scholarly journals Hysterosalpingography Vs Hysteroscopy in the Detection of Intrauterine Pathology in Infertility

1970 ◽  
Vol 7 (1) ◽  
pp. 6-9 ◽  
Author(s):  
B Shakya
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
False Negative Rate ◽  
Uterine Cavity ◽  
University Teaching ◽  
Endometrial Polyps ◽  
Proliferative Phase ◽  
Submucous Myoma ◽  
Health Research Council ◽  
Prospective Comparative Study

Background: This study was to compare the accuracy of hysterosalpingography (HSG) with hysteroscopy (HSC) in detection of uterine pathology in patients with infertility. Methods: This is a prospective comparative study done among 50 new cases of primary and secondary infertility presenting to infertility clinic of Tribhuvan University Teaching Hospital from March 2006 - 2007. HSG was performed in the proliferative phase of menstrual cycle followed by HSC in the proliferative phase of the same or the following cycle. Intra uterine findings on HSG were evaluated and compared with hysteroscopic findings. Results: Out of 50 cases, HSG revealed normal findings in 49 cases (98%) and HSC demonstrated normal uterine cavity in 44 of the cases (88%). There was one abnormality (2%) shown on HSG (subseptate uterus) which was confirmed at HSC. HSC demonstrated six cases (12%) of intrauterine pathologies and these were endometrial polyps, subseptate uterus and submucous myoma. HSG in the detection of intrauterine pathology had a sensitivity (SV) of 16.7% (95% CI 0.9-63.5), specificity (SP) 100% (95% CI 90-100), positive predictive value (PPV) 100% (95% CI 5.5-100), negative predictive value (NPV) 89.8% (95% CI 77-96.2), false negative rate (FNR) 83.3% and accuracy rate (AR) 90%. Conclusion: HSG is a specific, but not sensitive predictor of uterine pathology. However, HSG did not provide any additional finding in comparison to HSC. Therefore, HSG is not advisable in the detection of uterine pathology in infertility patients.Key words: diagnostic hysteroscopy, hysterosalpingography, infertility, uterine cavity.   DOI: 10.3126/jnhrc.v7i1.2271 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 6-9

scholarly journals Investigating Hysteroscopy Implementation in Infertile Women Candidate With a Normal Uterine Cavity for Laparoscopy in Hysterosalpingography

2018 ◽  
Vol 7 (1) ◽  
pp. 79-84
Author(s):  
Maliheh Amirian ◽  
Anis Darvish Mohammadabad ◽  
Negar Morovatdar ◽  
Leili Hafizi
Keyword(s):  
Diagnostic Laparoscopy ◽  
False Negative ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Endometrial Polyps ◽  
Infertile Women ◽  
Submucous Myoma ◽  
Age Range

Objectives: Endometrial pathologies inside the cavity can occur simultaneously with gestational unpleasant consequences but are not always capable of being diagnosed by the hysterosalpingography (HSG). This study aimed to examine the value of performing diagnostic hysteroscopy beside diagnostic laparoscopy among infertile women with normal uterine cavities in HSG. Materials and Methods: A total of 103 infertile women with normal uterine cavities in the HSG and within the age range of 18-40 who referred to Imam Reza hospital for laparoscopy during 2016-2017 were included in this cross-sectional study. Hysteroscopy was performed simultaneously with diagnostic laparoscopy. Then, the existence of uterine pathologies like endometrial polyps, submucous myoma, and uterine endometrial adhesions and their relationship with the patient’s age, infertility type and duration, and cycle time were evaluated. A P value less than 0.05 was considered statistically significant. Results: Overall, 64 patients (63.1 %) had a normal uterine cavity in the hysteroscopy while 39 of them had an abnormal uterine cavity, the HSG false negative cases of whom were reported 37.9%. The pathologies found in the hysteroscopy were endometrial polyp (16 cases), submucous myoma (1 case), uterine septum (6 cases), asherman syndrome (7 cases), bicornuate uterus (4 cases), polyp + asherman (3 cases), polyp + submucous myoma (1 case), and septum + submucous myoma (1 case). Patients’ age, type of infertility, and menstruation time during performing hysteroscopy made no particular difference in diagnosing pathologies of the uterine cavity in the hysteroscopy. Conclusions: Based on the findings, conducting hysteroscopy in infertile women who are candidates of laparoscopy and have normal uterine cavities in HSG can result in recognizing some cases of uterine pathologies which influence the outcomes of future pregnancies is not dependent upon the patient’s age, menstruation time, type and duration of infertility, and result of laparoscopy.

Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

2020 ◽  
Vol 103 (6) ◽  
pp. 585-593
Keyword(s):  
Predictive Value ◽  
Final Diagnosis ◽  
Saline Infusion ◽  
Transvaginal Ultrasonography ◽  
Histopathological Diagnosis ◽  
Endometrial Polyps ◽  
Saline Infusion Sonography ◽  
Submucous Myoma ◽  
Kappa Value ◽  
Sensitivity Specificity

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

scholarly journals Comparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility

2017 ◽  
Vol 13 (4) ◽  
pp. 281-285 ◽  
Author(s):  
A. Nigam ◽  
P. Saxena ◽  
A. Mishra
Keyword(s):  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Uterine Cavity ◽  
Cervical Canal ◽  
Diagnostic Modality ◽  
Infertile Patient ◽  
Infertile Women ◽  
Intrauterine Abnormalities

Background Hysterosalpingography (HSG) is a useful screening test for the evaluation of female infertility. Laparoscopy has proven role in routine infertility work up but role of hysteroscopy in an infertile patient with normal HSG for additional information is a subject of debate. Hysteroscopy permits direct visualization of the cervical canal and the uterine cavity and thereby helping in the evaluation of shape, and cavitary lesion.Objective To detect uterine abnormalities in infertile women by various approaches i.e. HSG and hysteroscopy and evaluating the role of combining hysteroscopy with laparoscopy for the evaluation of tubo-uterine factor for primary infertility.Method One twenty eight infertile women were evaluated and HSG was performed as a basic test for evaluation of tubes and uterine cavity. Women were subjected to combined laparoscopic and hysteroscopic examination on evidence of HSG abnormalities. In absence of any HSG abnormality, women were subjected to ovulation induction for three to six months and if they did not conceive during this period they were undertaken for combined laparo-hysteroscopic evaluation.Result The positive predictive value of HSG for detecting the intrauterine abnormalities was 70% among 126 patients where the hysteroscopy could be performed successfully. The diagnostic accuracy of HSG for intrauterine abnormalities revealed false negative rate of 12.96%. The most frequent pathologies encountered by laparoscopy were tubal and/or peritoneal and were found in 68% (87/128) of women. Total 64.06% infertile women had some abnormality on laparoscopy. This detection rate has been increased from 64.06% to 71.86% on including the concomitant hysteroscopy.Conclusion HSG is a good diagnostic modality to detect uterine as well as tubal abnormalities in infertile patient. HSG and hysteroscopy are complementary to each other and whenever the patient is undertaken for diagnostic laparoscopy for the infertility, hysteroscopy should be combined to improve the detection rate of abnormalities especially in communities where there is enormous risk of pelvic infection.

scholarly journals Hysteroscopy is Gold standard in Uterine evaluation for Infertility, but HSG still has a place

2021 ◽  
Vol 12 (4) ◽  
pp. 98-104
Author(s):  
Manisha Bajaj ◽  
Rajib Roy ◽  
Motiur Rahman ◽  
Joydeb Roychowdhury
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
Screening Method ◽  
Uterine Cavity ◽  
High Specificity ◽  
Filling Defect ◽  
Endometrial Polyp ◽  
Care Hospital ◽  
Saline Infusion Sonography ◽  
First Choice

