Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding

Background: Abnormal uterine bleeding is one of the most frequently encountered conditions in gynaecology practice and forms about 10% of all gynaecological admissions, the main concern in perimenopausal bleeding is that the bleeding could be the only external manifestation of many hidden serious pathologies of uterine-cavity. The objective of this study was to compare the results of transvaginal sonography (TVS) and drug and cosmetic (D and C) with histopathological examination (HPE) report of hysterectomy specimen in perimenopausal women with AUB.Methods: A prospective comparative study where 100 perimenopausal women with AUB were subjected to TVS then D and C and then the results were compared with histopathological report of the hysterectomized specimen.Results: With an endometrial thickness less than or equal to 15 mm the histopathology report is normal endometrium. When the endometrial thickness more than or equal to 15 mm the histopathology report is hyperplasia or carcinoma. Findings of TVS correlated well with histopathological report after hysterectomy. 14 cases of adenomyosis, 16 cases of myomatous polyp, and 6 cases of endometrial polyp missed by dilatation and curettage.Conclusions: TVS is a simple, non-invasive test to indirectly visualize the endometrial cavity and is useful as a first step diagnostic procedure in the evaluation of perimenopausal bleeding. Dilatation and curettage lags in detecting adenomyosis, endometrial and myomatous polyps, When TVS combined with dilatation and curettage, it can supplement the shortcomings of dilatation and curettage.

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Role of chromohysteroscopy in detection of endometrial pathology in abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190857 ◽

2019 ◽

Vol 8 (3) ◽

pp. 916

Author(s):

Aleena Haider ◽

Imam Bano ◽

Noor Afshan Sabzposh ◽

Sayeedul Hasan Arif

Keyword(s):

Predictive Value ◽

Histopathological Examination ◽

Uterine Cavity ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Sonography ◽

Blue Dye ◽

Diffuse Light ◽

Dark Staining ◽

Endometrial Pathology

Background: Abnormal uterine bleeding is one of the most common clinical problems encountered in gynaecological practice. Chromohysteroscopy is thought to improve the diagnostic accuracy of hysteroscopy and reach the final diagnosis in AUB and is the subject matter of this study.Methods: A prospective cross-sectional study was performed on 35 women with AUB, who presented to the Dept. of Obstetrics and Gynecology, JNMCH, Aligarh, over a period of 2 years (2014-2016). After transvaginal sonography, all cases underwent hysteroscopy followed by chromohysteroscopy using 5% methylene blue dye. Differentially stained pattern of the uterine cavity was observed and hysteroscopic guided biopsy was taken from stained and unstained areas, followed by endometrial aspiration biopsy. All three samples were sent for histopathological examination. Results were analyzed and compared.Results: Out of 35 cases studied, 13 cases showed diffuse light staining, while 22 cases had focal dark staining. Histopathology results from diffuse light stained group showed 9 (69.2%) had normal endometrium. Out of 22 cases with focal dark staining, 20 (90.0%) cases had abnormal histopathology. It was found that focal dark staining to detect endometrial pathology had a sensitivity of 83.3%, specificity of 81.8%, positive predictive value of 90.9 %, negative predictive value of 69.2% and accuracy 82.8%. The difference in the diagnostic ability of stained tissue biopsy was highly significant (p< 0.001) when compared to blind endometrial aspiration biopsy.Conclusions: Chromohysteroscopy is an efficacious simple tool for detecting endometrial pathology in cases of AUB.

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Evaluation of abnormal uterine bleeding with transvaginal sonography

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172556 ◽

2017 ◽

Vol 6 (7) ◽

pp. 2794 ◽

Cited By ~ 1

Author(s):

Monika Jain ◽

Saptrishi Chakraborty

Keyword(s):

