Evaluation of abnormal uterine bleeding patients by conventional dilatation and curettage and hysteroscopically guided dilatation and curettage

Abstract

Introduction: Abnormal uterine bleeding (AUB) is a newly coined term for describing the condition, wherein there is any deviation from a normal menstrual pattern. It is the most often encountered gynecological problem. Dysfunctional uterine bleeding and bleeding from structural causes both are included in it. Each year approximately 10% of women aged 30–50 years consult a gynecologist for treatment. This makes it imperative to accurately diagnose and treat the cause. This study aims at judging the place of diagnostic hysteroscopy in obtaining an accurate diagnosis of the etiology of AUB and outlining a mode of treatment. This is done by correlating the findings on hysteroscopy and those found on conventional dilatation and curettage (D and C). Materials and Methods: This prospective study was performed in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College (DMIMS), Wardha, Maharashtra. Eighty cases of AUB were chosen based on inclusion and exclusion criteria. The patients were subjected to routine investigations, ultrasonography. Forty patients underwent conventional D and C and next 40 patients underwent hysteroscopic guided curettage with biopsy. The findings of the two were compared and analyzed. Results: AUB was the most common between 30 and 40 years…. Maximum patients had complaints for 3 months to 1 year. Menorrhagia was the most common presenting complaint. Normal findings were observed in 19 cases with conventional D and C of 40 cases and 3 cases with hysteroscopic-guided biopsy out of 40 cases. Abnormal findings were seen in 2.5% of cases of 40 cases with conventional D and C, 42.5% of cases of 40 cases with hysteroscopic guided biopsy. Conclusion: This study reveals the superior ability of hysteroscopic guided D and C with biopsy in evaluating patients with AUB when compared to conventional D and C. These findings are in agreement with those of many other studies.