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

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.

scholarly journals Role of sonohysterography in evaluation of abnormally thickened endometrium causing abnormal uterine bleeding with histopathological correlation

2014 ◽  
Vol 40 (1) ◽  
pp. 10-14 ◽  
Author(s):  
S Parveen ◽  
SA Azad ◽  
J Mohammad ◽  
S Haque ◽  
RS Shanta ◽  
...  
Keyword(s):  
Predictive Value ◽  
Randomized Study ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Initial Examination ◽  
College Hospital ◽  
Histopathological Correlation ◽  
Endometrial Pathology

This prospective randomized study was carried out in the department of Radiology and Imaging in collaboration with the department of Obstetrics and Gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag and Dhaka Medical College Hospital (DMCH) during the period of January 2003 to December 2004. The aim of this study was to establish sonohyterography as a sensitive tool and superior to Transvaginal Sonography (TVS) for detection of endometrial pathology in women with abnormal uterine bleeding (AUB) and its validity by determining sensitivity, specificity, accuracy, positive predictive value and negative predictive value. For this purpose, a total number of 40 patients who had thickened endometrium (cut off level <15 mm for pre menopausal and <5 mm for post menopausal patients) detected on transabdominal or transvaginal sonography were selected. TVS and TV-SH were done in all these patients and findings were then compared with the final histopathological diagnosis. In our study, we found TV-SH has sensitivity of 100%, specificity of 80% and accuracy of 97.5 % compared to TVS (94 %, 66.66 % and 90 % respectively) in detection of endometrial pathology in women with AUB. TV-SH can thus be regarded as one of the most sensitive, specific and accurate modality in detecting and excluding endoluminal masses as the cause of AUB. It can be considered as the initial examination in the evaluation of all women with AUB. DOI: http://dx.doi.org/10.3329/bmrcb.v40i1.20322 Bangladesh Med Res Counc Bull 2014; 40: 10-14

scholarly journals A prospective study of comparison between transvaginal sonogram and histopathological examination in perimenopausal women with abnormal uterine bleeding

2019 ◽  
Vol 8 (11) ◽  
pp. 4233
Author(s):  
P. Rishma Priyanka ◽  
C. Rama Mani ◽  
A. Yamuna
Keyword(s):  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Main Concern ◽  
Dilatation And Curettage ◽  
Perimenopausal Women ◽  
Histopathological Report

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.

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

2014 ◽  
Vol 13 (2) ◽  
pp. 135-139 ◽  
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

Comparison of hydrosonography and transvaginal ultrasonography in the detection of intracavitary pathologies in women with abnormal uterine bleeding

2004 ◽  
Vol 14 (1) ◽  
pp. 57-63 ◽  
Author(s):  
M. A. Guven ◽  
T. Bese ◽  
F. Demirkiran
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Normal Endometrium ◽  
Pathologic Findings ◽  
History Of ◽  
Sensitivity Specificity

BackgroundThe aim of the study was to compare the accuracy of hydrosonography with that of transvaginal ultrasonography in detection of intracavitary pathologies in patients with history of abnormal uterine bleeding.Study designProspective, randomized, and unblinded study.Material and methodsA total of 197 women (n = 130 premenopausal and n = 67 postmenopausal) aged between 23 and 71 years (mean age 45.7 ± 8.9) presenting with a history of abnormal uterine bleeding were included into the study. Hydrosonography was carried out by experienced gynecologists, on the same setting in an outpatient clinic immediately after the performance of transvaginal sonography. The finally obtained surgical-pathologic findings were compared with the results obtained from transvaginal sonography and hydrosonography. Sensitivity, specificity, positive, and negative predictive values were calculated for each procedure.ResultsThe surgical-pathologic examination confirmed normal physiologic endometrium in 50 (48%) of 104 women who were said to have normal endometrium on transvaginal sonography. Seventy (75%) of 93 women diagnosed of intracavitary pathologies on transvaginal sonography were confirmed by surgical-pathologic findings. The sensitivity, specificity, positive predictive value, and negative predictive value of transvaginal sonography in the detection of intracavitary pathology were 56, 68, 75, and 48%, respectively. Surgical-pathologic results revealed intracavitary pathologies in 23 (30%) of 76 women who were said to have normal endometrium on hydrosonography. Among 121 women diagnosed of intracavitary pathologies on hydrosonography, 101 (81%) women were confirmed after histological evaluation of the surgical specimens. The sensitivity, specificity, positive predictive value, and negative predictive value of hydrosonography in the detection of intracavitary pathology were 81, 73, 83, and 70%, respectively. Sensitivity and negative predictive value were significantly higher with hydrosonography. There were five cases of endometrial malignancy in which one of the case of malignancy was on polyp and two cases of endometrial hyperplasia with atypia which were not stated on sonographic results.ConclusionHydrosonography is more accurate than transvaginal ultrasography in the detection of intracavitary pathologies in women with abnormal uterine bleeding.

