Trends in the evaluation of abnormal uterine bleedings with the introduction of manual vacuum aspiration.

In a 12-month period, a total of 507 diagnostic curettages were performed with manual vacuum aspiration (MVA) and sharp metallic curettage (SMC), at the Gandhi Memorial Hospital (GMH). Of these, 406(80.1%) and 101(19.9%) were managed with MVA and SMC, respectively. The bulk of the study population were married, of urban residence, paying and treated on ambulatory basis in the minor operation theater without anaesthesia and analgesia. There were significant differences in the gravidity, parity and abortion frequency of the groups (P < 0.05). The mean ages for MVA and SMC were 35.9 years +/- SD 7.6 years and 36.5 years +/- SD 8.5, years respectively (P < 0.05). The majority of the study population that were subjected for histopathological evaluation of the corpus uteri were in the age group of 35-39 years and accounted for 137 (27.0%) with a cumulative frequency of 66.1%. The service providers handled most of the cases with MVA (P > 0.05) and the indications were mainly for abnormal uterine bleeding and endometrial dating. The histological yields were 97.0% for MVA and 80.2% for SMC. The adequacy of the specimen for MVA and SMC were 0.95 and 0.78, respectively. Even if inadequate and non-conclusive are merged together, the adequacy of the specimen would still be 0.91 and 0.74 for MVA and SMC respectively, maintaining the same proportion. Coincidentally, the diagnostic accuracy for endometrial polyp and also for endometrial carcinoma were 0.7 for MVA and 0.3 for SMC. Our results are similar to that of other researchers.(ABSTRACT TRUNCATED AT 250 WORDS)