Role of diagnostic hysteroscopy in evaluation of abnormal uterine bleeding and its histopathological correlation

Abstract

Objectives: To correlate hysteroscopic findings with histopathologic findings and study the accuracy of hysteroscopy in evaluation of abnormal uterine bleeding.Methods: This prospective study was conducted at Tertiary care hospital, Department of Obstetrics and Gynaecology SMGS GMC Jammu, from July 2019 to Feb 2020. 100 patients who were admitted with history of abnormal uterine bleeding were selected for this study. Reproductive aged, perimenopausal and postmenopausal females with age between 25-70 years were included while pregnant females, females with clinically palpable pelvic pathology, unhealthy cervix and coagulation disorders were excluded from this study. All patients underwent Hysteroscopy and D&C postmenstrually with consent. The hysteroscopic and histopathologic findings (after D&C) obtained were compared.Results: This study was conducted on 100 patients of age group between 25-70 years, with mean age 41.2 years. Menorrhagia (35%) was the commonest presenting symptom. Diagnostic efficacy of hysteroscopy in terms of accuracy 84.6% for proliferative endometrium, 84.46% for secretory endometrium, 89% for hyperplasia, 100% for polyp, 100% for myoma, 100% for endometrial CA respectively.Conclusion: Diagnostic accuracy of hysteroscopy was found better in polyps and submucous myomas which were missed by traditional D&C. Although the diagnostic accuracy of pathological abnormalities in our study was 75%, hysteroscopy has 100% accuracy for CA endometrium, Myoma and polyp.Hysteroscopically directed biopsy would be an ideal procedure in abnormal uterine bleeding wherever facilities are available.