scholarly journals Comparison of saline instillation sonography with trans vaginal sonography in abnormal uterine bleeding: a prospective study

2018 ◽  
Vol 7 (12) ◽  
pp. 4819
Author(s):  
Banishree Pati ◽  
Rupa Vani K. ◽  
Gowri A. L. ◽  
Debendra Kumar Tripathy
Keyword(s):  
Diagnostic Accuracy ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histopathological Diagnosis ◽  
Outpatient Basis ◽  
Significant Difference ◽  
Vaginal Sonography ◽  
Sensitivity Specificity ◽  
Saline Instillation

Background: Abnormal vaginal bleeding may be caused by an extensive spectrum of disorders, both gynecologic and non-gynecologic. Diagnostic accuracy of abnormal uterine bleeding is important for the management.  Trans vaginal sonography (TVS) is one of the commonest investigation used for the diagnosis, but the diagnosis is not always accurate for all clinical conditions. Saline instillation sonography (SIS) has been shown to improve the diagnosis. Authors aimed to compare the TVS and SIS diagnosis with the final histopathological diagnosis.Methods: Seventy-five patients with the complained of abnormal uterine bleeding attending outpatient department of a tertiary care institute were enrolled for the study. Trans vaginal sonography (TVS) and saline instillation sonography (SIS) was done on outpatient basis. The diagnosis was compared with final histopathological diagnosis, in term of diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value.Results: Seventy-five patients who were enrolled for the study. Sixty-four patients underwent surgery and final histopathological diagnosis was established. Four patients SIS was not possible, data was analysed for sixty patients.Conclusions: In SIS abnormal uterus diagnosis confidence was significantly improved (p value 0.001) when compared to TVS. The diagnosis of submucous myoma significantly improved (p=0.015) by SIS when compared to TVS. There was no significant difference between TVS and SIS diagnosis of Myoma remote from the endometrium (p=0.522), Adenomyosis (p=1), Focal endometrial abnormality (p=0.654) and Diffuse endometrial abnormality (p=1). The SIS sensitivity, specificity, PPV and NPV were either improved or same, when compare to TVS for all the diagnosis except for the diagnosis of focal endometrial abnormality.

scholarly journals Evaluation of abnormal uterine bleeding with transvaginal sonography

2017 ◽  
Vol 6 (7) ◽  
pp. 2794 ◽  
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.

scholarly journals Validity of Hysteroscopy and Transvaginal Sonography in Evaluating Abnormal Uterine Bleeding- A Retrospective Study

2021 ◽  
Author(s):  
Sangam Jha ◽  
Monika Anant ◽  
Upasna Sinha
Keyword(s):  
Diagnostic Accuracy ◽  
Abnormal Uterine Bleeding ◽  
Minimal Invasive ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Operative Notes ◽  
Sensitivity Specificity ◽  
Reproductive Age Group

Introduction: Abnormal Uterine Bleeding (AUB) affects 14-25% of women of reproductive age group and accounts for 66% of hysterectomies. Accurate diagnosis of the cause of AUB will reduce the hysterectomy burden, but the ideal evaluating tool to accurately diagnose the cause of the same is debatable. Aim: To evaluate the diagnostic accuracy of transvaginal sonography and hysteroscopy in the evaluation of abnormal uterine bleeding, using histopathological diagnosis as gold standard. Materials and Methods: This retrospective descriptive study was conducted on patients who underwent transvaginal sonography and hysteroscopy for evaluation of abnormal uterine bleeding from January 2017 to January 2020. Data including demographic details, sonographic details, pre-operative diagnosis, anaesthesia used, operative notes, complications and histopathological diagnosis were obtained from clinical record sheet of the patients. Sensitivity, specificity, diagnostic accuracy of TVS and hysteroscopy was calculated using MedCalc software version 19.2.6. Results: A total of 214 patients were enrolled in the study. Hysteroscopy reported >95% diagnostic accuracy for all intrauterine pathology compared to TVS which revealed diagnostic accuracy of 73.13% for polyp, 77.1% for endometrial hyperplasia and 73.6% for all other pathology. Hysteroscopy revealed strong to almost perfect correlation with histopathological diagnosis for all pathology compared to TVS which demonstrated weak correlation for various intrauterine pathology. Conclusion: Hysteroscopy should be used as initial evaluating tool in AUB as it is simple and minimal-invasive with high diagnostic accuracy.

