scholarly journals Study of endometrium by trans-vaginal sonography and it’s correlation with histopathology in perimenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (9) ◽  
pp. 3554
Author(s):  
Vandana R. Saravade ◽  
Shuchi Chaturvedi
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Age Group ◽  
Dilation And Curettage ◽  
Perimenopausal Women ◽  
Multiparous Women ◽  
Vaginal Sonography

Background: Objectives of the study were to study the endometrial patterns in cases of abnormal uterine bleeding (AUB) and anatomical (structural) lesions of uterus using transvaginal sonography (TVS) and endometrial histopathology and to determine the efficacy of TVS.Methods: Cross-section study of 50 perimenopausal age group with AUB in TNMC BYL Nair hospital from Nov 2017 to Nov 2018.Results: AUB was seen 40 to 45 years multiparous women TVS endometrial thickness (ET) T 6-10 mm (46%), ET 11-15 (22%), ET>15 mm (14%), <5 mm in (18%), showed 21 (42%) patients with endometrial hyperplasia on TVS, 12 (24%) simple hyperplasia 4 (8%) complex hyperplasia on histopathology fibroid 8%, adenomyosis 2%. endometrial polyp 6%.Conclusions: Endometrial lining exceeds 10 mm dilation and curettage to be done r/o endometrial hyperplasia, to study the endometrial patterns in cases of abnormal uterine bleeding and anatomical (structural) lesions of uterus using transvaginal sonography and endometrial histopathology.

scholarly journals Evaluation of abnormal uterine bleeding with transvaginal sonography and hysteroscopy in perimenopausal women

2017 ◽  
Vol 6 (8) ◽  
pp. 3607 ◽  
Author(s):  
Jaya Choudhary ◽  
Veena Acharya ◽  
Monika Jain
Keyword(s):  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Transvaginal Sonography ◽  
Age Group ◽  
Perimenopausal Women ◽  
Normal Menstrual Cycle ◽  
Group A ◽  
Sensitivity Specificity

Background: Abnormal uterine bleeding is defined as any deviation from the normal menstrual cycle this include change in regularity, frequency of menses, duration or amount of bleeding during or in between periods. Objective of present study was to evaluate abnormal uterine bleeding with transvaginal sonography and hysteroscopy in perimenopausal women.Methods: This study is conducted on women presenting to the gynecological OPD with complain of abnormal uterine bleeding in perimenopausal age group. A total of 50 patients were subjected to transvaginal sonography and Diagnostic hysteroscopy.Results: On TVS, out of total 50 patients, 50% patient showed normal endometrial finding. 24% Patient showed Endometrial hyperplasia, 14% Endometrial Polyp, 8% Submucosal fibroid, 4% Adenomyosis. On TVS, out of total 50 patient, 50% patient showed normal endometrial finding. 24% Patient showed endometrial hyperplasia, 14% endometrial Polyp, 8% submucosal fibroid, 4% adenomyosis. Out of total 50 patients, 28 (56%) showed normal endometrial finding.20% cases showed endometrial Hyperplasia, 16% showed endometrial Polyp, 8% showed submucosal fibroid. Sensitivity, specificity, PPV, NPV of endometrial hyperplasia – 81.81%, 92.3%, 75%, 94.73% respectively.Conclusions: Transvaginal sonography has a moderate diagnostic accuracy in detecting endometrial hyperplasia and other intrauterine pathology. TVS is safe, acceptable and easily available & is noninvasive. It should be used as 1st line diagnostic tool in patients with AUB in perimenopausal women. Hysteroscopy has important tool in the diagnosis of various endometrial and intrauterine lesions TVS and hysteroscopy should be employed hand in hand in evaluation of AUB.

scholarly journals Comparison of transvaginal sonography with hysteroscopy and correlation with histopathological report in case of abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 710
Author(s):  
Gunadhar Maiti ◽  
Prasad Lele ◽  
Dhananjay Borse
Keyword(s):  
Sensitivity And Specificity ◽  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Lower Sensitivity ◽  
Age Group ◽  
Histopathological Report

