DIAGNOSTIC ACCURACY OF CHROMOHYSTEROSCOPY IN DIAGNOSIS OF UNDIAGNOSED ENDOMETRITIS IN WOMEN WITH ABNORMAL UTERINE BLEEDING (AUB)

Abstract

Introduction: Chronic endometritis has been related to abnormal uterine bleeding but being a clinically silent disease, it is often asymptomatic. In absence of findings in TVS as well as in fluid hysteroscopy, endometrial dyeing using methylene blue helps in identifying abnormal areas and with HPE examination gives a better diagnosis of endometritis.

Methods:  This study included 27 women with abnormal uterine bleeding in Department of Obstetrics and Gynaecology at SMS Medical College, Jaipur over a period of one year. All women underwent hysteroscopy and in the absence of any macroscopic abnormalities, chromohysteroscopy using 1% methylene blue dye. Biopsy was taken from light as well as dark stained areas. The histopathological results of these samples were compared and analysed in relation with differential staining pattern on chromohysteroscopic findings and diagnostic accuracy was calculated.

Results: Out of total 27 patients with AUB, 21 had DLS and 6 had FDS on chromohysteroscopy. 4(66.67%) patients of FDS were positive for endometritis on HPE. FDS had sensitivity, specificity, PPV and NPV as 100%, 91.30%, 66.67% and 100% respectively.

Conclusion:  Chromohysteroscopy is a new, gainful and remunerative adjunct to hysteroscopy, for targeted sampling from correct site, worth pursuing to improve the diagnostic accuracy of endometrial biopsy.

Keywords: AUB, chromohysteroscopy, chronic endometritis.