Diagnostic comparison of ultrasonography, hysteroscopy and histopathology in abnormal uterine bleeding

Srushti Sunil Raut; Kavita Babbar

doi:10.18203/2320-1770.ijrcog20242076

Authors

Srushti Sunil Raut Department of Obstetrics and Gynecology, Apollo Hospitals, Bilaspur, Chhattisgarh, India
Kavita Babbar Department of Obstetrics and Gynecology, Apollo Hospitals, Bilaspur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20242076

Keywords:

Hysteroscopy, Abnormal uterine bleeding, Ultrasonography, Diagnostic accuracy

Abstract

Background: The objective of the study was to do diagnostic comparison of ultrasonography, hysteroscopy and histopathological examination in evaluation of abnormal uterine bleeding.

Methods: An observational prospective study is conducted amongst 219 married women between age of 25 years to 59 years with Abnormal uterine bleeding admitted for diagnostic hysteroscopy at Obstetrics and Gynecology Department, Apollo Hospital, Bilaspur, Chhattisgarh from November 2022 to October 2023. Statistical analysis was assessed by chi square test.

Results: Myoma is best diagnosed by Sonography. The exact size, shape, type of fibroid and location can be accurately diagnosed by USG. Endometrial hyperplasia, endometrial polyp, submucous fibroid, growth, septum, flimsy adhesions, focal lesions and intracavitary intrauterine lesions are best diagnosed by hysteroscopy. Endometrial carcinoma is best diagnosed by histopathology.

Conclusions: Hysteroscopy has important role in diagnosis of intrauterine and endocervical canal abnormalities. Addition of hysteroscopy with histopathological examination of endometrial and cervical biopsy sample along with transvaginal ultrasonography enhances the accuracy of diagnosis. Use of hysteroscopy, ultrasonography and histopathology were not competitive rather complementary for diagnosing patients with abnormal uterine bleeding. Diagnostic tools like ultrasonography, hysteroscopy and histopathology helps in accurate, early diagnosis of endometrial and cervical cancer which prevents further damage and further spread and metastasis of disease to adjacent tissues/ organs. Early diagnosis and cure increases life expectancy and decreases morbidity and mortality.

Metrics

Metrics Loading ...

References

Lasmar EB, Dias R, Barrozo PRM, Oliveira MAP, Coutinho EDSF, Rosa DBD. Prevalence of hysteroscopic findings and histologic diagnosis in patients with abnormal uterine bleeding. Fertil Steril. 2008;89(6):1803-5.

Chowdhury, L. Ultrasonography in Gynecology. J Obstet Gynecol India. 2015;65:65-6.

Günakan E, Atak Z, Albayrak M, Kurban Y, Şimşek GG. Endometrial histopathology results and evaluation of endometrial cancer risk in geriatric women. Prz Menopauzalny. 2018;17(1):18-21.

Munro MG, Critchley HOD, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynecol Obstetr. 2011;113(1):3-13.

Valson H, Kulkarni C, Mukerjee S, Gowda SN. The role of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation following blind dilatation and curettage. Int J Reprod Contracept Obstet Gynecol. 2016;5(3):609-15.

Kumaresan S, Perumal D. A clinical study of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation. Int J Reprod Contracept Obstet Gynecol. 2018;7(2):396-400.

Patil SG, Bhute SB, Inamdar SA, Neema SA, Deepti SS. Role of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation. J Gynecol Endosc Surg. 2009;1(2):98-104.

TrajkovicDinic SP, Kopitovic V, Antic V. Role of hysteroscopy in evaluation of patients with Abnormal uterine bleeding. Sci J Facul Medi Nis. 2011;28(3):177-81.

Gita G, Kaur SS, Arvind L, Shashi K. Hysteroscopy in evaluation of abnormal uterine bleeding. J Obs Gyn India. 2011;61(5):546-9.

Nanda SS, Dash S, Behera A. Diagnostic value of hysteroscopy in perimenopausal abnormal uterine bleeding compared to histopathologic study of blind D and C. J Evolut Medi Dent Sci. 2013;2(39):74-97.

Singh S, Taneja BK, Singh P, Ahlawat R. Role of diagnostic hysteroscopy in abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2014;3(3):544-51.

Munusamy MM, Sheelaa WG, Lakshmi VP. Clinical presentation & prevalence of uterine fibroids: a 3year study in 3decade rural South Indian women. Int. J Reprod Contracept Obstet Gynecol. 2017;6(12):5596-601.

Clark TJ, Middleton LJ, Am Cooper N, Diwakar L, Denny E, Smith P, et al. A randomized controlled trail of outpatient versus inpatient polyp treatment (OPI) for abnormal uterine bleeding. Health Technol Assess. 2015;19(61):101-194.

GGA Abnormal uterine bleeding. Gynecol Reproduct Health. 2017;1(4).

Dreisler E, Stampe Sorensen S, Ibsen P H, Lose G. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years. Ultrasound Obstet Gynecol. 2009;33(1):102-8.

Moore E, Shafi M. Endometrial hyperplasia. Obstetr Gynaecol Reproduct Medi. 2013;23(3):88-93.

Vaidya R, Vinayachandran S, Devi S, Prejisha B, Lekshminath G, Sreedharan S, et al. Prevalence of abnormal uterine bleeding and its associated risk factors in women of perimenopausal age groupa retrospective study. J Clin Diagnos Res. 2022;16(12):QC09-13.