The Histological Spectrum Reported on Evacuated Endometrial Tissue From Patients With Secondary Postpartum Hemorrhage: A Pilot Study

Background/aim This study sought to explore the possible yield of pathology requests on tissue obtained in uterine evacuation for secondary postpartum hemorrhage (SPPH) at our institution over five years. Material and methods A content categorization of histological reports on endo-uterine tissue obtained from patients with secondary postpartum hemorrhage was undertaken. The aggregate tissue dimensions were also recorded. Additional information on the time elapsed between delivery and hospital presentation was deduced from medical records. Results From the 53 tissue samples reported, we clustered 114 descriptive mentions of phrases and terms and categorized them based on parent tissue, changes, and background cellularity. Inflammation and/or inflammatory changes were mentioned 18.4% of the time, no tissue was identified in 5.8% of instances, whilst placental tissue was encountered in 9.7% of specimens. Separately or in variable combination, decidua, decidualized tissue, hemorrhagic tissue, fibrinous material, and membranous tissue amounted to 48.5% of mentions. There was no correlation between aggregate tissue measurements and time elapsed since delivery. Conclusion Nearly half of the content of histological reports on tissue evacuated SPPH patients were consistent with expected findings on a postpartum endometrium. Remnants of placental tissue were mentioned in about 10% of instances.