INTRODUCTION- Endometrial diseases are prevalent across all age group and to a great extent are a leading cause of increases mortility and morbidity.The majority of females with endometrial diseases present with abnormal uterine bleeding(AUB).(1,2) Abnormal Uterine bleeding (AUB) is dened as any departure from normal menstruation or from a normal menstrual cycle pattern.(3) Bleeding is considered abnormal when the pattern is irregular, abnormal duration , or menorrhagia or abnormal ammount.(4) Causes include functional causes like normal cyclical endometrium abnormal physiological changes of endometrium (atrophic endometrium, weakly proliferative endometrium, disordered proliferative) and organic lesions like chronic endometritis, hyperplasia, polyp, carcinomas and pregnancy related complications. Histopathological examination of endometrial biopsy is a major diagnostic tool in evaluation of abnormal uterine bleeding.(5) The underlying disaese can be detected by histological variations of endometrium taking into account the age of woman, the phase of her menstrual cycle and use of exogenous hormones. The aim of the study was to analyze the histomorphological patterns of endometrium in various age group of patients presenting with AUB and their frequencies. MATERIAL & METHOD- The study conducted in the histopathological section of department of pathology, SSMC, SGMH/GMH, Rewa, MP. Specimen of Endometrial tissue received in the duration of 6 month from January 2019 to june 2019 were included in the study. A total of 87 Specimen were received in 10% buffered neut ra l fo rmal in and were sub jec ted to rou t ine histopathological processing. Section of 5 micron thickness were taken and stained with H& E stain. The nal diagnosis was given after detailed study of these sections under the light microscope.Specimens where there is no endometrial tissue or no only minimal stromal elements or couldn't be concluded, in spite of the presence of some tissue, a diagnosis of inadequate for evaluation were given. RESULTS- The present study received 87 endometrial biopsy during 6 month of study period, of which 5 excluded from study due to inadequate sampling. The patient age ranges from from 20 years to 60 years . Maximum cases were in the age group of 31- 50 accounting for 86.5% of total cases. Table 1:- Cases in different age groups: Table 2:-Organic lesions of Abnormal Uterine bleeding STUDY OF HISTOPATHOLOGICAL LESION OF ENDOMETRIAL BIOPSY IN WOMEN PRESENTING WITH ABNORMAL UTERINE BLEEDING: A RETROSPECTIVE STUDY Original Research Paper Dr. Yogita Singh Tomar PG Resident & Room no. G-9 Sumati Pg Girls Hostel, Shyam Shah Medical college, sanjay gandhi hospital rewa, MP, India, (486001) Pathology Introduction: - Abnormal uterine bleeding is a common symptom of the patients in all age group. AUB is caused by a wide variety of causes in different age.Histopathological examination of endometrial biopsy is a major diagnostic tool in evaluation of AUB. Aim:- To study the endometrial lesion in all age group presenting with AUB. Methodology:-A retrospective study was designed to study of various D& C and endometrial biopsies sent for histopathological examination at department of pathology, Shyam Shah Medical College, Rewa, M.P. from 1st January 2019 to 30th June 2019.The study is based on the histopathological evaluation of endometrial biopsies received during the 6 month of study period. Result: - Total 87 specimen of endometrial biopsies were collected in 6 month of study period, of which 5 cases excluded from study due to inadequate sampling and 82 cases were analyzed. We found that all age group was presented with AUB but women with age group 36-50 years were more common. 53.7% cases were the organic cause and in which endometrial hyperplasia was most common. 46.3% cases were the functional causes in which proliferative phase was most common. 2 cases of endometrial carcinoma found. Conclusion: - Histopathological evaluation of endometrial samples can be used as rst step for diagnosis of abnormal uterine bleeding. ABSTRACT KEYWORDS : endometrial biopsy, functional, organic. Dr. Kalpit Agarwal PG Resident & F-3/4, New Doctors Colony, near PTS chauraha, Shyam Shah Medical college, sanjay gandhi hospital rewa, MP, India(486001) *Corresponding Author Dr. Santosh Singh Associate Professor, Dept of Pathology, shyam shah medical college & SGMH, Rewa. MP VOLUME-8, ISSUE-12, DECEMBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Dr. U. R. Singh Professor and Head, Dept of Pathology, shyam shah medical college & SGMH, Rewa. MP Age group No. of Patients % of Patients 20-30 yrs 06 7.31% 31-40 yrs 33 40.24% 41-50 yrs 38 46.34% 51-60 yrs 05 6.09% Total 82 100% Causes No. of Cases % of Cases Retained product of conception 06 13.6% H. mole 01 2.27% 84 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Table 3:-Functional Causes of Abnormal Uterine bleeding Table 4:- Distribution of Study subjects (n=82) according to histological diagnosis in different age group DISCUSSION- The present study shows that maximum number of cases were from 41-50 age group (46.3%) which is comparable with the different