Background: Uterine abnormalities, congenital or acquired are implicated as causal factor in 10%-15% of infertile couplesreporting for treatment. Hysteroscopy, hysterosalpingography (HSG), saline-infusion-sonography and USG are available for evaluation of uterine cavity. HSG helps in initial evaluation of a sub-fertile woman, but hysteroscopy is gold standardas itallows direct visualisation ofintrauterine pathology and treatment in same-setting, if required. Aims and Objective: To describe hysteroscopic findings of infertile patients and compare the observations with their respective HSG findings. Materials and Methods: It’s a prospective analysis of 105 women with infertility who attendedtertiary-care hospital during 18 monthsfulfilling pre-defined inclusion and exclusion criteria. All cases were evaluated with both HSG and hysteroscopy, observations were recorded and co-related with each other. Results: Among 105 cases, maximum (76.19%) were 25-35 years of age. The primary infertility accounted for 68.57% cases.Abnormal HSG findings observed in 19 cases (20%), most common being filling-defect.Hysteroscopy detected abnormalities in 39 cases (37.14%), commonest being endometrial polyp. Out of 39 cases of abnormal uterine cavity detected on hysteroscopy only 19 were picked-up by HSG, rest 20 cases failed to be identified. The strength of agreement between hysteroscopy and HSG calculated is moderate (Kappa=0.505). Conclusion: As HSG hadlow false positivity (03%), high positive-predictive-value (90.48%) and negative-predictive-value (76.19%) and high specificity (96.96%) it is still considered as a first-choice screening method of uterine cavity. However, high false-negative-value (51.28%)of HSG makes Hysteroscopy a better diagnostic test. HSG couldn’t differentiate endometrial polyp, adhesions and submucous fibroid, shown them as filling defect only.

scholarly journals Algoritma Naïve Bayes Untuk Memprediksi Kredit Macet Pada Koperasi Simpan Pinjam

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Diah Puspitasari ◽  
Syifa Sintia Al Khautsar ◽  
Wida Prima Mustika
Keyword(s):  
Data Mining ◽  
Predictive Value ◽  
Naive Bayes ◽  
False Negative ◽  
False Negative Rate ◽  
True Positive Rate ◽  
Naïve Bayes ◽  
Data Mining Technique ◽  
Application Form ◽  
Using Data

Cooperatives are a forum that can help people, especially small and medium-sized communities. Cooperatives play an important role in the economic growth of the community such as the price of basic commodities which are relatively cheap and there are also cooperatives that offer borrowing and storing money for the community. Constraints that have been felt by this cooperative are that borrowers find it difficult to repay loan installments, causing bad credit. Because the cooperative in conducting credit analysis is carried out in a personal manner, namely by filling out the loan application form along with the requirements and conducting a field survey. Therefore there is a need for an evaluation to be carried out in lending to borrowers. To minimize these problems, it is necessary to detect customer criteria that are used to predict bad loans and to determine whether or not the elites are eligible to take credit using data mining. The data mining technique used is classification with the Naive Bayes method. Based on testing the accuracy of the resulting model obtained accuracy level of 59%, sensitivity (True Positive Rate (TP Rate) or Recall) of 46.80%, specificity (False Negative Rate (FN Rate or Precision) of 69.81%, Positive Predictive Value (PPV) of 57.89%, and Negative Predictive Value (NPV) of 59.67%.

scholarly journals A new criterion for the alarm point using a combination of waveform amplitude and onset latency in Br(E)-MsEP monitoring in spine surgery

2018 ◽  
Vol 29 (4) ◽  
pp. 435-441 ◽  
Author(s):  
Kazuyoshi Kobayashi ◽  
Kei Ando ◽  
Ryuichi Shinjo ◽  
Kenyu Ito ◽  
Mikito Tsushima ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Predictive Value ◽  
False Positive ◽  
Roc Analysis ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
High Rate ◽  
Motor Deficit ◽  
Onset Latency

OBJECTIVEMonitoring of brain evoked muscle-action potentials (Br[E]-MsEPs) is a sensitive method that provides accurate periodic assessment of neurological status. However, occasionally this method gives a relatively high rate of false-positives, and thus hinders surgery. The alarm point is often defined based on a particular decrease in amplitude of a Br(E)-MsEP waveform, but waveform latency has not been widely examined. The purpose of this study was to evaluate onset latency in Br(E)-MsEP monitoring in spinal surgery and to examine the efficacy of an alarm point using a combination of amplitude and latency.METHODSA single-center, retrospective study was performed in 83 patients who underwent spine surgery using intraoperative Br(E)-MsEP monitoring. A total of 1726 muscles in extremities were chosen for monitoring, and acceptable baseline Br(E)-MsEP responses were obtained from 1640 (95%). Onset latency was defined as the period from stimulation until the waveform was detected. Relationships of postoperative motor deficit with onset latency alone and in combination with a decrease in amplitude of ≥ 70% from baseline were examined.RESULTSNine of the 83 patients had postoperative motor deficits. The delay of onset latency compared to the control waveform differed significantly between patients with and without these deficits (1.09% ± 0.06% vs 1.31% ± 0.14%, p < 0.01). In ROC analysis, an intraoperative 15% delay in latency from baseline had a sensitivity of 78% and a specificity of 96% for prediction of postoperative motor deficit. In further ROC analysis, a combination of a decrease in amplitude of ≥ 70% and delay of onset latency of ≥ 10% from baseline had sensitivity of 100%, specificity of 93%, a false positive rate of 7%, a false negative rate of 0%, a positive predictive value of 64%, and a negative predictive value of 100% for this prediction.CONCLUSIONSIn spinal cord monitoring with intraoperative Br(E)-MsEP, an alarm point using a decrease in amplitude of ≥ 70% and delay in onset latency of ≥ 10% from baseline has high specificity that reduces false positive results.

