Correlation of Endometrial Thickness, Hysteroscopic Finding and Histopathological Diagnosis in Patients with Abnormal Uterine Bleeding

ABSTRACT

Background:To correlate endometrium thickness(ET) measured by trans vaginal sonography (TVS) with their hysteroscopy finding along with histopathological diagnosis in patients of abnormal uterine bleeding.Methods: 120 patients of AUB in reproductive age group to post menopause were included in study. All were subjected for investigations including CBC,TSH,FBS and USG pelvis. Endometrial thickness was measured by TVS and were subjected for diagnostic Hysteroscopy(DH) . DH findings were noted as normal endometrium or abnormal findings . Endometrial curettage was performed in all patients and sample collected sent for histopathological study. Result: AUB was common in 41-50yrs age group and menorrhagia being the most common symptoms. The Prevalence of disease finding by DH ,its sensitivity and specificity were 46.6%,89.2% and 60.9% respectively. False positive rate and False Negative rate, positive predictivity ,negative predictivity, Calculated positive like hood ratio & negative likehood ratio were 39%,10.7%,86.2%,2.2 and 5.6 respectively with Diagnostic accuracy was 74.1%. Hysteroscopic diagnosis of polyp has sensitivity & specificity of 100% who presented with post menopausal bleeding. Carcinoma endometrium was diagnosed in 3 patients (13%) out of 23 case of PMBPV. Maximum number of normal endometrium were observed when ET<15mm while polyp and Ca endometrium when ET was >15mm.But Ca endometrium was also diagnosed when ET was in range of 5-10mm.When ET was<5mm the endometrium pattern observed were either normal or atrophic. Conclusion: It is concluded from our study that in all AUB cases ET can impose an idea of case selection for Hysteroscopic procedure and D&C combined with hysteroscopy is the gold standard evaluation.