A study to analyze and correlate histopathology of hysterectomy specimen, ultrasonography and clinical presentation in perimenopausal women with abnormal uterine bleeding
Roma Sharma, Achala Sahai
Background: Abnormal uterine bleeding (AUB) is defined as any variation from the normal menstrual cycle, including changes in regularity and frequency of menses, in duration of flow, or in amount of blood loss. Objectives: To study various USG findings, histopathology of hysterectomy specimens and bleeding patterns in perimenopausal women and to correlate it. Material and methods: It was a prospective observational study done from November 2017 to April 2019 on 250 perimenopausal women (aged 40 years and above till 1 year beyond menopause) with AUB. Results: Maximum number of cases 176 (70.4%) were in the age group of 40- 45 years. Out of 250 cases 109 cases (43.6%) belongs to parity 4. Majority of cases 136 cases (54.4%) presented with menorrhagia. AUB most common preoperative diagnosis or provisional diagnosis made by clinical examination was of fibroid in 94 cases (37.6%) followed by polyp and adenomyosis 17 cases. Out of 250 USG diagnosed 122 cases as fibroid (48.8%). Final diagnosis was made by HPE which showed leiomyoma in 107 cases. USG and HPE showed statistically substantial agreement (kappa= 0.647) in diagnosis of fibroid with p value < 0.05 showing that the result was significant. Conclusion: Enhancement in the skill and experience of examiner will go a long way in giving better and more accurate clinical diagnosis of AUB cases for timely intervention and management of AUB in perimenopausal women.