Abstract

ABSTRACT:
BACKGROUND:
Bleeding that occurs 12 months or more following the last menstrual period is known as postmenopausal bleeding.
OBJECTIVE:
Is to assess the frequency and pattern of uterine lesions in women with post-menopausal bleeding and to correlate the histopathological changes with clinical variable i.e. the age, associated illness, parity and ultrasonography finding.
MATERIALS AND METHODS:
A retrospective study, which include analysis of 110 cases of women presented with post-menopausal bleeding, the samples were collected from the Teaching Laboratories of Al-Imamain Al-Kadhumain, and Baghdad Medical City from January 2020 to June 2021. For each case  the histopathological reports, slides  and  Paraffin block (if needed)  were collected, in addition the clinical parameters such as age, parity, history of previous Dilatation &Curettage, diabetes mellitus and/or hypertension, and ultrasound findings such as (endometrial thickness, uterine size) were also obtained.
RESULTS:
The age range of 110 cases was (45-90 years) with a mean age of 58 years ± 6.6 years. Hypertension was the most common associated illness as it was present in (42.7%) cases. Diabetes mellitus was present in (33.6%) patients. The parity distribution was (4.5%) cases recognized as nulliparous, and (95.4%) were multiparous. The endometrial thickness obtained from ultrasonography ranged from (3-25) mm and distributed as following: 22 (20%) cases were equal to or less than 4 mm, and (80%) were more than 4mm.The most common histopathological diagnosis was endometrial hyperplasia with frequency of (28.5%) of cases and (10.9%) cases were diagnosed as carcinoma.
CONCLUSION:
The most common etiology for postmenopausal bleeding was endometrial hyperplasia. While, the lowest one was chronic endometritis. There is significant correlation between the clinical parameters with endometrial hyperplasia and malignancy.