Background: Abnormal uterine bleeding (AUB) is change in frequency of menses, duration of flow or amount of blood loss. The objectives of the present study were to determine and compare the diagnostic accuracy of TVUS (Transvaginal ultrasonogrphy) with hysteroscopy for diagnosis of endometrial and intramyometrial pathology in case of abnormal uterine bleeding, to study the correlation with histopathological report of endometrial biopsyMethods: It was a prospective comparative study. 200 cases of AUB were selected from June 2010 to May 2012 attending Gynaecology OPD in tertiary care level public sector teaching hospital at Mumbai, meeting the selection criteria were enrolled into the study. Complete history, detail general, systemic and local examination was performed for all patients. Two-dimensional transvaginal ultrasonography was performed to see for endometrial or intramyometrial pathology. Endometrial thickness was noted for all patients. Hysteroscopy and D&C was performed within 48 hours of ultrasonography. After hysteroscopy, curettage was performed and sent for histopathological examination.Results: TVUS detected, 19 polyps (9.5%) and 81 myomas. It was able to differentiate these myomas as 64 interstitials (32%) and 17 submucous (8.5%) hysteroscopy detected 26 submucous myomas (13%), 31 polyps (15.5%), endometrial hyperplasia detected by TVUS, 19 in premenopausal and 06 in postmenopausal age group. Hysteroscopy detected 24 in premenopausal and 06 in post-menopausal age group. Histopathology of endometrial biopsy it came positive for 13 in premenopausal and 08 in postmenopausal age group. Two cases of CA endometrium were diagnosed on HPE out of which one was diagnosed by TVUS and same was diagnosed by hysteroscopy. Conclusions: TVUS has significantly lower sensitivity but comparable specificity with hysteroscopy in diagnosing endometrial polyp and submucous fibroid, comparable sensitivity and specificity in diagnosing endometrial hyperplasia, equivalent sensitivity and specificity in diagnosing endometrial carcinoma, accuracy of TVUS for detecting pathology in AUB is comparable to hysteroscopy, suitable for developing countries as first diagnostic step for AUB.

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

TRANSVAGINAL SONOGRAPHY VERSUS SALINE INFUSION SONOHYSTEROGRAPHY FOR EVALUATION OF ABNORMAL UTERINE BLEEDING IN PERIMENOPAUSAL AGE GROUP

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Anjali Chandra ◽  
Shashibala Arya ◽  
J. K. Goel ◽  
Rajneesh Madhok ◽  
M. Sinha ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Saline Infusion ◽  
Transvaginal Sonography ◽  
Highly Sensitive ◽  
Perimenopausal Women ◽  
Prospective Comparative Study ◽  
Fibroid Polyp ◽  
Saline Infusion Sonohysterography

<bold>Introduction:</bold> The present study was conducted to evaluate the validity of Transvaginal Sonography (TVS) in perimenopausal women with abnormal uterine bleeding (AUB), validity of saline infusion sonohysterography in perimenopausal women with abnormal uterine bleeding and to compare the diagnostic accuracy of the above mentioned modalities. <bold>Material and Methods:</bold> It was a prospective comparative study of TVS and Saline Infusion Sonohysterography (SIS) in 100 perimenopausal women presenting with AUB. The findings of TVS and SIS was compared with histopathology. <bold>Result:</bold> The sensitivity of TVS for submucosal fibroid, polyp, intramural fibroid and endometrial hyperplasia was found to be 50%,44.44%, 40%, 33.33% respectively while specificity being 88.29%, 95.60%, 88.88%, 95.60% respectively. The sensitivity of SIS for endometrial hyperplasia and submucosal fibroid was found to be same (66.66%) whereas for polyp and intramural fibroid was 55.55% and 50% respectively. Specificity of SIS for polyp, endometrial hyperplasia, intramural fibroid and submucosal fibroid was found to be 98.90%,95.60%,92.2% and 90.42% respectively. Overall sensitivity and specificity of TVS was 79.4% and 75.8 % respectively whereas for SIS is 82.4% and 80.3% respectively. <bold>Conclusion:</bold> SIS is simple, highly sensitive and specific technique to detect intrauterine pathology.