scholarly journals Role of Sonography in the Evaluation of Endometrial Aetiology in Abnormal Uterine Bleeding

2021 ◽  
Vol 8 (12) ◽  
pp. 682-687
Author(s):  
Seema Pandey ◽  
Mamta Kumari ◽  
Amrita Chaurasia ◽  
Gyan Prakash
Keyword(s):  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Saline Infusion ◽  
Transvaginal Sonography ◽  
Care Hospital ◽  
Female Population ◽  
Saline Infusion Sonography ◽  
Vaginal Sonography

BACKGROUND Abnormal uterine bleeding is an important cause of morbidity in the female population, which can be attributed to several reasons. Trans-vaginal sonography and saline-infusion sonography are the mainstay of diagnosis and govern the further management of this condition. This study was conducted to evaluate the thickness and pattern of endometrium with transvaginal sonography and determine any abnormality in the uterine cavity which can be attributed to saline infusion sonography (SIS) in cases of abnormal uterine bleeding (AUB). METHODS The study was conducted among 122 women with complaints of abnormal uterine bleeding attending Outpatient Department and indoor cases of a tertiary care hospital over a period of twelve months. RESULTS The most common presenting complaint was heavy menstrual bleeding in 27.04 % cases. Maximum (44.26 %) cases had normal finding on transvaginal sonography; most common pathological finding was leiomyoma (22.31 %), and endometrial hyperplasia (15.5 %). More than one third (37.7 %) of patients had no abnormalities on saline infusion sonography; while 62.3 % had one or more pathologies; the most common lesion was fibroid in 25.4 % cases. Normal proliferative and secretary endometrium was found on histopathological examination in 50 % cases, while remaining half cases had one or more pathology, most common pathology detected was endometrial hyperplasia in 25.4 % cases. On trans-vaginal sonography (TVS), 11 cases of endometrial polyp were missed, which were detected after infusion of saline and confirmed by histopathological examination. The diagnostic indices of SIS were superior to TVS in diagnosis of any pathology. Sensitivity of TVS was 86.94 % and SIS was 91.94 %. Specificity of TVS (75.41 %) was greater than SIS (68.33 %). CONCLUSIONS TVS and SIS scanning techniques play a very important role in endometrial disorders in woman with AUB. KEYWORDS SIS, Transvaginal, AUB, Endometrium

scholarly journals Comparison of MR Hysterography and Sonohysterography in Women with Abnormal Uterine Bleeding: An Interventional Study

2021 ◽  
Author(s):  
Tsella Lachungpa ◽  
Radha Sarawagi ◽  
Sunitha Vellathussery Chakkalakkombil
Keyword(s):  
Cervical Carcinoma ◽  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Public Health Issue ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Endometrial Pathology

Introduction: Abnormal Uterine Bleeding (AUB) is very common and major public health issue. AUB along with its sub-group often affects 14.25% women of reproductive age and have major impact on their physical, social, emotional and material quality of life. It not only has direct impact on the woman and her family, but also on both economy and health services. Aim: To compare Magnetic Resonance (MR) hysterography and Sonohysterography (SSHG) for detection of uterine pathologies in women with AUB. Materials and Methods: An interventional cross-sectional study was conducted over a period from July 2019 to July 2020, among 30 patients with severe AUB. SSHG and MR hysterography were used to assess endometrial pathology, and endometrial pathology was assessed by both the diagnostic modality and considering histopathology as gold standard. We calculate sensitivity, specificity, positive predictive value and negative predictive value for both the diagnostic modalities. Results: Very good agreement was noted in case of the cervical carcinoma whilst fibroid and endometrial hyperplasia showed good and fair agreement respectively by both the diagnostic modality. Sensitivity of fibroid and cervical carcinoma was 100%, polyp was 33.33%, and endometrial hyperplasia was 87.50%. Whereas specificity of fibroid was 91.67%, endometrial hyperplasia was 86.30% and cervical carcinoma was 100%. Polyp and submucosal fibroid both showed 96.30% specificity. For pathology like cervical carcinoma, endometrial hyperplasia, fibroid had very high agreement with kappa value 1, 0.684 and 0.814 respectively, whereas agreement for two tests for pathology like submucous fibroid, dual pathology was less. Conclusion: MR Hysterography and Sonohysterography were having almost equal sensitivity and specificity for abnormal uterine bleeding and can be used as per patient preference, patient discomfort, and availability of investigation.

