Endometrial histological patterns and associated factors of abnormal uterine bleeding among women seeking gynecological services from referral hospitals in Western Uganda: a cross-sectional study.

Abstract

Background: Women of all ages are susceptible to abnormal uterine bleeding (AUB), a relatively frequent gynecological issue. In the gynecology outpatient department, abnormal uterine bleeding is a problem that affects one-third of the patients, making them feel less financially secure and have a lower quality of life. Our study aimed to determine the endometrial histological patterns and factors associated with abnormal uterine bleeding among women seeking gynecological services from referral hospitals in western Uganda.

Methods: A cross-sectional study was conducted from June 2023 to September 2023. We systematically enrolled 361 participants after getting consent. A structured questionnaire was used to collect information needed for analysis. The endometrial samples were collected immediately from eligible patients with Abnormal Uterine bleeding and taken to the histopathology laboratory for examination. Descriptive statistics followed by binary logistic regression were conducted to achieve the study objectives.

Results: The study enrolled 361 participants with the mean age was 32.7 years (SD = 12.5). Of the total participants, 54(14.96%) had Abnormal Uterine bleeding. The common endometrial histological patterns among women with Abnormal uterine bleeding were; proliferative endometrium 21(38.9%), simple endometrial hyperplasia without atypia 11(20.4%), and secretory Endometrium 6 (11.1%). Women with BMI ranging between 25 and 29.9 [aOR = 5.61 (1.42-22.19), p = 0.014], those with a history of genital infection in the past 1 year [aOR = 2.49 (1.2-5.13),p = 0.013], those who were nulliparous [ aOR = 13.31( 4.94-35.82), p = 0.001], Primiparous [aOR = 4.32( 1.83-10.16), p ≤ 0.001] and women who reported HIV positive serostatus [aOR = 3.65(1.74-7.66), p = 0.001] were independently associated with Abnormal Uterine Bleeding at Fort portal Regional Referral hospital.

Conclusions and recommendations: The prevalence of AUB was within the global range. Simple endometrial hyperplasia without atypia and chronic endometritis were the commonest pathological patterns. BMI, History of genital infection, nulliparity, primiparity, and HIV serostatus were the factors that were independently associated with abnormal uterine bleeding. There is a need for routine endometrial sampling for all eligible women with abnormal uterine bleeding at FRRH.