The New Indian Journal of OBGYN. 12(1):179-182

A hysteroscopic view of abnormal uterine bleeding

Divya Sharma, Mita Mazumdar

ABSTRACT

Background: Abnormal uterine bleeding (AUB) is the most common presenting complaint in reproductive age women. A complete real time visualization of endometrial cavity by hysteroscopy would be the best modality to investigate the etiology of AUB and give targeted treatment to women avoiding unnecessary hysterectomies. Aims and objectives: 1.To evaluate the diagnostic relevance of hysteroscopy in cases of abnormal uterine bleeding; 2. To correlate findings on hysteroscopy with ultrasound findings and histopathology of uterine tissue. Materials and methods: A prospective study was undertaken in the Department of Obstetrics and Gynaecology of RKDF Medical College, Bhopal from December 2018 to January 2022. 100 consecutive patients were enrolled in the study. All cases underwent pelvic ultrasound followed by hysteroscopy. Endometrial sampling and histopathological study were done. The findings of ultrasonography, hysteroscopy and histopathology were compared and analyzed. Results: On hysteroscopy among 100 patients abnormal findings were documented in 71 patients. In comparison, on histopathology among these 100 cases, pathology was detected in 64 cases. The most common abnormality detected in the 71 hysteroscopy positive cases was endometrial hyperplasia, in 41 cases. The sensitivity of hysteroscopy was found to be 71.83% with 95% confidence intervals and specificity was found to be 55.17% when compared using histopathology as the gold standard. Conclusion: Hysteroscopy is the gold standard diagnostic modality in the evaluation of AUB as it combines the diagnostic benefits of sonography and histology. In combination, ultrasonography, hysteroscopy with endometrial biopsy can be a potent tool to diagnose gynaec pathologies and treat them without resorting to hysterectomy.