Indications, macroscopic and microscopic findings of out-patient hysteroscopy in a university hospital in Oman

Maryam Al-Shukri, Naama Albadowi, Azza AlHarassi, Asha Nair, Bushra Ahmed, Wadha Al-Ghafri, V Gowri
2019 Clinical Obstetrics Gynecology and Reproductive Medicine  
Out-patient hysteroscopy is an important tool of evaluation to women with reproductive difficulties like subfertility and recurrent pregnancy loss. It is also valuable to evaluate women with abnormal uterine bleeding. We conducted this retrospective study to evaluate the indications, macroscopic and microscopic findings of out-patients hysteroscopy at Sultan Qaboos University in Oman. The included patients were referred for outpatient hysteroscopy in the department of Obstetrics and Gynecology
more » ... etween February 2016 and December 2017. The electronic patient records were reviewed from the indications, findings on hysteroscopy and the results of endometrial biopsy if obtained. Descriptive analysis was performed. Results: A total of 141 patients underwent out-patient hysteroscopy during the study period of 23 months. The age of the patients ranged from 21 to 58 years with a mean of 34± 6.3 years. The most frequent indication was recurrent pregnancy loss (RPL) in 33.3% (47/141). The most common abnormality found on hysteroscopy was congenital anomalies of the uterine cavity in 27 patients (19.1%). When specifically looking at the 63(44%) of women who had normal 2D-Trans-vaginal ultrasound scan (2D-TVS), 61.9% of them had abnormal hysteroscopic findings including congenital anomalies in 13 (20.6%). For congenital anomalies, 2D-TVS has a poor ability to pick-up those abnormalities with sensitivity of only 22%. On biopsy, histological evidence of endometritis was found in 12.7% of patients whereas the bacterial endometrial culture was positive in (28/60) 46% of the samples. Conclusion: In view of poor sensitivity of 2D-TVS for congenital anomalies and uterine synechiae; it is important to supplement pelvic ultrasound examination with hysteroscopic evaluation in symptomatic women. Our histological and microbiological evidence of endometritis is consistent with the fact that the offending organisms are the once usually contaminate the urogenital tract.
doi:10.15761/cogrm.1000272 fatcat:5utmdnskxjfc5npqgnbjledfae