TO EVALUATE THE ROLE OF CHROMO HYSTEROSCOPY IN ABNORMAL UTERINE BLEEDING

Abstract

Objective: To evaluate the role of chromohysteroscopy in improving diagnostic accuracy of endometrial biopsy in cases of AUB.

Design: This observational prospective study was conducted in 60 women with complaint of AUB attending, outpatient Department of Obstetrics and Gynaecology at SMS Medical College, Jaipur over a period of one year. Conventional hysteroscopy was followed by chromo hysteroscopy using 5 ml of 1% methylene blue. Differential patterns of staining noted. Focal staining was considered positive finding whereas diffuse light blue staining was considered as normal finding. These findings were compared with the previously noted findings (on conventional hysteroscopy).Biopsies were obtained from differentially stained areas. Hysteroscopic and chromo-hysteroscopic findings were correlated with histopathology results.

Result  The diagnostic accuracy of chromo hysteroscopy in detecting endometrial disease was found to be high (Sensitivity - 85.70%, specificity - 84.80%, negative predictive value - 95.10%, positive predictive value - 63.20%). 2 cases of chronic endometritis, 4 cases of simple hyperplasia and 2 cases of complex hyperplasia were detected on chromo hysteroscopy which were missed on conventional hysteroscopy.

Conclusion: chromo hysteroscopy has definitely increased the efficacy of conventional hysteroscopy in diagnosing as well as excluding endometrial disease in AUB.

Keywords: Abnormal uterine bleeding, chromohysteroscopy, diffuse light blue staining, endometrial pathology, focal staining.