Histopathologic Study of Endometrium in Patients with Abnormal Uterine Bleeding

90 patients with abnormal uterine bleeding who were admitted to the Department of Obstertrics and Gynecology. Ewha Womans University Hospital during the period of 6 years from January 1985 to December 1990 wer analysed.

The patients with abnormal uterine bleeding secondary to pregnancy and pelvic mass were excluded in this study.

This study was planned to evaluate the clinical aspects and the histopathology of the endometrium.

The results were as follows:

1) 44.4% of the patients were included in the 40 to 49 years, and the patients of 30 to 39 years and of 50 to 59 years were 16.7% respectively. Mean age of the patients was 40.9 years.

2) The most common gravidity of the patients was 7 or more in number(32.2%), but 20.0% or the patients had never pregnancy and mean gravidity was 4.6 in number.

Para 3 to 4 in number(31.1%) was the most common parity of the patients, but 22.2% of the patients had never delivery, and mean parity was 2.7 in number. 98.9% of the patients had 1 to 2 times of abortion's history, but 20.0% of the patients had never abortion, and mean number of abortion was 1.9.

3) Mean age of onset menarche was 14.9 years and the majority of the patients were included in the 13 to 16 years.

Mean age of onset menopause was 50.1 years and the patients were included in the 49 to 54 years.

4) The most common bleeding pattern was intermenstrual bleeding(33.3%), and the next pattern was menorrhagia(30.0%).

Others were bleeding with amenorrhea, menorrhagia, vaginal spotting, and postmenopausal bleeding, 5 of 8 patients with postmenopausal bleeding were confirmed to endometrial adenocarcinoma. Other symptoms were lower abdominal pain, lumbago, and dizziness.

5) The most common histological finding of endometrium was proliferative phase(33.8%), and the next finding was endometrial hyperplasia(20.3%), and the third finding was secretory phase(14.9%).

Other findings were atrophic endometrium, adenocarcinoma, menstrual phase and irregular shedding of endometrium.

6) Coexisting diseases in patients with abnormal uterine bleeding were myoma uteri(10.0%), adenomyosis(10.0%) and hypertension(10.0%).

Others were ovarian cyst, primary infertility. endometrial polyp, cervical polyp. and diabetes.

7) 30.0% of the patients with abnormal uterine bleeding had 1 to 4 times of previous bleeding episode and curettage was performed in the majority of the patients.

8) 35.5% of the patients had initial hemoglobin level below 10g% at admission and mean hemoglobin level of these patients was 7.99g%.

The majority of these patients had blood transfusion, and mean volume of blood transfusion was 2.88 pints.

9) 16.7% of the patients with abnormal uterine bleeding had conservative treatment and 28.9% of the patients had curettage.

Total abdominal hysterectomy with or without salpingoophorectomy, and adjuvant radiation therapy were performed in the other patients.