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 VALUE OF ENDOMETRIAL THICKNESS MEASUREMENT FOR DIAGNOSING ENDOMETRIAL HYPERPLASIA IN PERIMENOPAUSAL WOMEN

2020 ◽  
pp. 1-3
Author(s):  
Bishnu Prasad Das ◽  
Chintumoni Gogoi
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Strong Association ◽  
Abnormal Uterine Bleeding ◽  
Thickness Measurement ◽  
Endometrial Biopsy ◽  
Transvaginal Sonography ◽  
Dilatation And Curettage ◽  
Perimenopausal Women ◽  
Invasive Method

Objective- to determine the sonographic findings associated with endometrial hyperplasia (EH+) in perimenopausal women with abnormal uterine bleeding (AUB). Methods- a retrospective study, in which 150 subjects, perimenopausal women with AUB, underwent transvaginal sonography (TVS) and endometrial biopsy. The TVS findings were evaluated with regard to EH+. Result- Biopsy proven EH+ was seen in 18.67% of subjects. EH+ was not found in any patient with TVS showing endometrial thickness < 8 mm. Conclusion- There is a strong association between TVS endometrial thickness and endometrial biopsy findings. The risk of development of endometrial cancer is 29% in patients with complex atypical hyperplasia and 2% in patients with hyperplasia without atypia. Thus TVS should be in the first investigation in the management of AUB. Invasive method like dilatation and curettage (D&C) to be considered in cases with endometrial thickness > or = 8 mm.

scholarly journals An analytical study of abnormal uterine bleeding in women of child bearing age group

2021 ◽  
Vol 10 (8) ◽  
pp. 3011
Author(s):  
Jayneel V. Shah ◽  
Munjal J. Pandya ◽  
Prakash B. Prajapati ◽  
Dharmik B. Senta ◽  
Meet K. Patel
Keyword(s):  
Medical Therapy ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Transvaginal Sonography ◽  
Age Group ◽  
Child Bearing ◽  
Causative Factors ◽  
Multiparous Women ◽  
Normal Menstrual Cycle

Background: AUB (abnormal uterine bleeding) is defined as any variation from the normal menstrual cycle including alteration in its frequency, regularity of menses, duration of flow and amount of blood loss. In India, the reported prevalence of AUB is 17.9%. It can occur any time between menarche to menopause. A good clinician tries to recognize and identify the causative factors responsible for the disease, reverse the abnormality and induce or restore the cyclic predictable menses which should have normal volume and duration.Methods: 200 cases of AUB fitting the selection criteria were taken from OPD and gynecology ward between September 2020 to June 2021.Results: AUB was more common in the age group 41-45 years, that is, perimenopausal age group, more in multiparous women and women with previous surgeries on uterus and adnexa. Heavy menstrual bleeding was the most common complaint. Endometrial hyperplasia was the most common finding on ultrasound examination. Medical therapy was beneficial in some patients, rest had to undergo surgical intervention later.Conclusions: Transvaginal sonography is very accurate in assessing the endometrium as well as uterus and adnexa and diagnosing their abnormalities. Medical therapy is the first line of management in most cases. Dilatation and curettage should be used along with hysteroscopy for better results. LNG-IUS gives very good result in suitable cases. Hysterectomy is the final measure if everything else fails. Vaginal hysterectomy is preferred wherever possible.

