Role of Hysteroscopic EvaluationinAbnormal Uterine Bleeding and its histopathological co-relation.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9
Abstract
The present study was conducted to assess the feasibility and accuracy of hysteroscopy in evaluation of intrauterine abnormalities in women with abnormal uterine bleeding and to correlate it with histopathological evaluation.50 women in the reproductive, perimenopausal and postmenopausal age group, up to the age of 65 years presenting with AUB were included as per the inclusion and exclusion criteria. All patients underwent a hysteroscopic examination followed by a biopsy and histopathological evaluation. Hysteroscopic findings were noted and compared with histopathological findings.sensitivity, specificity, PPV, NPV and accuracy of hysteroscopy was calculated. Results: Maximum age incidence was between 41-50 years (46%).Of the 100 patients, maximum number of women (66%) had symptoms for less than 6 months, 13 patients (26%) had symptoms for 6 months to 1 year and 4 patients (8%) had symptoms for more than 1 year.Out of total 50 patients, 42% presented with Menorrhagia. The second commonest presentation was metrorrhagia (32%). There were 7 cases (14%) with Polymenorrhea and 14 (28%) patients with post-menopausal bleeding and 6% had intermenstrual spotting.Of the 50 patients, 46 cases (924%) were Multiparous, and 4 cases (8%) were Nulliparous. Abnormal findings were seen in 35 patients (70%), while in the remaining 15 patients (29%), no abnormality was detected (negative hysteroscopic view). The most common abnormality was endometrial Hyperplasia (20%cases), followed by Endometrial Polyps (18%) and submucosal fibroids (16%).There were also 7 cases (14%) of endometrial atrophy and 1 case of endometrial carcinoma. Of the 50 cases, 23 (46%) were normal on histopathology. The most common abnormality observed was polyp (20% cases), followed by submucosal fibroids (16%), endometrial Hyperplasia (14%) and endometrial carcinoma (4%).The sensitivity, specificity, PPV and NPV of Hysteroscopy to diagnose polyp was 90%, 100%, 100% and 97.6% respectively. All the case of fibroids were correctly diagnosed by hysteroscopy, thus sensitivity, specificity, PPV and NPV of Hysteroscopy were all 100%. The sensitivity, specificity, PPV and NPV of Hysteroscopy to diagnose endometrial hyperplasia was 85.7%, 90.7%, 60% and 97.5% respectively. The sensitivity, specificity, PPV and NPV of Hysteroscopy to diagnose endometrial carcinoma was 50%, 100%, 100 and 98% respectively.
Authors and Affiliations
Sabrina Mhapankar, Swapna kadam, Ajita goli, Sushil Kumar
Keywords
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- EP ID EP395492
- DOI 10.9790/0853-1709113242.
- Views 69
- Downloads 0
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