Evaluating and comparing the efficacy of histopathology to TVS/TAS in diagnosing the abnormal uterine bleeding: A prospective clinical study

Abstract
Background: AUB (Abnormal Uterine Bleeding) is any bleeding outside normal frequency, regularity, duration, and volume. Abnormal bleeding in menstruation is depicted using terms such as oligomenorrhea, Polymenorrhea, Metorrhagia, and menorrhagia.Objectives: The present clinical study was conducted to assess the efficacy of histopathological findings and TVS/TAS in subjects with AUB.Methods: In the present prospective clinical study, 102 subjects within the age of 21-85 years with abnormal uterine bleeding. All subjects underwent hysteroscopy and premenstrual dilatation and curettage despite sonography findings and baseline investigations. The obtained endometrial tissue was assessed via histopathological examination.Result: Cervical carcinoma, Endometrial carcinoma, Cervical polyp, Endometrial polyp, Adenomyosis, and Myoma as seen in 3.92% (n = 4), 12.74% (n = 13), 2.94% (n = 3), 32.35% (n = 33), 51.96% (n = 53), and 54.90% (n = 56) study subjects respectively. Tissue findings in the study were assessed as Cervical Carcinoma, Endometrial Carcinoma, Endometrial polyp, Endometritis, Atrophic endometrium, Mixed, Secretary, Proliferative phase, Endometrial hyperplasia, and normal epithelium was seen in 1.96% (n = 2), 10.78% (n = 11), 5.88% (n = 6), 0.98% (n = 1), 2.94% (n = 3), 3.92% (n = 4), 15.68% (n = 16), 11.76% (n = 12), 25.49% (n = 26), and 20.58% (n = 21) subjects respectively.Conclusion: The present study concludes that transvaginal/transabdominal ultrasounds are an economical and primary assessment tool for screening of AUB, and must be included in routine assessment and examination. Although, the diagnosis and management of AUB are confusing among non-gravid females, however, histopathologic assessment is the gold standard in such cases.