scholarly journals Diagnostic Accuracy of Fine Needle Aspiration Cytology of Thyroid Pathologies

2020 ◽  
Vol 19 (2) ◽  
pp. 84-89
Author(s):  
Shova Kunwar ◽  
Barsha Bajracharya ◽  
Kavita Karmacharya ◽  
Amar Narayan Shrestha
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Thyroid Lesion ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Introduction: Fine needle aspiration cytology is considered as the gold standard for the diagnosis of thyroid nodules. This study aimed to evaluate and compare the accuracy of fine-needle aspiration cytology in the diagnosis of thyroid lesion by comparing it with the corresponding histopathologic diagnosis after thyroidectomy. Methods: This is a retrospective study conducted over five years at a teaching hospital in Kathmandu. Eighty-nine cases of FNAC of thyroid nodule with subsequent histopathological reports were reviewed. The corresponding reports were compared and the accuracy of FNAC diagnosis was evaluated. Results: 87% of the cases were females and the majority of cases were in the age group 41 to 50 years. Among 89 cases, 55 were reported as benign on cytology and 34 were reported as malignant. On histopathological examination, out of 55 cases diagnosed as benign on cytology, 47 cases were diagnosed as benign whereas eight cases were diagnosed as malignant. HPE of 34 cases diagnosed as malignant on cytology showed that 29 were malignant and five were benign. The false-positive rate was 9.6% and the false-negative rate was 21.6%. The sensitivity was 78.3% and specificity was 90.3%. The positive predictive value and negative predictive value were 85.2% and 85.4% respectively. The accuracy of FNAC in differentiating benign from malignant thyroid lesions was 85.3%. Conclusions: The findings of this study showed that FNAC is a sensitive method for the diagnosis of a solid thyroid lesion

scholarly journals Evaluation of the anterior cervical angle of the uterus to predict spontaneous preterm birth

2017 ◽  
Vol 6 (6) ◽  
pp. 2323 ◽  
Author(s):  
Bijay Sur ◽  
Sujata Misra ◽  
Sanghamitra Dash
Keyword(s):  
Preterm Birth ◽  
Predictive Value ◽  
False Negative ◽  
False Negative Rate ◽  
Cervical Length ◽  
Small Sample ◽  
Transvaginal Sonography ◽  
P Value ◽  
Spontaneous Preterm Birth ◽  
Preterm Group

Background: This prospective observational study was conducted to evaluate the anterior cervical angle (ACA) of the uterus by transvaginal sonography (TVS) and to determine the feasibility to predict spontaneous preterm birth (PTB). The duration of the study was from December 2014-December 2016.The participants included 100 pregnant women with singleton pregnancy who were asymptomatic. They were enrolled after excluding all known risk factors of preterm birth.Methods: The ACA and cervical length were measured in all cases by transvaginal sonography either in the 1st trimester or 2nd trimester. All cases were followed and well documented with respect to the gestational age at delivery.Results: There was a significant risk of preterm labour in women with cervical length <2.5cm in the 2nd trimester with Odds Ratio 3.625, P value=0.001, sensitivity 75% and specificity 79.31%. The positive predictive value was 33.33% and negative predictive value 95.83%. The false positive rate was 20.65% and false negative rate 25%. The difference of mean cervical angle in women who delivered preterm and that of those who delivered at term, in the 1st    trimester (preterm group 114.2°Vs term group 93.0°, P<0.001) and in the 2nd trimester (preterm group 127.66° Vs term group 103.65°, P <0.001) was significant. An ACA of 114.2° in the 1st trimester was associated with a risk of spontaneous preterm birth (P value 0.0065, sensitivity 90% and specificity 80%). An ACA of 127.66° in 2nd trimester was associated with a risk of spontaneous preterm birth (P value 0.0004, sensitivity 80%and specificity 88.23%).Conclusions: Despite the limitations of a small sample size, the results suggest that the anterior cervical angle has potential as a new predictor of spontaneous preterm birth especially when measured in the 1st trimester.