scholarly journals A comparative study of hysteroscopy and transvaginal ultrasonography in diagnosis of endometrial pathology in abnormal uterine bleeding

2020 ◽  
Vol 9 (5) ◽  
pp. 1772
Author(s):  
Guntupalli R. Swathi ◽  
Madhu K. Nataraja ◽  
Shukla S. Shetty
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Poor Correlation ◽  
Age Group ◽  
Inclusion Criteria ◽  
Normal Variants ◽  
Medical College ◽  
Endometrial Pathology ◽  
The Ideal

Background: Abnormal uterine bleeding is the most common complaint in gynaecology and an important source of morbidity. The ideal diagnostic tool to determine the cause for the same continues to be debated. Objective of this study was to compare accuracy of hysteroscopy and transvaginal sonography in diagnosis of endometrial pathology in abnormal uterine bleeding.Methods: A total 100 women attending gynaecological outpatient in hospital attached to J. J. M. Medical College, Davangere with abnormal uterine bleeding fitting into the inclusion criteria during November 2014 to August 2016, were admitted and evaluated with Transvaginal sonography (TVS) and hysteroscopy. Data was collected and analysed.Results: Among 100 patients of AUB in this study, majority of the patients were in perimenopausal age group. Menorrhagia is the most common presentation (45%) followed by postmenopausal bleeding (20%). Anaemia was detected in 79% of patients. Hysteroscopy was taken as gold standard and TVS findings were compared. The sensitivity of TVS in detecting polyps, submucous fibroid were 22.2%, 11% respectively and for the normal variants like proliferative and secretory it was 50% and 79.2% respectively. TVS showed good correlation with hysteroscope findings for normal variants of endometrium, but poor correlation for intracavitary pathologies.Conclusions: Hysteroscopy is a rapid, safe, well tolerated and highly accurate means of diagnosing the cause of abnormal uterine bleeding in perimenopausal age group. Thus, it is advised as a first line investigation in evaluation of AUB.

scholarly journals A comparative study to evaluate endometrial aspiration using Karman’s cannula versus dilatation and curettage in cases of abnormal uterine bleeding

2020 ◽  
Vol 9 (3) ◽  
pp. 1218
Author(s):  
Neetu Sangwan Tomar ◽  
Seerat Sandhu ◽  
Supriya Mahipal ◽  
Abhimanyu Chaudhary
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Aspiration Biopsy ◽  
Age Group ◽  
Vacuum Aspiration ◽  
Dilatation And Curettage ◽  
Normal Menstrual Cycle ◽  
Endometrial Pathology

Background: Abnormal uterine bleeding (AUB) is defined as any variation from the normal menstrual cycle such as changes in regularity, frequency, duration of flow or amount of flow. Objective of this study was to compare the adequacy and diagnostic accuracy of endometrial aspiration using Karman’s cannula versus dilatation and curettage in women with abnormal uterine bleeding.Methods: This prospective study was conducted on 250 women with AUB in age group of more than 40 years. In all patients, endometrial aspiration was done with manual vacuum aspiration (MVA) syringe attached to 4 mm Karman's cannula without anesthesia. The sample was collected in a bottle containing formalin and was labelled as sample A. After that, intracervical local anesthesia (1% Xylocaine) was given and cervix was dilated and scrapping of endometrial lining with sharp curette was done. The sample was also collected in a bottle containing formalin and was labelled as sample B. Both the samples A and B were sent for histopathology. The histopathology report of aspiration was compared with that of dilatation and curettage sample.Results: Endometrial aspiration biopsy had sensitivity of 92.3%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.56% for diagnosis of endometrial pathology while considering D and C gold standard. The sample adequacy of endometrial aspiration was 98.8% as compared to dilatation and curettage (98%).Conclusions: Present study showed that endometrial aspiration biopsy is an alternate to traditional dilatation and curettage in diagnosing endometrial pathologies in women with abnormal uterine bleeding.

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