scholarly journals Study of hysteroscopic evaluation in patients with abnormal uterine bleeding

2017 ◽  
Vol 6 (4) ◽  
pp. 1413
Author(s):  
Ashok Kumar K. ◽  
Sathya P. ◽  
Sreelatha Sampathkumar
Keyword(s):  
Diagnostic Accuracy ◽  
Histopathological Examination ◽  
Financial Burden ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Appropriate Treatment ◽  
Diagnostic Hysteroscopy ◽  
Sensitivity Specificity

Background: Abnormal uterine bleeding in women is the commonest presenting complaint which accounts for one third of all gynecological consultations. It not only causes discomfort, inconvenience to healthy women but also affects their quality of life and impose financial burden on them. This insists the physician to diagnose its etiology and provide appropriate treatment. Hysteroscopy guided biopsy is a simple, safe, reliable procedure in the diagnosis of abnormal uterine bleeding. The objective of the study was to evaluate the uterine pathology in premenopausal women with abnormal uterine bleeding by hysteroscopy.Methods: This prospective study was conducted at ESIC-MC and PGIMSR, Rajajinagar, Bangalore, in 50 premenopausal women with abnormal uterine bleeding over 18 months from Dec 2012 to May 2014. All 50 women were subjected to diagnostic hysteroscopy followed by curettage. The sample was sent to histopathological examination. Data was collected and analyzed.Results: In the present study, abnormal uterine bleeding was more common in 41-45yrs of age. The commonest presenting complaint was heavy menstrual bleeding (menorrhagia) in 54% of cases. The abnormal findings on hysteroscopy were: Hyperplasia 42%, endometrial polyp 22%, sub-mucous myoma 4%, carcinoma endometrium 2%, synechiae 2% and endometritis 2%. Negative hysteroscopic view was seen in 26%. The sensitivity, specificity, positive and negative predictive value of hysteroscopy was 91.89%, 92.31%, 97.14% and 80% respectively. The overall diagnostic accuracy of hysteroscopy was 92%.Conclusions: Hysteroscopy and its directed biopsy renders high diagnostic accuracy in patients with abnormal uterine bleeding and thereby guiding them for further management.

scholarly journals Clinicopathological and Radiological Profile of Multinodular Goitre – A Prospective Study

2021 ◽  
Vol 29 (2) ◽  
pp. 164-168
Author(s):  
Koustav Mondal ◽  
Chiranjib Das
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Multinodular Goitre ◽  
Sensitivity Specificity

Introduction Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis. Materials and Methods A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report. Results Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%. Conclusion USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.

scholarly journals Diagnosis of endometrial pathologies: transvaginal sonography versus hysteroscopy

2017 ◽  
Vol 6 (2) ◽  
pp. 544
Author(s):  
Berna Aslan Çetin ◽  
Ayşe Beyaz ◽  
Lale S. Türkgeldi ◽  
Pınar Yalçin Bahat ◽  
Nadiye Köroğlu
Keyword(s):  
Diagnostic Accuracy ◽  
Standard Procedure ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Ultrasonography ◽  
Transvaginal Sonography ◽  
Office Hysteroscopy ◽  
Simultaneous Treatment ◽  
Predictive Values ◽  
Sensitivity Specificity

