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 ◽  
...  

<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.

Author(s):  
Neerja Gupta ◽  
Geeta Singh ◽  
Bharti Jain ◽  
Satakshi Garg

Background: Abnormal uterine bleeding (AUB) is one of the most common reasons for women seeking gynaecological advice. The objective of this study was to determine the accuracy of Transvaginal sonography (TVS) and Saline Infusion Sonography (SIS) in evaluation of Abnormal Uterine Bleeding (AUB) and to compare the diagnostic accuracy after hysterectomy.Methods: Prospective, comparative study of TVS and SIS in evaluation of AUB in patients who are being subjected to hysterectomy with uterus of less than 12 weeks.Results: 100 patients were included in the study. 98% were of 30-50 years. Heavy menstrual bleeding was the commonest symptom (52%) and most common finding was fibroid, and Polyp followed by abnormal endometrium. The overall sensitivity and specificity when correlated with operative and HPE were 66% and 88% respectively for TVS and 82% and 95% for SIS respectively. The false positive and false negative rates were more in TVS compared to SIS. Commonest histopathology was intramural fibroid in 42% followed by sub mucus myoma in 21%, polyp 18% and endometrial hyperplasia 10%.Conclusions: SIS is a simple highly sensitive and specific technique to detect intra uterine pathology in the evaluation of AUB when TVS findings are inconclusive.


Author(s):  
Saika . ◽  
Tania Singh

Background: Saline infusion sonohysterography (SIS) is a simple, safe, reliable, effective and well-tolerated method without complications that complements transvaginal sonography (TVS) in the pre-operative examination of uterine pathology. SIS has been found to be superior to TVS in most studies that have compared their effectiveness in detecting intracavitary lesions and has also been found to decrease the number of diagnostic hysteroscopies to as much as 50%. Patients in whom no intracavitary abnormality is detected by SIS require no further evaluation and are best treated with medical therapy.Methods: The observational study was conducted in the postgraduate department of gynaecology and obstetrics, Lalla Ded Hospital, Government Medical College Srinagar. All consecutive patients with perimenopausal abnormal uterine bleeding attending gynaecology OPD were enrolled in the study after taking informed written consent.Results: SIS has better accuracy than TVS in diagnosing the cause of AUB in perimenopausal women. TVS had sensitivity, specificity and PLR of 60 and 93.8, 9.8, respectively for fibroids while polyps had 27.3, 98.8 and 17.5, respectively, AUP had 81.8, 79.2, 3.9 respectively. SIS had sensitivity, specificity, PLR and NLR values of 80.0, 96.9, 40.7 and 0.21, respectively for diagnosing fibroids, while 63.6, 98.4, 26 and 0.37 respectively for polyp, and 90.9, 94.3, 16.1 respectively for AUP.Conclusions: Accuracy of SIS as a test for detecting pathology in AUB in perimenopausal patients is moderately good and suitable for developing countries.


2021 ◽  
Vol 8 (12) ◽  
pp. 682-687
Author(s):  
Seema Pandey ◽  
Mamta Kumari ◽  
Amrita Chaurasia ◽  
Gyan Prakash

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


Author(s):  
Vandana R. Saravade ◽  
Shuchi Chaturvedi

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.


Author(s):  
Jaya Choudhary ◽  
Veena Acharya ◽  
Monika Jain

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.


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