Clinical Presentation, Diagnostic Findings, and Management of Abnormal Uterine Bleeding: A Case Series

Abstract

Aims: To describe the clinical profile, aetiological patterns, diagnostic findings, and management               approaches among women presenting with abnormal uterine bleeding (AUB) in a tertiary-care gynaecology setting. Presentation of Cases: This descriptive case series included five women with AUB managed at Queen Mary Hospital, King George’s Medical University, Lucknow, during January–April 2026. The cases represented a broad clinical spectrum, including suspected synchronous endometrial and ovarian malignancy in a postmenopausal woman, clinically documented stage IIB cervical carcinoma with chronic kidney disease and severe anaemia, a large intramural uterine fibroid in a young woman, a submucosal FIGO type 0 fibroid in a multiparous woman, and endometrial tissue showing glandular crowding and nuclear atypia in a perimenopausal woman. Clinical examination, haematological investigations, ultrasonography, magnetic resonance imaging, cervical biopsy, and endometrial tissue examination were used according to clinical indication. Management ranged from medical treatment and supportive care to blood transfusion, bilateral DJ stent placement, major surgery, chemotherapy, and radiotherapy. Discussion: AUB occurred across reproductive, perimenopausal, and postmenopausal age groups. Fibroid-related disease and suspected or confirmed gynaecological malignancy were prominent clinical diagnoses. Anaemia was substantial in several cases, including haemoglobin values of 4.2 and 5.5 g/dL. The series illustrates the importance of evaluating persistent and postmenopausal bleeding, distinguishing clinical or radiological suspicion from histopathological confirmation, and individualising management according to age, disease severity, comorbidities, and diagnostic findings. Conclusion: This case series demonstrates the heterogeneous presentation of AUB and the need for timely assessment, appropriate imaging and tissue diagnosis when indicated, correction of anaemia, individualised treatment, and close follow-up. Because long-term outcomes and complete pathological details were not available for every case, the observations are descriptive and should not be generalised beyond the reported cases.