Ghazala Mahmud
Kausar Bangash
Asia Ashraf

Abstract

Objective: To determine the hysteroscopy findings (by outpatient diagnostic hysteroscopy) in Premenopausal Women with Abnormal Uterine Bleeding below 35yrs of Age.
Study Design: Descriptive study.
Settings: It was one year study conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad from 27th Feb 2010 to 28th Feb 2011.
Methodology: Total 51 married women were included in our study between 19 to <35yrs of age. All women with irregular pervaginal bleeding, failed medical treatment or pathology detected on ultrasound pelvis were included. Women with Pregnancy, lower genital tract infection and those with incomplete follow-up were excluded. Diagnostic hysteroscopy and curettage was done under paracervical block in the outpatient department. Endometrial curretings were sent for histopathology and data was recorded on predesigned proformas.
Results: On hysteroscopy the findings were, endometrial hyperplasia in 12 cases (23.5%), submucous fibroids in 03 (5.9%), intrauterine adhesions in 02 (3.9%) and retained products of conception (RPOC) in 02 (3.9%) cases, respectively. Total 22 (43.1 %) patients had a pathology detected on histopathology; hormonal imbalance in 11(21.5%), endometrial hyperplasia in 4(7.8%), disordered proliferative endometrium in 3 (5.8%), Asherman`s and RPOCs in 2 cases each(3.9%), as already stated.
Conclusion: Diagnostic hysteroscopy remains a gold standard in patients with failed medical treatment. Premenopausal women with irregular cycles or failed medical treatment should have an endometrial biopsy regardless of the age because they are at increased risk of having an endometrial pathology.
Key Words: Hysteroscopy, premenopausal bleeding, histopathology.