Introduction: Abnormal uterine bleeding (AUB) is a common gynecological issue, characterized by change in frequency of menstruation, duration of bleeding phase or amount of blood loss. In gynecological outpatient department about 33% of women have AUB and the percentage raises more in perimenopausal women. It can be associated with various causes like endometrial polyp, leiomyoma, adenomyosis, endometrial hyperplasia, ovulatory dysfunction and sometimes endometrial carcinoma. A number of diagnostic techniques like transvaginal ultrasonography, endometrial curettage and hysteroscopic guided biopsy are available. Aims: To study hysteroscopic findings and its correlation with histopathology of endometrium in AUB. Setting and design: Observational cross-sectional study conducted at a tertiary care hospital. Methods and materials: Demographic details and clinical history were obtained and 70 cases out of 162 were selected based on inclusion and exclusion criteria. Thorough examination and essential investigations like complete blood count and transvaginal ultrasonography (TVUS) were done. After preoperative preparations patients were subjected to hysteroscopy and guided biopsy. Hysteroscope was used to visualize the uterine cavity and to detect uterine malformations, polyps, submucosal fibroids, hyperplastic endometrium or endometrial atrophy. Results and conclusion: The accuracy of hysteroscopy in identification of polyp, endometrial hyperplasia and endometrial carcinoma was found to be 97.1%, 77.1%, 75.7%, respectively and overall accuracy of hysteroscopy in diagnosing pathology behind abnormal uterine bleeding was 67%. Hence, hysteroscopy though can act as an adjunct in diagnosis of AUB, histopathology will continue to be superior and gold standard.

Keywords: Polyps; Endometrial hyperplasia; Endometrial carcinoma; Endometrial curettage; Dilatation and curettage; Endometrial biopsy.