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Category: Volume 07 Issue 09 September 2019
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Title: Use of Hysteroscopy in abnormal uterine bleeding: An edge over histopathological examination & blind D & C: an ambulatory procedure

Authors: Dr Jyoti Narayan Puhan, Dr Sujata Misra, Dr Rabi Narayan Satapathy

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.73

Abstract

  

AUB is the most common complain of reproductive age group women. In this study the causes & findings of AUB were compared by performing hysteroscopy & D & C and their histopathology also compared thoroughly .

Materials & Methods: This study was a prospective study carried out in SCB medical college, a tertiary care hospital in Odisha, from Aug 2013 to Aug 2015 for 2 years. 200 cases were selected for this study aging 18 years and above with menstrual irregularities. Hysteroscopy was performed in 100 patients, endometrial biopsy was taken during the procedure & sent for HP study. In another 100 patients, D & C was performed & sent for HP study as control basis. The findings on hysteroscopy and D & C and there HP reports were correlated and compared.

Results: On hysteroscopy , out of 100 cases , 32 % came as proliferative , 16 % secretory ,16 cases as sub mucous fibroid , 13 cases as endometrial hyperplasia ,8 cases as endometrial atrophy, 4 cases as endometrial adhesion ,1 case as CuT in situ & 1 case of endometrial carcinoma whereas HP study on same patients came as 43 % as proliferative, 20 % as secretary, 18 % as hyperplasia, 6% as endometrial polyp,4% as atrophic endometritis, 2 % as fibroid polyp, 1% absent endometrium & 1% as endometrial carcinoma . Another 100 patients on whom blind D & C were performed came as 52 % as proliferative, 20 % secretory, 19% as endometrial hyperplasia, 6% as atrophic endometrium and 3 % as endocervical polyp.

Conclusion: In patients with AUB, hysteroscopy provides more accurate and detailed diagnosis than dilatation and curettage alone. Especially endometrial cavity lesions are more accurately diagnosed by hysteroscopy and also in similar setting; therapeutic procedures can be performed than the blind D & C procedure.

Keywords: D & C – dilatation and curettage, HP report – histopathological report, DH – diagnostic hysteroscopy.

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Corresponding Author

Dr Jyoti Narayan Puhan

Resident Doctor (MS O G), SCB Medical College, Cuttack, Odisha, India