"Role of Hysteroscopy in Cases of Perimenopausal Abnormal Uterine Bleeding and its Correlation with Histopathology"

Authors: Shikha S*, Sinha M and Shubhangi Gupta

DOI: 10.23880/oajg-16000297

Volume 9, Issue 4

Abstract

Introduction: Abnormal uterine bleeding (AUB) is a common clinical issue among perimenopausal women aged 40-49 years, often requiring multifaceted diagnostic approaches. This study aimed to evaluate the role of hysteroscopy in diagnosing causes of AUB in this demographic profile and correlate its finding with histopathological results to enhance diagnostic accuracy and treatment outcomes. Material & Methods: This prospective observational study included 60 perimenopausal women aged 40-49 years presenting with AUB at the Department of Obstetrics and Gynaecology, Shri Ram Murti Smarak Institute of Medical Sciences, between August 2022 and January 2024. Participants underwent a comprehensive clinical assessment, including blood tests, transvaginal sonography, and diagnostic hysteroscopy followed by endometrial sampling. The findings were correlated with histopathological reports, and statistical analysis was performed using SPSS version 23 to determine significance and correlations. Results: The largest age group was 48-49 years (23%). Socioeconomic status was evenly distributed across lower middle, upper lower, and lower classes each (25%), with upper primary education being the most common educational status (33%). Frequent and heavy bleeding was the predominant symptom 37%, with 50% of participants experiencing symptoms for less than 12 months. For diagnosing endometrial polyp histopathology being the gold standard demonstrated the highest sensitivity and specificity of 98% and 100% respectively, followed by hysteroscopy with 90% sensitivity at 95% specificity and TVS with sensitivity of 85% at specificity of 90% respectively. For diagnosing secretory endometrium, submucous leiomyoma, endometrial carcinoma histopathology remains the gold standard with highest sensitivity and specificity followed by hysteroscopy and TVS. Conclusion: The study found that TVS, hysteroscopy and histopathology are effective diagnostic tools for AUB in perimenopausal women, with histopathology being the gold standard. Combining these methods enhances diagnostic accuracy and confirms better treatment planning, underscoring the importance of a comprehensive approach in managing AUB.

Keywords: Abnormal Uterine Bleeding; Perimenopausal Women; Hysteroscopy; Histopathology; Diagnostic Accuracy; Transvaginal Sonography

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