Profiling the pathological findings of diagnostic curettage for abnormal uterine bleeding a retrospective cross-sectional study among reproductive-aged women

Abstract

Background: Abnormal uterine bleeding (AUB) is a common condition among women of reproductive age. This symptom is characterized by irregularities in menstrual frequency, duration, and volume. Early detection and management of AUB are crucial for improving women's health outcomes. This study aimed to assess the pathological findings of diagnostic curettage (D&C) in women of childbearing age with AUB at Afzalipour Hospital, Kerman, Iran.

Methods: This cross-sectional study included 1053 women aged 15-49 who underwent D&C for AUB between 2020 and 2021. Patient demographics and histopathological findings were gathered retrospectively from the pathology reports. Statistical analysis was conducted using the Kruskal-Wallis test to evaluate the relationship between pathological findings and patient age.

Results: Among the participants, 99.3% of the findings were benign, with pregnancy-related issues, normal-phase lesions, and hormone imbalances being the most common diagnoses, respectively. The average ages for the normal phase and pregnancy-related issues were significantly lower than those for malignancies, which were predominantly found in older women (average age of 45 years). Statistical analysis revealed significant age-related differences in the types of pathologies (P-value <0.001).

Conclusion: This study suggests that benign conditions are the primary cause of AUB in younger women, whereas the risk of malignancy increases with age. These findings underscore the importance of targeted diagnostic approaches, timely interventions, and appropriate management, particularly in resource-limited countries, such as Iran.

Keywords: AUB; abnormal uterine bleeding; bleeding; pathology; reproductive age; women.

Figure 1.

Sample of patient’s microscopic representation with hematoxylin and eosin (H&E) staining. (A) Proliferative endometrium. (B) Secretory endometrium. (C) Disordered proliferative endometrium.

Figure 2.

Age distribution of different categories of pathology findings.

Figure 3.

Age distribution of various subgroups of pathology findings. (A) Normal phase; (B) hormone imbalance; (C) pregnancy; (D) polyp; (E) hyperplasia; (F) adenocarcinoma subgroups. POC, product of conception.