Morphometric Evaluation Of Endometrial Blood Vessels In Patients Presenting With Abnormal Uterine Bleeding.

Abstract

Background – Abnormal uterine bleeding (AUB) is one of the commonest problem encountered in gynaecological practice. The incidence of AUB in perimenopausal and postmenopausal women is more than 70% of all gynaecological problems. Various benign and malignant disorders of endometrial tissue show vascular changes such as congestion, dilatation, and vessel wall irregularities. Hence the present study was done to evaluate the role of vascular morphometry in patients presented with AUB. Objectives of the study: To evaluate morphometry of endometrial blood vessels and morphological pattern of endometrium in various endometrial lesions in patients presenting with history of AUB. Materials and Methods: A prospective cross sectional study of endometrial blood vessels in patients presented with AUB was undertaken for morphometric analysis. This study was carried out for a duration of 18 months from 1st December 2018 - 30thMay 2020. Endometrial tissue samples such as dilatation and curettage (D and C) sample, endometrial biopsy, fractional curettage and endometrial tissue processed from hysterectomy specimen were included in the study. Paraffin blocks were prepared and tissue section of 3-6 μ thickness were cut, H and E staining was done and were evaluated for vascular morphometry. Evaluation of vascular morphometry was done under the following headings stating as average number of blood vessels/HPFs, vessel size, contour of blood vessels, degree of dilatation and congestion. DocuSign Envelope ID: FC8F0C950FCD14E0--288F089D-4-4179615-B-B5566C3--E8F9D1275A21604EBFB372AB X Results:- Total 150 cases of endometrial tissue in patients presented with AUB were studied. Out of it, 80 cases were reported as proliferative phase, 41 as secretory phase, 15 as disordered proliferative endometrium (DPE), 6 as atrophic phase, 4 as simple hyperplasia without atypia and 4 as endometrial carcinoma. Average number of endometrial blood vessels/HPF in endometrial carcinoma and simple hyperplasia without atypia were more as compared to proliferative, secretory, atrophic and DPE. Endometrial carcinoma and simple hyperplasia without atypia showed large sized blood vessel. Vessel shape irregularities and vascular congestion was observed in all the cases of atrophic phase endometrium, endometrial carcinoma and simple hyperplasia without atypia. Endometrial carcinoma showed significant severe dilatation of endometrial blood vessels. Vascular dilatation was statistically significant with p value less than 0.001. Conclusion: - Vascular morphometry plays an important role in various endometrial lesions and can be used to plan the anti-angiogenic therapy in patients presenting with abnormal uterine bleeding