study. In the Present Study, most common histopathological ndings was proliferative endometrium(25.6%) followed by endometrial hyperplasia without atypia(19.5%) which was comparable with the Bhatta S et al(8) study in which 26.23% was proliferative endometrium and 18.03% was endometrial hyperplasia without atypia. Proliferative endometrium as a leading cause of AUB also seen in Deka R.R.et al(9) study(24.2%), Salvi A et al(10) study(37.2%), Khare et al(11)study(26.8%). In our study most common organic cause of AUB was due to endometrial hyperplasia (40.9%),which is consistent with other studies conducted by Anwar M et al(12) Study (62.8%) and Mirza T et al(13) study(30%). In reproductive age group, pregnancy related complications were the most common nding below 30 years of age and in 31-40 yrs of age cyclical endometrial change was predominant nding which is comparable to the study Deka RR et al (9) . In perimenopausal age,prol i ferat ive endometrium(32%) was the major cause which is comparable to the ndings in Daka R R et al(9) study(35.6%), Salvi et al (10) study (53%), Bhatta S et al(8) study(29.8%. Table 5:-Comparison of Causes of AUB with different study CONCLUSION- Endometrial causes of AUB are age related pathology. Histopathological examination of Endometrium is the gold standard to evaluate AUB.Accurate analysis of endometrial s a m p l i n g i s t h e k e y t o e f f e c t i v e t h e r a p y. T h u s Histopathological evaluation of endometrium is, especially, indicated in women over the age of 35 years presenting with AUB to rule out preneoplastic lesions and malignancies. REFERENCES- 1. Sarwar A, Haque A. Types and frequencies of pathologies in endometrial curretings of abnormal uterine bleeding.Int J Pathol. 2005;365-70. 2. Crum CP, Hornstein MD, Nucci MR, Mutter GL. Hertig and beyond: A systematic and practical approach to the endometrial biopsy.Adv Anat Pathol. 2003;10(6):301-18. 3. Ian S. Fraser, M.D., Hilary O.D. Critchley, M.D., Michael Broder, M.D. and Malcolm G. Munro, M.D.The FIGO recommendations on Terminologies and Denitions for Abnormal uterine blrrding, seminars in reproductive medicine 2011; vol 29(5)383-390 4. Speroff L, Fritz MA. In: Clinical gynecologic endocrinology and infertility. 7th edition. Jaypee Brothers Med Publishers (P) Ltd; 2005. Menopause and the perimenopausal transition;621-88. 5. Critchley HOD, Maybin JA. Molecular and cellular causes of abnormal uterine bleeding of endometrial origin. Semin Rerod Med 2011;29(5):400-409. 6. Elavarasan T, Puthiva RD, Shruthi MS , Shylaja S.Histopathological study of endometrium in abnormal uterine bleedding An Experience in a tertiary care centre of Rural south India, NJBMS 2017; 8(1)32-38. 7. Rajagopal I, Thomas BM, Rao VNKR. Endometrial pathology in abnormal uterine bleeding,IJRMS,oct 2019;7(10)3762-3766. 8. Bhatta S, Sinha AK. Histopathological study of endometrium in abnormal uterine bleeding, Journal of pathology of nepal 2012;2,297-300. 9. Deka RR, Saikia T, Handique A, Sonowali B. Histopathological spectrum of Endometrial changes in women presenting with Abnormal Uterine Bleeding with Special Reference to Endometrial Malignancies: A two years Hospital Based Study.AABS 2016; 3(2):152-157. 10. Salvi A, Mital P, Hooja N, Batar Alka, Soni P, Beniwal R. Spectrum of endometrial histopathology in women presenting with abnormal uterine bleeding Sch. App Med Sci,2015;3(1A):1-4. 11. Khare A, Bansal R., Sharma S, Elhence P. Makkar N, Tyagi Y. Morphological spectrum of Endometrium in patients presenting with dyfunctional uterine bleeding. People’s Journal of Scientic Research.2012;5(2):13-16. VOLUME-8, ISSUE-12, DECEMBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Endometrial Polyp 07 15.9% Leiomyoma 06 13.6% Chronic Endometritis 04 9.1% Endometrial hyperplasia without atypia 16 36.4% Endometrial hyperplasia without atypia 02 4.5% Endometrial Carcinoma 02 4.5% Total 44 100% Causes No. of cases % of Cases Proliferative phase 21 55.3% Secretory phase 06 15.8% Proliferative Anovulatory phase 04 10.5% Disorderd Proliferative endometrium 03 7.9% Hormaonal changes/Decidualization 04 10.5% Total 38 100% Histopathological diagnosis5 20-30yrs 31-40yrs 41-50yrs 51-60yrs RPOCs 5(83.3%) 1 H.Mole 1(16.6%) Endo. Polyp 5 2 Leiomyoma 2 4 Chronic endometritis 1 2 1 EH without atypia 5 9(23.6%) 3 EH with atypia 1 1 Endo. Carcnoma 2 Proliferative Phase 9(27.27%) 12(34.2%) Secretory Phase 4 2 Anovulatory Phase 2 2 Disorderd proliferative endometrium 2 1 Hormonal changes/pseudodeci dualization 2 3 Total 6 33 38 5 Study Elavarasan. T et al study(6) Rajgopal I et al study(7) Bhatta S et al study(8) Present study Cases 111(48.7%) 81(48.5% 48(39.3%0 57(46.3%) Study/ Causes EH PP SP RPOC Endo. Carcinoma Deka R.R. et al study(9) 15 (11.3%) 32 (24.2%) 16 (12.1%) 25 (18.9%) 01 (0.75%) Chhatrasal et al study(14) 395 (25.5%) 117 (7.6%) 372 (24.1%) - 28 (1.8%) Rajgopal I et al study(7) 38 (22.6%) 15 (8.9%) 40 (23.9%) 6( 3.5%) 3 (1.7%) Bhatta S et al study(8) 22 (18.03%) 32 (26.23%) 20 (16.39%0 - 7 (5.74%) Present Study 18 (21.9%) 21 (25.6%) 06 (7.3%) 06 (7.35%) 02 (2.4%) X 85GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS