Comparative study of hysteroscopy with ultrasonography and its correlation with histopathology in cases of abnormal uterine bleeding in perimenopausal women

Abstract

Aim: To compare the diagnostic efficacy of ultrasonography and hysteroscopy in detecting uterine abnormalities in abnormal uterine bleeding by correlating the results with histopathological examination. Material and Method: This prospective study was conducted among women attending OPD of Department of Obstetrics and Gynaecology, IMS & SUM Hospital, Bhubaneswar from April 2019 to March 2021. A total of 100 perimenopausal women with abnormal uterine bleeding attending Obstetric and Gynaecology OPD were included in this study. All patients underwent transvaginal scan to note down the endometrial thickness and to rule out uterine and adnexal pathology. All the patients underwent diagnostic hysteroscopy, followed by a biopsy of the endometrium. The endometrium was sent to the pathologist. Findings of these diagnostic modalities then correlated. Results: Out of 100 women, USG detected that 54 patients (54%) had no pathology and 46 patients (46%) had abnormal findings, out of which maximum patients i.e., 29 patients (63.04%) had endometrial hyperplasia. According to Hysteroscopy, 46 patients (46%) had normal hysteroscopic findings while 54 patients (54%) had abnormal findings of which maximum were 18 patients (33.33%) who had endometrial hyperplasia. Histopathology findings revealed that 47 patients (47%) had normal findings and 53 patients (53%) had abnormal findings out of which maximum patients 20(37.7%) had endometrial hyperplasia. In our study of 100 women with AUB, on USG only 1 patient had endometrial malignancy and the same was reported by hysteroscopy and histopathology. Conclusion: In our study hysteroscopy proved to be highly sensitive and specific considering histopathology as gold standard. Ultrasonography has good sensitivity and specificity but less as compared to hysteroscopy.