Histopathological Evaluation of Endometrial Curettage in Patients with Abnormal Uterine Bleeding: A Retrospective Study in Al Kharj City, Saudi Arabia

International Journal of Biomedicine 15(4) (2025) 674-678 http://dx.doi.org/10.21103/Article15(4)_OA4 ORIGINAL ARTICLE INTERNATIONAL JOURNAL OF BIOMEDICINE Obstetrics and Gynecology Histopathological Evaluation of Endometrial Curettage in Patients with Abnormal Uterine Bleeding: A Retrospective Study in Al Kharj City, Saudi Arabia Ali Hassan A. Ali1, 2 *, Wafaey Badawy3, Samah O. Mohager1, Saud A. Alsharif4, Rabie Elsayed I. Elshaer5,6, Aryam Shudayyid R. Almutairi7, Haya Abdulaziz M. Alwtaidy7, Asma Muneer S. Alharthi7, A ⁠ rwa Ibrahim Alwabran7, Shahad Mohammed S. Alkhashan7, Amerah Omar Qirat7, Mariyyah Abdulrahman Alnathir7, Razan Saleh A. Hazzaa7, Shahad Zaid M. Aloqayli7 Basic Medical Science Department, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia 2 Anatomy Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt 3 Department of Pathology, Military Industries Hospital, Al-Kharj, Saudi Arabia 4 Department of Obstetrics & Gynecology, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia 5 Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt 6 Histopathology Department, Delta Medical Lab., Riyadh, Saudi Arabia 7 College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia 1 Abstract Background: One of the most common issues that adult females face is abnormal uterine bleeding (AUB). The preferred sampling method for identifying endometrial pathology is still uterine curettage or biopsy. Hormonal imbalance patterns, atrophic endometrium, endometritis, endometrial polyps, endometrial hyperplasia, and endometrial cancer are examples of common diseases. The purpose of this study was to identify the endometrial histological pattern in women of different ages who presented with AUB. Methods and Results: In this retrospective study, the medical records of 309 women who had endometrial curettage for AUB were reviewed. Every endometrial curettage specimen received for histological examination between January 2025 and June 2025 by the histopathology department of the Al Kharj Military Industries Corporation Hospital, in cooperation with the Department of Obstetrics and Gynecology, PSA Hospital, is included in the study. Endometrial biopsies were taken using a dilation and curettage (D&C) procedure. Following hematoxylin and eosin staining, a microscopic analysis was conducted. The most common histopathological finding was proliferative endometrial disorders (34.95%), followed by endometrial polyps (32.36%). Endometrial hyperplasia without atypia was found in 91 cases (29.45%). Endometrial adenocarcinoma was the sole diagnosis in four cases (1.29%). Conclusion: Abnormal uterine bleeding may be the only complaint presented by patients with endometrial lesions. Endometrial curettage and biopsy are reliable procedures for detecting endometrial pathology.(International Journal of Biomedicine. 2025;15(4):674-678.) Keywords: histopathology • abnormal uterine bleeding • endometrial curettage • Al Kharj For citation: Ali AHA, Badawy W, Mohager SO, Alsharif SA, Elshaer REI, Almutairi ASR, Alwtaidy HAM, Alharthi AMS, Alwabran AI, Alkhashan SMS, Qirat AO, Alnathir MA, Hazzaa RSA, Aloqayli SZM. Histopathological Evaluation of Endometrial Curettage in Patients with Abnormal Uterine Bleeding: A Retrospective Study in Al Kharj City, Saudi Arabia. International Journal of Biomedicine. 2025;15(4):674-678. doi:10.21103/Article15(4)_OA4 675 A. H. A. Ali et al. / International Journal of Biomedicine 15(4) (2025) 674-678 Introduction The most prevalent gynecologic symptom and complaint among gynecological outpatients is abnormal uterine bleeding (AUB), which affects women of all ages. 1 It has a noticeable impact on quality of life and places a significant financial strain on women’s health care. Healthcare professionals routinely deal with this issue. There are several classifications and definitions for AUB. A loose definition of it would be a deviation from the typical menstrual cycle. Variations may occur in the amount of blood loss, regularity, frequency, or length of the flow. Excessive monthly blood loss that interferes with a woman’s physical, social, emotional, and/or material quality of life is sometimes referred to as “heavy” bleeding. Abnormal uterine bleeding can have a variety of reasons, including systemic, anatomical, and drug-related ones. Chronic endometritis, endometrial polyps, and endometrial hyperplasia are common reasons for AUB. Patients who have a malignant or premalignant endometrial lesion may present with AUB.2 Thyroid issues, submucosal fibroids, and coagulation abnormalities can all contribute to ovulatory AUB, or menorrhagia.3 Following examination and ruling out premalignant and malignant etiology, many of the treatment strategies are the same.4 Menstrual cycles may be regulated by treatment with progestins or combination oral contraceptives. Treatment options for histologic evidence of hyperplasia without atypia include continuous or cyclic progestin. Gynecologists or gynecologic oncologists should be consulted for women with hyperplasia with atypia or adenocarcinoma, respectively. The most reliable method for determining the causes of atypical uterine bleeding is still endometrial biopsy followed by histological analysis. Endometrial curettage is a simple and safe method for endometrial collection, and its histopathological analysis is regarded as the gold standard for diagnosing the cause of AUB. It also has a fair turnaround time and high diagnostic accuracy.5 The purpose of this study was to identify the endometrial histological pattern in women of different ages who presented with AUB. AUB were included. The study excluded patients who met the following criteria: unsatisfactory samples, such as only fibrin and blood clots and no endometrial glands or stroma; AUB from gestational causes, such as tubal pregnancy, molar pregnancy, or abortion; hormone therapy during the previous six months; and cervical pathology, such as cervical cancer. The cause of AUB was confirmed by microscopic examination of the slides. SPSS software was used for statistical analysis. Results This study included 309 patients, ranging in age from 34 to 81 years, with a mean age of 48.9±7.9 years. Among 309 patients, 236 (76.38%) were married, 33 (10.68%) were widows, and 40 (12.94%) were divorced. The majority of patients (73.79%) had a parity of three to four. 173 patients (55.99%) experienced AUB for less than six months (Table 1). The percentage of endometrial histological findings after uterine curettage in AUB patients is shown in Table 2. Table 1. Age, marital status, and obstetric history of the study population (n=309). Parameter Category No. of patients Percentage Age <40 40-50 51-60 > 60 11 189 99 10 3.56% 61.16% 32.04% 3.24% 173 65 39 32 55.99% 21.04% 12.62% 10.36% <6 months 7-12 months Duration of bleeding One-two (...truncated)