Diagnostic Accuracy ◽

Transvaginal Ultrasound ◽

Tertiary Care ◽

Uterine Cavity ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Sonography ◽

Age Group ◽

Perimenopausal Women ◽

Sensitivity Specificity

Background: Abnormal uterine bleeding (AUB) is an important cause of health hazard in perimenopausal women. Accurate diagnosis for the causative factor of AUB in this age group is of utmost importance so that appropriate management can be established. Objective pf present study was to estimate the diagnostic accuracy, efficacy, sensitivity and specificity of transvaginal ultrasound in evaluation of uterine cavity lesion in perimenopausal women with abnormal uterine bleedingMethods: This is a prospective study. This study was carried out in the Department of Obstetrics and Gynecology of Mahatma Gandhi Medical College and Hospital, Jaipur. We included 50 patients of perimenopausal age group who attended the gynecology department with the complaint of AUB. After selecting the patients who fulfill the eligibility criteria in the OPD detailed clinical history, obstetrical and gynecological history taken and detail clinical examination was done as per proforma followed by TVS.Results: In the present study, maximum no of cases between age group of 40 to 44 with 48%, and 38% of cases between age group of 45-49 yr. This suggests abnormal uterine bleeding is common in perimenopausal women. In present study overall sensitivity, specificity, PPV, NPV of TVS were 76%, 94%, 76% and 94%.Conclusions: In conclusion, abnormal uterine bleeding which often prevails as an important and common gynecological ailment. The Sensitivity, Specificity, PPV, NPV of TVS was 76%, 94%, 76% and 94%. The result showed that Transvaginal sonography has a moderate diagnostic accuracy in detecting endometrial hyperplasia and other intrauterine pathology. TVS is safe, acceptable and easily available in most secondary and tertiary care setting and is noninvasive. It should be continued as 1st line diagnostic tool in patients with AUB in perimenopausal women.

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Abnormal Uterine Bleeding in Perimenopausal Age: Different causes and its relation with histopathology

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v13i2.18295 ◽

2014 ◽

Vol 13 (2) ◽

pp. 135-139 ◽

Cited By ~ 1

Author(s):

Nazlima Nargis ◽

Iqbal Karim ◽

Khondaker Bulbul Sarwar

Keyword(s):

Histopathological Examination ◽

Medical Science ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Sonography ◽

Age Group ◽

Histopathological Findings ◽

Medical College ◽

Gynecology And Obstetrics ◽

Study Results

Background: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. Objective: This study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with ultrasonographic and histopathological examinations. Study Method: This descriptive study was conducted in the department of gynecology and obstetrics, Ibn Sina Medical College, Dhaka during January to December 2012. Two hundred and eleven women were selected for this study, who admitted into the hospital with abnormal uterine bleeding in perimenopausal age. The clinical, ultrasonographic and histopathological findings of these women were evaluated in this study. Results: Menorrhagia was the major symptom (52.6%) irrespective of age and parity. All these women underwent D&C followed by either medical management or hysterectomy depending upon the diagnosis. The histopathological findings of endometrium were analyzed and confirmed as fibroid uterus (58.28%) and DUB (17.58%) correlated well with transvaginal sonography (TVS) and histopathological examination. Hysterectomy conferred other uterine lesions as adenomyosis (18.71%), endometrial polyp (4.81%) and malignancy (1.06%). Conclusion: Abnormal uterine bleeding in perimenopausal age group is a common but ill-defined entity which needs proper evaluation. Accurate diagnosis of the causative factors of AUB in this age group is of utmost importance so that appropriate management can be established early that leads the minimization of the patients sufferings. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18295 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.135-139

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Diagnostic value and agreement of transrectal in comparison with transvaginal sonography among women with abnormal uterine bleeding

Journal of Ultrasound ◽

10.1007/s40477-021-00647-y ◽

2022 ◽

Author(s):

Azadeh Akbari Sene ◽

Farah Farzaneh ◽

Afsaneh Mehrnami ◽

Ali Mohammad Faizei ◽

Ahad Alizadeh ◽

...

Keyword(s):

Abnormal Uterine Bleeding ◽

Diagnostic Value ◽

Uterine Bleeding ◽

Transvaginal Sonography

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Hysteroscopic evaluation in infertility and abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180181 ◽

2018 ◽

Vol 7 (2) ◽

pp. 612

Author(s):

Navneet Kaur ◽

Ruby Bhatia ◽

Paramjit Kaur ◽

Surinder K. Bhopal

Keyword(s):

Endometrial Hyperplasia ◽

Uterine Cavity ◽

Invasive Procedure ◽

Abnormal Uterine Bleeding ◽

Endometrial Biopsy ◽

Uterine Bleeding ◽

Therapeutic Modality ◽

Secondary Infertility ◽

Endometrial Polyps ◽

Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

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Evaluation of the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213856 ◽

2021 ◽

Vol 10 (10) ◽

pp. 3885

Author(s):

Kushla Pathania ◽

Surbhi Sharma

Keyword(s):

Diagnostic Accuracy ◽

Postmenopausal Women ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Sonography ◽

Cross Sectional ◽

Predictive Values ◽

Menopausal Women ◽

Submucous Fibroid ◽

Post Menopausal

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.

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