Background: Abnormal uterine bleeding (AUB) constitutes 69% of all gynecological complaints in the peri- and postmenopausal age groups. The aim of present study was to compare the accuracy of transvaginal sonography and hysteroscopy in diagnosing intracavitary pathologies in women with abnormal uterine bleeding.Methods: A total of 303 premenopausal women with abnormal uterine bleeding who admitted to the gynecology outpatient clinic of the Istanbul Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey, between April 2010 and July 2015, and received hysteroscopy, were evaluated retrospectively. The collected data were assembled from the computerised database. All patients underwent pelvic examination, transvaginal ultrasonography, office hysteroscopy and hystopathologic evaluation. Patients with normal appearing uterine cavities on hysteroscopy additionally underwent full curettage. The pathology reports were considered to be the definitive diagnoses of patients. Transvaginal ultrasonography and office hysteroscopy findings were compared with the pathological reports and the sensitivity, specificity, positive and negative predictive values, accuracy values and likelihood ratios of office hysteroscopy and transvaginal ultrasonography were calculated for the detection of endometrial abnormalities.Results: Endometrial polyps were the most commonly identified pathology with a rate of 77.56%. The sensitivity, specificity, positive and negative predictive values of transvaginal sonography for diagnosing endometrial pathologies were 77%, 32%, 75% and 32%, respectively. The same values for hysteroscopy were 93%, 44%, 88% and 48% respectively. Transvaginal sonography had a sensitivity of 20% with a specificity of 4% for submucous myomas. The sensitivity, specificity, positive and negative predictive values of hysteroscopy for submucous myomas when compared to histopathology were 100% for all.Conclusions: The diagnostic accuracy of office hysteroscopy for focal lesions such as polyps or submucous myomas is higher than the accuracy of transvaginal ultrasonography. Due to its high diagnostic accuracy, lower complication rate and the ability to obtain direct biopsy specimens while providing simultaneous treatment, we believe that hysteroscopy will retain its place as the gold standard procedure for the investigation of endometrial pathologies.

scholarly journals Study of the efficacy of ormeloxifene in abnormal uterine bleeding

2020 ◽  
Vol 9 (12) ◽  
pp. 4941
Author(s):  
Priyanka B. Varwatte ◽  
Michelle Fonseca
Keyword(s):  
Medical Management ◽  
Endometrial Thickness ◽  
Tertiary Care ◽  
Hemoglobin Concentration ◽  
Abnormal Uterine Bleeding ◽  
Significant Rise ◽  
Uterine Bleeding ◽  
Duration Of Treatment ◽  
Significant Difference

Background: Abnormal uterine bleeding (AUB) is a diagnosis that does not apply to menorrhagia only, but also includes (menometrorrhagia) excessively prolonged and frequent bleeding. Ormeloxifene (also known as centchroman) is a selective estrogen receptor modulator. This study was conducted to assess the efficacy, safety and compliance of ormeloxifene in the medical management of AUB.Methods: This quasi experimental, one group pre and posttest research design study was conducted among 30 participants in a tertiary care institute in a metropolitan city during January 2016 to June 2017. Patients with AUB were administered with ormeloxifene were advised to follow up one monthly for the first three months and then three monthly follow up for 6 months.Results: The mean age of all the patients was 35.96±5.62 years. There was statistically significant difference of mean hemoglobin, mean endometrial thickness and mean pregnancy-associated breast cancer (PABC) score observed between pre-treatment and 3 months and 6 months of post treatment. Mean hemoglobin concentration was increased while mean endometrial thickness and mean PABC score was decreased as the duration of treatment was increased from 3 months to 6 months.Conclusions: Ormeloxifene is quick acting, effective and appears to be a promising option for the medical management of dysfunctional uterine bleeding. It leads to a significant reduction in menstrual blood loss, a significant rise in hemoglobin concentration and a significant decrease in endometrial thickness with very minimal side effect.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

scholarly journals Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Laban ◽  
Sherif H. Hussain ◽  
Alaa S. Hassanin ◽  
Waleed M. Khalaf ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Final Analysis ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Predictive Values ◽  
Endometrial Volume ◽  
Sensitivity Specificity

The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223;P=0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

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

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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