Abnormal uterine bleeding (AUB) is one of the common yet complicated complaints to the gynecologist’s office, accounting for at least one-third of outpatient gynecology visits. There are different patterns of AUB across age groups, with causes being either functional or structural. Different studies done across Africa and internationally all show varied results in the predominant histopathological patterns across different age groups. Endometrial sampling is the gold standard of diagnosis in patients presenting with AUB. Interpreting these endometrial biopsy samples starts with determining specimen adequacy. While there is no universally accepted method of determining adequacy in endometrial biopsies, several studies have attempted to define it, both qualitatively and quantitatively. There is also interobserver and intraobserver variability in interpreting endometrial biopsy specimens, particularly in endometrial dating. This study aims to determine the proportion of histopathological patterns of endometrial biopsies in women presenting with AUB, as well as help to define adequacy criteria suitable for our facility and improve reporting consistency among pathologists.

This is a descriptive retrospective study which will use tissue blocks of endometrial biopsy specimens received at the Gaborone National Health Laboratory (NHL) from January 2021 to December 2025. The study will require 384 endometrial samples, whose blocks will be retrieved from archives for sectioning and staining. The microscopic slides will then be read by the principal investigator and two other supervisors, all of whom will comment on specimen adequacy and provide a histopathological diagnosis. The data retrieved will be captured in Microsoft Excels spreadsheet and analyzed using Stata 13.1.

The results of this study will guide pathologists in terms of endometrial biopsy specimen adequacy criteria and understanding interobserver variability, thus improving reporting consistency. The findings of the proportions of endometrial histopathological patterns among different age groups can guide management by clinicians, including the need for biopsy.