Correlation Of Structural Uterine Abnormalities With Abnormal Uterine Bleeding Among Premenopausal Women With Infertility

Abstract

Objective: To document the various structural uterine abnormalities detected on transabdominal ultrasonography (TAUS) and hysterosalpingography (HSG) of premenopausal women with infertility and abnormal uterine bleeding (AUB) and determine whether the structural abnormalities correlate well with the clinical forms of AUB among the patients. Methodology: This is a prospective and analytical study of 98 infertile women with history of AUB, referred for HSG. Clinical history including the forms of AUB were obtained from the subjects. Subjects were evaluated with TAUS and HSG after obtaining both ethical clearance and informed consent. Statistical analysis was with the Statistical Package for Social Sciences (SPSS) version 21. Simple frequency, measures of central tendency and dispersion, crosstabulation as well as Pearson’s correlation tests were carried out. For correlation, p ≤ 0.05 was considered significant. Result: Fibroids, followed by intrauterine adhesions (IUA) were the commonest structural uterine abnormalities. Fibroids were detected with both TAUS and HSG, while IUA were detected with HSG only. Shortened menstrual flow was the commonest form of AUB and occurred in 52 (53.1%) of the subjects, followed by light menstrual flow 41(41.8%). The menses were irregular in 33(33.7%), light and shortened in 32(32.7%), heavy in 21(21.4%), prolonged in 16(16.3%), and, heavy and prolonged in 9(9.2%). Fibroids occurred most frequently among those with heavy and prolonged menstrual bleeding while IUA occurred most frequently among those with scanty and reduced menstrual bleeding. On TAUS, HSG, or combined TAUS and HSG, there were significant correlations between fibroids and prolonged heavy menses, fibroids and heavy menses, and, fibroid and prolonged menses. On HSG, significant correlation existed between IUA and scanty short menses. Conclusion: Uterine fibroids and intrauterine adhesions were the commonest structural uterine abnormalities detected. There was significant correlation between fibroids and history of heavy menstrual flow as well as between fibroids and prolonged menses, and IUA and scanty short menses.