CLINICAL, HYSTEROSCOPIC AND HISTOPATHOLOGICAL EVALUATION OF WOMEN WITH ABNORMAL UTERINE BLEEDING IN REPRODUCTIVE AND PERIMENOPAUSAL AGE GROUP

Abstract

Background: AUB is one of the most challenging and common problems presenting to the gynaecologists. A rationale approach and accurate diagnosis is important for proper treatment modality. It was an observational study done from April 2014 to March 2015. 112 patients presenting with AUB were included in the study. Clinical, hysteroscopy and histopathological study was done after excluding puberty menorrhagia, postmenopausal bleeding, pregnancy related bleeding, bleeding dyscrasias and endocrine disorders.

Results: Out of 112 women in this study 66% (74) were in the age group of 36-50 years,  26.8% (30) were in the age group of 21-35 years and 7.1% (8%) were in the age group of >51 years. In this study 48.2% (54) of women were para 2, 28.6% (32) had parity of more than 3, 17.9% (20) were para 1 and 5.3% (6) of women were nulliparous. This shows incidence of abnormal uterine bleeding increases as the parity increases. In this study 62.5% (70) of women presented with menorrhagia, 30.35% (34) had metrorrrhagia and7.1% (8) of women presented with polymenorrhagia. There was no case of oligomenorrhea. Clinically 50% (56) of women had dysfuctional uterine bleeding, 30.35% (34) had uterine leiomyomas, 8.9% (10) had polyps and 7.14% (8) had adenomyosis. On hysteroscopic examination 30.35% (34) of women had fibroid, 28.6% (32) had endometrial hyperplasia, 10.7% (12) of women had endometritis and 8.9% (10) women had endometrial polyp. Endometrium appeared normal in 21.42% (24) of women. Histopathological reports revealed that endometrium was proliferative in 30.35% (34) and secretory in 23.21% (26) of women. Endometrial hyperplasia was seen in 28.6% (32) of women. Endometritis was seen in 10.7% (12) of women and adenomyosis in 7.14% (8) of women.

Conclusion: hysteroscopy and histopathological examination is the gold standard for diagnosis of AUB.

Key words: Abnormal uterine bleeding, Hyysteroscopy, Histopathological examination, Endometrial Biopsy, Endometrial Hyperplasia.