November 2017 · Volume 6 · Issue 11 Page 4835
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Naik M et al. Int J Reprod Contracept Obstet Gynecol. 2017 Nov;6(11):4835-4839
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
Hysteroscopy in evaluation of intrauterine causes of AUB
Meena Naik*, Rekha Ratnani, Swati Thaore
INTRODUCTION
AUB is a common clinical presentation it amounts to
35% of gynae OPD visits and 25% of gynaecological
surgeries and this incidence rises to 69% in peri and
postmenopausal age.
1
There are various causes of AUB
from hormonal dysfunction to endometrial cancer .in
order to manage effectively it is important to diagnose
accurately the cause of abnormal bleeding.
Various methods used to diagnose the structural causes of
AUB include ultrasonography, sonosalpingography,
ABSTRACT
Background: Abnormal uterine bleeding is the most common gynecological problem comprising more than 30-50%
of gynecological OPD patients. There are various causes of AUB from hormonal dysfunction to endometrial cancer.
In order to manage effectively it is important to diagnose accurately the cause of abnormal bleeding. This study
outlines the place of hysteroscopy and its role in evaluation of intrauterine causes of AUB.
Methods: This is a Retrospective cross sectional observational study conducted in department of Obstetrics and
Gynaecology at CCM Medical College, Durg, Chhattisgarh. 350 Patients between 20-70 years age presenting to
general gynae OPD with abnormal uterine bleeding at CCM medical college over a period of 2 years between 1
st
January 2015 to December 2016 were studied. All patients were subjected to thorough clinical evaluation followed by
sonography and hysteroscopy. Data collected from medical records, analysed and various intrauterine causes of AUB
were studied.
Results: Mean age of patients in our study was 45 years with majority of patients in 40-50 year age group.
predominant complaint reported was menorrhagia (52%) followed by menometrorrhagia (18.86%) and
polymenorrhoea (18.58%). USG detected abnormality in 65.6 % of cases and 34.4% were normal on USG but
majority of these were fibroids and ovarian cysts. However, diagnosis of specific intrauterine pathology was made in
only 12.8%. Hysteroscopy detected intrauterine abnormality in 60% cases. Most common being polyp in 94 patients
(26.8%) followed by hyperplastic endometrium in 74 (21.1%). 18 (5.1%) patients had polypoidal endometrium which
is also type of hyperplastic endometrium. 17 (4.85%) had submucous fibroid, 4 (1.1%) had atrophic lining and 3 (0
.85%) had intrauterine adhesions. Diagnostic accuracy of hysteroscopy was found better in polyps and submucous
myomas which were missed by usg and also can be missed by traditional D and C only.
Conclusions: Hysteroscopy allows exclusion of intracavitary pathology as well as treatment of them in same sitting
with proper tissue biopsy from the abnormal area which can be of help in proper treatment planning. Though
hysteroscopy helps in diagnosing cause of AUB their proper management will depend on final histology, age of
patient and fertility goals.
Keywords: AUB, Hysteroscopy, Intracavitary pathology
Department of Obstetrics and Gynecology, Chandulal Chandrakar Memorial Medical College, Kachandur, Durg,
Chhattisgarh, India
Received: 10 September 2017
Accepted: 26 September 2017
*Correspondence:
Dr. Meena Naik,
E-mail: m.naik1971@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174653