Original Research Article Archives of Cytology and Histopathology Research, October-December, 2016; 1(3):99-103 99 Histopathology of endometrium in dysfunctional uterine bleeding Divya K. N. 1* , Jayashree K. 2 , Bharath C. 3 1 Associate Professor, 2 Professor, 3 Professor and Head, Dept. of Pathology, VIMS, Ballari *Corresponding Author: E-mail: divyaural@yahoo.co.in Abstract Introduction: Abnormal uterine bleeding is a common condition affecting women of reproductive age that has significant social and economic impact. Dysfunctional uterine bleeding (DUB) is defined as abnormal uterine bleeding in the absence of organic disease. Dysfunctional uterine bleeding is one of the most commonly encountered gynaecological problems. Objectives: This study is done to evaluate the histopathological pattern of the endometrial biopsies of patients with dysfunctional uterine bleeding and its correlation with clinical data. Methods: The present prospective study included evaluation of 104 cases of dysfunctional uterine bleeding in the Department of Pathology, Vijayanagar Institute of Medical Sciences, Ballari, over a period of 1 year, from January 2015 to December 2015. Women presenting with abnormal uterine bleeding were included in the study. Those women in which bleeding is secondary to systemic causes, organic causes and due to cervical and vaginal causes were excluded. The specimens were processed, embedded and cut into sections of 3-4 microns. The histopathological patterns were studied Results: Age distribution varied from 18 years to 70 years, majority of the patients were between 21 to 30 years. Among the cases of DUB, proliferative phase accounted for 66.3% and secretory phase accounted for 21.3%. 9 cases (8.6%) of atrophic endometrium, two cases (1.9%) of irregular shedding and two cases of luteal phase insufficiency were received. Conclusion: Dysfunctional uterine bleeding is a common and debilitating condition in women of reproductive age. Endometrial biopsy could be effectively used as the first diagnostic step in DUB and thus ensures correct management. Keywords: AUB, DUB, Endometrial biopsy, Histopathology, Patterns. Introduction Menstrual dysfunction is the cause of discomfort, inconvenience and disruption of a healthy life style, which affects millions of women in both the developed and developing countries. Successful management of dysfunctional uterine bleeding requires a rational organized approach. [1] Excessive menstrual bleeding has several adverse effects, including anaemia and iron deficiency, reduced quality of life, and increased healthcare costs because it is a major indication for referral to gynaecological outpatient clinics. [2] About 25- 30% of abdominal hysterectomies are done for abnormal uterine bleeding. Decades have not changed this picture. [3] Dysfunctional uterine bleeding is a form of abnormal uterine bleeding for which no detectable pathology is found. It is the abnormalities of endometrial development and maturation, which are secondary to ovarian dysfunction. Dysfunctional uterine bleeding is defined as pathological bleeding from uterus unexplained on the basis of inflammation, neoplasia or pregnancy within the uterus. [4] A study showed high incidence of apparently normal endometrium in cases of Dysfunctional uterine bleeding. [5] The present study is undertaken to evaluate the histopathological patterns of the patients presenting with dysfunctional uterine bleeding. Methodology The present study was a prospective study, conducted in the Department of Pathology, Vijayanagar Institute of Medical Sciences, Ballari for a period of one year from January 2015 to December 2015. Patients of dysfunctional uterine bleeding attending outpatient department, admitted in OBG Department of VIMS, Ballari and other peripheral hospitals formed the source of data. Relevant clinical details were collected. Inclusion Criteria: Women presenting with abnormal uterine bleeding. Exclusion criteria: 1. Abnormal bleeding secondary to systemic diseases like coagulation disorders, hypothyroidism and cirrhosis. 2. Abnormal bleeding secondary to organic causes within the uterus like infection, pregnancy and neoplasia. 3. Abnormal bleeding secondary to cervical and vaginal lesions. Timing of Endometrial Biopsy: The best time for observing cyclical changes is between 7 th and 11 th postovulatory days. If tuberculosis is suspected, biopsy may be done on 12 th and 13 th postovulatory days. However in presence of abnormal uterine bleeding, it may be impossible to select the accurate time for biopsy. [6] The material consisted of endometrial biopsy and dilatation and curettage of the patients presenting with dysfunctional uterine bleeding. The specimens were fixed in 10% formalin and examined grossly for amount, colour and consistency. They were processed using automatic tissue processor