TO STUDY THE RELATIONSHIP BETWEEN ABNORMAL UTERINE BLEEDING AND ENDOMETRIAL THICKNESS AND ITS CORRELATION WITH HISTOPATHOLOGY IN PERI-MENOPAUSAL WOMEN AT TERTIARY HEALTH CARE CENTRE OF CENTRAL INDIA

Aim: The aim of this research trial was to study the relationship between abnormal uterine bleeding and endometrial thickness in peri-menopausal women and to nd out the correlation between endometrial thickness and its histopathology in peri-menopausal women with abnormal uterine bleeding. Methodology: A cross sectional observational study was conducted at a tertiary care health centre. Peri-menopausal women more than 40 years of age with abnormal uterine bleeding who presented to the Gynaecology department were included after taking an informed consent and obtaining ethical committee approval. A pre-designed case record form (CRF) was used to collect demographic details like name, age, address, body mass index along with data about physical examination and clinical history. A pelvic examination including speculum ndings to rule out cervical or vaginal causes of bleeding. Bimanual pelvic assessment was done for size and contour of the uterus. Ultrasonography was done, patients having endometrial thickness> 6mm and no structural pathology (broid, polyp) were enrolled. Under aseptic precaution blood was collected and was sent for C-reactive protein, blood glucose, Kidney function test (KFT) and liver function test (LFT), thyroid function test, serum electrolyte (sodium, potassium, calcium) and routine urine tests. The results were subjected to statistical analysis. Results: The mean age was 46.18±3.4. Heavy menstrual bleeding was the most common clinical presentation (62%), followed by irregular menses (17%) and frequent menstrual bleeding (14%). Hygroscopic ndings found 56 patients (56%) to be having normal view and 44 patients (44%) to be having abnormal view. Endometrial atrophy (21%) was the most common abnormality followed by endometrial hyperplasia (20%). There was one case of suspected endometrial carcinoma on dilatation and curettage which was conrmed as endometrial carcinoma on histopathological examination. Most common abnormal nding noted on histopathology was proliferative 41%, hyperplasia 19%, secretory 17%, atrophic 16%, 4% had endometritis, 3% had atypical hyperplasia. On ultrasonography, 54% had bulky uterus, 46% had thickened endometrium, 8% had adenomyosis and 35 had ovarian cyst. There was statistically signicant difference regarding association between clinical presentation and hysteroscopic ndings. There was no statistically signicant difference regarding association between histopathological ndings and parity. There was statistically signicant difference between histopathological and hysteroscopic ndings. The sensitivity, specicity, positive predictive value, negative predictive value for corelation between histopathology and hysteroscopic ndings was 82.7%, 80.9%, 85.7% and 77.2% for abnormality detection rate. The sensitivity, specicity, positive predictive value, negative predictive value was 89.4%, 96.3%, 85% and 97.5% for corelation between hysteroscopy and histopathology for detection of hyperplastic endometrium. Conclusion: Abnormal uterine bleeding can be evaluated with the help of a clinical assessment, dilatation and curettage. Any case of abnormal uterine bleeding in perimenopausal women should be examined because it might be the only sign of an underlying malignancy that manifests itself.