Publication:

Correlation of ultrasound, hysteroscopic and endometrial histopathology findings in patients with post-menopausal bleeding

Background To study endometrial changes by hysteroscopy and ultrasonography in women presenting with postmenopausal bleeding and correlate it with histopathological endometrial findings.

Methods This was prospective observational study carried out in the Department of Obstetrics and Gynaecology at Lokmanya Tilak Municipal Medical College and General Hospital. The materials for the present study included patients diagnosed with postmenopausal bleeding visited to a Municipal Tertiary care centre and teaching institute in between January 2019 to June 2020. Total 51 eligible patients were evaluated.

Results In this study, on TVS examination, maximum patients 45.10% were having endometrial thickness in between 6-12mm. On hysteroscopy, 35.29% of the patients were having atrophic endometrium which was the most common finding followed by Endometrial Hyperplasia in 29.41% patients. The most common histopathological finding was atrophic endometrium in 41.18% patients followed by endometrial hyperplasia in 23.53% patients. In TVS, lowest sensitivity and lowest specificity was in case of Atrophic Endometrium and highest sensitivity and highest specificity was in case of fibroid. In Hysteroscopy, lowest sensitivity was in case of carcinoma and lowest specificity was in case of Endometrial Hyperplasia and highest sensitivity was in case of fibroid and highest specificity was in case of fibroid and carcinoma.

Conclusions Hence from this study, hysteroscopy is found to be an easy, safe, alternative and effective means to investigate postmenopausal women with a thickened endometrium found on TVS. Hysteroscopy guided biopsy in postmenopausal women with uterine bleeding decreases the risk of false negative histopathological report which is more commonly found in blind dilatation and curettage. This is also a useful method of visualizing the uterine cavity pathologies.