Abstract: Background:Abnormal uterine bleeding (AUB) is a prevalent gynecological concern among perimenopausal women, often necessitating accurate evaluation to determine underlying pathology. This study aimed to evaluate the diagnostic role of transvaginal ultrasonography (TVS) and hysteroscopy and correlate these findings with histopathological results in perimenopausal women with AUB.
Objectives: To assess the endometrium using TVS and hysteroscopy and compare these findings with histopathology to establish diagnostic accuracy in perimenopausal women presenting with AUB.
Materials and Methods: A prospective observational study was conducted on 120 perimenopausal women with AUB at a tertiary rural center. All participants underwent detailed clinical evaluation, TVS, and hysteroscopic examination. Endometrial samples were obtained for histopathological evaluation, which was considered the gold standard. Data were analyzed to compare diagnostic concordance. Results: The most common age group was 40-45 years (66.7%), with a predominance of lower-middle socioeconomic status. TVS revealed a normal endometrium in 56.7% and a thickened endometrium in 30% of cases. Hysteroscopy identified proliferative (29.2%) and hyperplastic endometrium (22.9%) as the most frequent findings. Histopathology confirmed hyperplastic endometrium in 30.2%, followed by proliferative (20.8%) and secretory patterns (16.7%). The combined use of TVS and hysteroscopy significantly improved the detection of intrauterine pathology, particularly endometrial hyperplasia and polyps, with strong histopathological correlation.
Conclusion: TVS and hysteroscopy are complementary tools in the evaluation of perimenopausal AUB, providing accurate assessment when correlated with histopathology. Their combined use improves diagnostic precision, facilitates early detection of premalignant lesions, and optimizes management, especially in rural healthcare settings.
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