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Use of Hysteroscopy in Abnormal Uterine Bleeding: An Edge Over Histopathological Examination

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Abstract

Purpose of the Study

To assess the efficacy of hysteroscopy in diagnosis of AUB.

Method

A total of 56 women in reproductive and peri-menopausal age group (20–50 years) with complaints of abnormal uterine bleeding were enrolled in the study. All the patients underwent hysteroscopic examination followed by biopsy/histopathological evaluation. Hysteroscopic findings were compared against histopathological findings. Sensitivity, specificity, PPV, NPV and accuracy of hysteroscopy were calculated.

Results

Mean age of patients was 36.4 ± 7.6. Majority (60.7%) presented within 6 months of complaints. Clinically, 66.1% were diagnosed as menorrhagia, 30.4% polymenorrhoea and 3.6% intermenstrual bleeding. Hysteroscopically 53.6% presented with abnormal pathology, it diagnosed polyps in 16.1%, calcification in 12.5%, submucous fibroma in 10.7%, necrotic mass in 7.1%, adhesion and forgotten IUCD in 5.4% cases each. However, on histopathology, 33 (58.9%) cases had normal/proliferative/atrophic endometrium, 12 (21.4%) had hyperplasia, 7 (12.5%) had calcified endometrium, and 12 (21.4%) had polyp. No significant difference between two modalities was observed with respect to number of normal/proliferative/atrophic endometrium (p = 0.185). Histopathology diagnosed hyperplasia in significantly higher proportion of patients as compared to hysteroscopy (p = 0.042). Hysteroscopy diagnosed significantly higher proportion of patients with submucous myoma (p = 0.012) and necrotic mass (p = 0.042). Statistically, no significant difference between two modalities was observed with respect to other pathologies (p > 0.05). Overall agreement between two modalities was 62.5%. For pathological abnormalities in general, hysteroscopy had sensitivity, specificity, PPV, NPV and accuracy values of 78.3, 63.6, 60, 80.8 and 69.6%, respectively.

Conclusion

Hysteroscopy provided additional information for some of the pathologies, otherwise remaining undiagnosed by HPE.

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Authors and Affiliations

  1. Era’s Lucknow Medical College, Lucknow, India

    Parul Sinha, Nidhi Yadav & Uma Gupta

  2. Mayo Institute of Medical Sciences, Lucknow, India

    Uma Gupta

Authors
  1. Parul Sinha
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  2. Nidhi Yadav
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  3. Uma Gupta
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Corresponding author

Correspondence to Parul Sinha.

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Conflict of interest

Dr. Nidhi Yadav, Dr. Parul Sinha, Dr. Uma Gupta declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the institutional ethical committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.

Additional information

Dr. Parul Sinha is the Assistant Professor (Obst. & Gynae) at the Era’s Lucknow Medical College, Lucknow; Dr. Nidhi Yadav is the Junior Resident (Obst. & Gynae) at the Era’s Lucknow Medical College, Lucknow; Dr. Uma Gupta is the Professor (Obst. & Gynae) at the Mayo Institute of Medical Sciences, Lucknow, and Ex-Professor (Obst. & Gynae) in the Era’s Lucknow Medical College, Lucknow

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Sinha, P., Yadav, N. & Gupta, U. Use of Hysteroscopy in Abnormal Uterine Bleeding: An Edge Over Histopathological Examination. J Obstet Gynecol India 68, 45–50 (2018). https://doi.org/10.1007/s13224-017-1065-5

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  • DOI: https://doi.org/10.1007/s13224-017-1065-5

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