Publication:

Correlation of histopathological findings with ultrasound imaging and hysteroscopic findings in perimenopausal and postmenopausal women with abnormal uterine bleeding

Background Heavy breakthrough bleeding is a very frequent complaint in gynecological practice, more common during perimenopause and can be associated with structural pathologies, and abnormalities. Proper diagnosis as well as treatment are very vital for enhancing quality of the lives of such individuals and also treating possible malignancies. This research paper discusses the correlation of clinical presentation, USG and histopathology in the diagnosis of AUB in women to determine the most effective course of action. To compare and describe clinical features of AUB in perimenopausal and postmenopausal women and to posit Association between ultrasound findings and histopathological examination of hysterectomy samples, as well as to identify types of causal pathology.

Methods A cross-sectional study was carried out in the Obstetrics and Gynecology department of a tertiary teaching hospital. Finally, 200 women aged 45 and above with AUB were recruited over a three-year period. Information on clinical presentation was also obtained and ultrasonographic evaluation with regard to endometrial thickness and uterine abnormalities noted. Objective assessment of the findings obtained by USG was done by histopathological examination of hysterectomy specimens and statistical correlation was done.

Results 200 patients diagnosed with AUB aged 45 years and above, 66% of the patients were aged between 45-49 years. The highest frequency of pain was reported during menstruation followed by postmenstrual and intermenstrual pain; heavy menstrual bleeding was most prevalent 60%, postmenopausal bleeding 12% and intermenstrual bleeding 11%. The detailed ultrasonographic changes were abnormal in 83% of patients; endometrial thickening was seen in 44%, and fibroids in 17%. Comparison between hysteroscopy, and histopathological findings showed abnormal endometrium had significant positive relation with each other p=0.02.

Conclusion This study shows that USG offers value as the primary diagnostic modality, especially in diagnosing fibroid-associated AUB.