standardizes the classification of AUB, emphasizing the need to differentiate between physiological irregularity and pathological bleeding, particularly to rule out endometrial hyperplasia and carcinoma.
Methods: Conducted over 18 months, the study included 150 women aged 40-55 years, most of whom presented with heavy menstrual bleeding. Transvaginal ultrasonography revealed increased endometrial thickness and structural lesions such as leiomyoma and endometrial polyps. Histopathological findings indicated that 90.7% of participants had benign conditions, with endometrial hyperplasia observed in 20.7% and malignancies in 3.3%. Prevailing associations were noted between heavy bleeding and significant endometrial pathologies.
Results and Conclusion: The results underscore the importance of comprehensive clinical assessments integrated with imaging and histopathological evaluations to enhance the diagnosis of significant endometrial conditions. Although benign changes were most common, the existence of atypical hyperplasia and carcinoma stresses the necessity for vigilant surveillance in women experiencing AUB during menopause. The findings are particularly relevant for improving clinical practices in managing AUB in this demographic.