Background:Abnormal uterine bleeding is dened as bleeding from uterus that differs from that of usual
normal menstrual bleeding, in frequency of occurrence or in amount or in alteration of ow. The
advantages of hysteroscopy as an accurate diagnostic technique are that it not only allows direct visual observation of
pathology but also provides a means to sample the site, most likely to yield positive results. The present study was conducted to
study the role of Hysteroscopy in abnormal uterine bleeding in Peri and Post-menopausal women at a tertiary care hospital.
Material And Methods: Present study was single-center, prospective, Cross sectional study, conducted in women age
≥40years with heavy menstrual bleeding, prolonged bleeding, frequent menstruation, intermenstrual bleeding and post coital
bleeding, Post-menopausal bleeding. Hysteroscopy was performed preferably in post-menstrual phase or post bleeding phase
with a standard 4mm hysteroscope(Stryker) with a 30 degree fore-oblique lens. Procedure was performed under IV sedation
with normal saline as distention media. Results: In present study, majority of the subjects (n=28) i.e. 36.8% presented with
heavy menstrual bleeding followed by prolonged bleeding (32.8%), post- menopausal bleeding (21%), frequent menstruation
(7.89%) and inter-menstrual bleeding (1.3%). On hysteroscopy normal ndings were present in 32 subjects (42%) followed by
hyperplasia (17.1%), atrophic endometrium (13.1%), submucous broid (14.4%), endometrial growth (2.96%) & broid polyp
(1.36%). Histopathology examination noted Proliferative endometrium (31.5%), secretory (10.5%), disordered proliferative
phase (1.3%), simple hyperplasia (18.4%), complex hyperplasia with atypia (1.3%), submucous broid (14.4%), endometrial
polyp (34.2%), atrophy (13.1%), broid polyp (1.34%) and malignancy (3.96%). Sensitivity, Specicity, PPV, NPV values were 100
% except for sensitivity for endometrial growth (66.7 %). p Value was highly signicant for all parameters (p <0.0001)
Conclusion: Hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for
peri and post-menopausal women with AUB.. The intracavitary lesions (submucous leiomyomas, polyps, endometrial growth
are) better diagnosed on hysteroscopy
Clinicopathological analysis of abnormal uterine bleeding in reproductive and post menopausal women in a tertiary care centre of south eastern part of India