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 Abnormal uterine bleeding in perimenopausal women: sonographic and histopathological correlation and evaluation of uterine endometrium

2020 ◽  
Vol 9 (5) ◽  
pp. 1959
Author(s):  
Rupali Modak ◽  
Amitrajit Pal ◽  
Amitava Pal ◽  
Kausik Bose
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Clinical History ◽  
Uterine Bleeding ◽  
Teaching Hospitals ◽  
Histopathological Diagnosis ◽  
Eligibility Criteria ◽  
Uterine Endometrium ◽  
Perimenopausal Women

Background: The objectives of the study was to establish the role of histopathological diagnosis of uterine endometrial lesions in patients of AUB at perimenopausal age and to correlate the transvaginal sonographic (TVS) finding with histopathological examination.Methods: This prospective observational study was carried out over 1 and 1/2 years in the two apex level teaching hospitals in eastern India. A total of 197 women in the age group of 40-49 years and ≥50 years (up to 55 years) who presented with abnormal uterine bleeding were included in the study. After selecting the patient with eligibility criteria in the OPD, detailed clinical history, systemic and gynecological examinations and investigations were done as per proforma. TVS study of endometrial pattern and thickness was measured followed by dilatation and curettage (D and C) and HPE of the endometrial curetting was done.Results: Menorrhagia (44.67%) was the most common clinical finding. Mean endometrial thickness measured by TVS was 7.04±2.11 mm in proliferative phase and 10.25±1.27 mm in the secretory phase. Proliferative endometrium (37.06%) was the most frequent finding in HPE followed by secretory endometrium (20.3%). Hyperplasia of endometrium was noted in 27 cases (100%) at 12-15 mm of endometrial thickness on TVS whereas endometrial hyperplasia with and without atypia and endometrial carcinoma was noted in 25 cases (92.59%) at the same thickness of 12-15 mm of uterine endometrium on HPE. Endometrial hyperplasia and polyp both had sensitivity of 84.21% and 71.43% respectively on TVS as compared with histopathology.Conclusions: Increased endometrial thickness and echo pattern by TVS correlated well with abnormal endometrial tissue histopathology in perimenopausal women with AUB.

scholarly journals A descriptive study of Endometrial Biopsies in perimenopausal women having Abnormal uterine bleeding

2021 ◽  
Vol 6 (3) ◽  
pp. 203-205
Author(s):  
Sandhya I ◽  
Manjushree Prabhu P ◽  
Purnima S Rao ◽  
Sameeksha Alwa
Keyword(s):  
Gold Standard ◽  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Perimenopausal Women ◽  
Pathological Evaluation ◽  
Secretory Endometrium

Abnormal uterine bleeding (AUB) is one of the commonest symptom with which the perimenopausal female visits the gynaecologist accounting for over 70% of all gynecological consultations in that age group. The clinical presentation of AUB can range anywhere menorrhagia, polymenorrhea, polymenorrhagia, metrorrhagia, and menometrorrhagia. Though biopsy is the gold standard it is an invasive procedure and hence often an Ultrasound is used to evaluate the pathology of the endometrium routinely hence, we decided to study the accuracy between radiological ET thickened and its usefulness in detecting endometrial pathology. This study was carried out in the Department of Pathology at AJIMS, Mangalore for a period of 2 years. The sample included endometrial biopies and hysterectomy specimens of perimenopausal women for AUB. The ultrasonographic findings and Histopathological (HPE) reports were analysed. Among 101 cases for AUB, 67 cases were diagnosed as non secretory endometrium. Out of these 67 cases, 49 cases were associated with fibroids. Out of the rest of the AUB cases, 31 of them were diagnosed to have endometrial hyperplasia and 3 cases were diagnosed to have endometrial carcinoma. USG thickness of 17(54%) out of 31 endometrial hyperplasia cases were abnormal. Radiological and pathological evaluation were concordant with diagnosis of AUB associated with fibroids. However only 54% of the endometrial hyperplasia were found to have abnormal endometrial thickness. Radiological evaluation of endometrial thickness is not concordant in 46 % of the cases. This implies that histopathological examination is gold standard diagnostic tool for endometrial abnormalities in perimenopausal women.

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