scholarly journals A Comparative Observational Study of the Use of Saline Uterine Hydrosonography for the Diagnosis and Assessment of Uterine Cavity Lesions in Women

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Veluppillai Vathanan ◽  
Nii Adjeidu Armar
Keyword(s):  
Predictive Value ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Diagnostic Efficacy ◽  
Endometrial Polyps ◽  
Saline Infusion Sonography ◽  
Middlesex Hospital ◽  
Diagnostic Hysteroscopy ◽  
Intrauterine Abnormalities ◽  
Transvaginal Ultrasound Scan

Aim of this study was to evaluate the performance of saline hydrosonography (HSGM) (also known as saline infusion sonography (SIS)) against transvaginal ultrasound scan (TVS) and hysteroscopy in the diagnosis of uterine cavity lesions. Diagnostic hysteroscopy with biopsy is considered as the “gold standard” to diagnose intrauterine abnormalities. The introduction of HSGM has improved the diagnostic capability of ultrasound. It is important to establish the efficacy and safety of HSGM before it is widely recommended for use. This retrospective observational data was collected from all 223 patients who underwent TVS, HSGM, and hysteroscopy as part of their gynaecological investigations from 1 January 2008 to 31 December 2010 at Central Middlesex Hospital, London.Endometrial Polyps. TVS: sensitivity 60.53%, specificity 97.06%, positive predictive value (PPV) 95.83%, and negative predictive value (NPV) 68.75% and HSGM: sensitivity 95%, specificity 97.14%, PPV 97.44%, and NPV 94.44%.Submucous Leiomyoma. TVS: sensitivity 57.14%, specificity 93.48%, PPV 84.21%, and NPV 78.18% and HSGM: sensitivity 96.55%, specificity 100.00%, PPV 100.00%, and NPV 97.92%. Diagnostic efficacy of HSGM is superior to TVS for the diagnosis of endometrial polyps and submucous fibroids. HSGM should be considered as an intermediate investigation after TVS to assess intracavity pathology and to confirm the diagnosis; hysteroscopy should become a therapeutic intervention.

scholarly journals Cell-free DNA in spent culture medium effectively reflects the chromosomal status of embryos following culturing beyond implantation compared to trophectoderm biopsy

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246438
Author(s):  
Akihiro Shitara ◽  
Kazumasa Takahashi ◽  
Mayumi Goto ◽  
Harunori Takahashi ◽  
Takuya Iwasawa ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Predictive Value ◽  
Culture Medium ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Concordance Rate ◽  
Preimplantation Genetic Testing ◽  
Cell Free Dna ◽  
Free Dna

This prospective study evaluated the accuracy of non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) using cell-free DNA in spent culture medium, as well as that of preimplantation genetic testing for aneuploidy (PGT-A) using trophectoderm (TE) biopsy after culturing beyond implantation. Twenty frozen blastocysts donated by 12 patients who underwent IVF at our institution were investigated. Of these, 10 were frozen on day 5 and 10 on day 6. Spent culture medium and TE cells were collected from each blastocyst after thawing, and the embryos were cultured in vitro for up to 10 days. The outgrowths after culturing beyond implantation were sampled and subjected to chromosome analysis using next-generation sequencing. Chromosomal concordance rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), false-positive rate (FPR), and false-negative rate (FNR) of niPGT-A and PGT-A against each outgrowth were analyzed. The concordance rate between the niPGT-A and outgrowth samples was 9/16 (56.3%), and the concordance rate between the PGT-A and outgrowth samples was 7/16 (43.8%). NiPGT-A exhibited 100% sensitivity, 87.5% specificity, 88.9% PPV, 100% NPV, 12.5% FPR, and 0% FNR. PGT-A exhibited 87.5% sensitivity, 77.8% specificity, 87.5% PPV, 75% NPV, 14.3% FPR, and 22.2% FNR. NiPGT-A may be more accurate than PGT-A in terms of ploidy diagnostic accuracy in outgrowths.

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