CLINICO-PATHOLOGICAL CORRELATION OF HYSTERECTOMY SPECIMENS FOR ABNORMAL UTERINE BLEEDING IN RURAL AREA

BACKGROUND: Excessive and abnormal menstrual bleeding is the commonest symptom which brings a perimenopausal woman to the hospital. This age group is more amenable to serious conditions like genital cancer; hence this bleeding should be seriously evaluated to exclude the life threatening conditions by easily available investigating modalities like ultrasonography (USG) and biopsy before deciding their line of treatment. OBJECTIVE: To ascertain the most common pathology causing abnormal uterine bleeding by studying histopathological findings in hysterectomy specimens and correlating this with clinical and ultrasonography findings at a tertiary care centre in rural area of Madhya Pradesh. PERIOD: From April 2009 to March 2012. SETTING: Index Medical College Hospital and Research Centre, Indore. MATERIALS AND METHODS: In this prospective study, 288 hysterectomy specimens were included. The women were above 35years of age and reported to the obstetrics and gynaecology department with chief complaint of abnormal uterine bleeding. A correlation between age, parity, clinical findings, USG findings, pap's smear, mode of surgery and histopathological examination was done. RESULTS: The final histopathology of hysterectomy specimens exhibited leiomyoma as the most common lesion in 24.6% cases, adenomyosis in 12.15% cases, endometrial hyperplasia in 9% cases, fibroid combined with adenomyosis in 4.8% and malignancy in 0.34% cases. In 36% of cases there was no specific pathological lesion found on histopathological examination and these cases were labeled as DUB. CONCLUSION: Majority of women included in the study was perimenopausal and abnormal uterine bleeding was most commonly dysfunctional in origin in this age group. There was a very high clinico-pathological correlation when the clinical diagnosis was leiomyoma.