INTRODUCTIONSome women conclude that any deviation from their personal menstrual experience is abnormal, and they will take treatment for the same. Many of them ignore even significant variations in their menstrual function; sometime to such an extent that severe iron deficiency anemia occurs. The most common reason for gynecological referrals is abnormal uterine bleeding in premenopausal and postmenopausal women. More than 40% of them are having polyps and fibroids. Hysteroscopy gives an accurate diagnosis by direct visualization of the cervical canal and endometrial cavity, and results in medical or surgical management related to the specific etio-pathology, avoiding the need for major surgery 1 . Previously dilatation and curettage was usual method of evaluating abnormal uterine bleeding and it misses the cause in more than 50% of the cases. 1,2Gimpelson and Rappold 2 reported that hysteroscopy is considered an accurate "gold standard" in endometrial cavity evaluation and hysteroscopy associated with guided biopsy was more accurate than dilatation and curettage.The aims and objectives of this study were to assess the accuracy of diagnostic hysteroscopy in evaluation of abnormal uterine bleeding and to correlate its findings with histopathology reports. METHODS ABSTRACT Background:The objective was to assess the accuracy of diagnostic hysteroscopy in evaluation of abnormal uterine bleeding and to correlate hysteroscopic findings with histopathology reports. Methods: A prospective study was carried out at our institute from January 2010 to December 2013. Ninety cases were included in this study. Patients" age varied from 20 to 60. Those women with the history of abnormal uterine bleeding were admitted. In all cases diagnostic hysteroscopic examination and dilatation and curettage were carried out. Endometrium was sent for histopathology and correlation of hysteroscopic findings with histopathology reports was studied. Results: Various findings on hysteroscopy are as following: proliferative endometrium 36.66%, secretary endometrium 17.77% endometrial hyperplasia 24.44%, atrophic endometrium 5.55%, endometrial polyp 8.88%, submucous fibroid 4.44%, and endometrial carcinoma 2.22%. Conclusions: Hysteroscopy is an eye in uterus and it provides more accurate diagnosis than dilatation and curettage alone in patients with abnormal uterine bleeding.

Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality, and one of the common obstetrical emergencies. Quite commonly, it occurs in patients where PPH is not expected. Management has to be swift and precise according to the steps and the response initiated by the uterine musculature during the management. In our patient, we had a localized multifocal atony of the uterus, at points where the uterine sinuses were bleeding due to atony, and medical management and uterine tamponade failed, with a raised D-dimer level. As the stepwise management failed with uterine devascularisation failing to control PPH, a decision for uterine compression suture (UCS), Cho suture was taken.

Cervical agenesis is an extremely rare form of congenital Mullerian anomaly. Due to the rarity of the cases with different presentations ranging from cervical agenesis to dysgenesis (fragmentation, fibrous cord, obstruction of external os), along with the functionality of the uterus, there are numerous conservative surgical options involving uterovaginal anastomosis, cervical reconstruction, and cervical canalization, and total hysterectomy in cases where conservative surgical procedures fail or not feasible. In our case, the patient was a 32-year-old female with primary amenorrhea with, a history of marriage for 6 years and a history of surgery for primary amenorrhea during adolescence. During the present visit, she had severe abdominal pain due to massive hematometra with a short blind vagina. She was planned for laparoscopic Uterovaginal anastomosis but converted to abdominal hysterectomy due to the large size of uterus, lack of uterine supports, and high length of the defect between the lower end of the uterus and vaginal end. Due to the lack of proper guidelines and variations in clinical presentation, a case-based approach is required.