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 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.

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 A clinical study of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation

2018 ◽  
Vol 7 (2) ◽  
pp. 396
Author(s):  
Shanmugapriya Kumaresan ◽  
Devika Perumal
Keyword(s):  
Tamil Nadu ◽  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Clinical Problem ◽  
Uterine Bleeding ◽  
College Hospital ◽  
Histopathological Correlation ◽  
Diagnostic Hysteroscopy ◽  
Sensitivity Specificity ◽  
A Prospective Study

Background: Abnormal uterine bleeding is a common clinical problem with myriad of causes. The diagnosis and management of abnormal menstrual function must be based on an understanding of the physiologic mechanisms involved in the regulation of the normal cycles. Diagnostic hysteroscopy is a valuable tool in diagnosing structural intra-cavital pathology, very suitable for out-patient clinic.Methods: This is a prospective study which has been carried out in the Department of Obstetrics and Gynecology, Tirunelveli medical college hospital, Tirunelveli, Tamil Nadu from January 2011 to October 2011.Results: A total of 50 cases were analysed among the 50 patients tested. 26 patients had some pathology of which 24were accurately detected by hysteroscopy, missed 2 cases of irregular shedding endometrium which was reported by histopathology.Conclusions: Hysteroscopy is a safe, reliable and quick procedure in the diagnosis of cases with abnormal uterine bleeding with high sensitivity, specificity and negative predictive value.

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 Value of endometrial aspiration cytology in assessing the endometrial status in symptomatic peri and postmenopausal women and its histological correlation with fractional curettage

2021 ◽  
Vol 10 (2) ◽  
pp. 717
Author(s):  
M. Vennila ◽  
Thangalakshmi .
Keyword(s):  
Predictive Value ◽  
Abnormal Uterine Bleeding ◽  
Antenatal Clinic ◽  
Diagnostic Techniques ◽  
Uterine Bleeding ◽  
Aspiration Cytology ◽  
College Hospital ◽  
Abdominal Ultrasonography ◽  
Medical College ◽  
Thyroid Profile

Background: Abnormal uterine bleeding (AUB) is associated with a wide variety of endometrium. Endometrial interpretation is valuable not only to find the etiology of AUB but also to rule out any organic cause for abnormal uterine bleeding. Fractional curettage is one of the most reliable and commonly performed diagnostic techniques used in the investigation of AUB. To evaluate the efficacy of endometrial aspiration cytology in the diagnosis of abnormal uterine bleeding by correlating it with histopathology.Methods: This comparative study to be conducted in100 patients attending antenatal clinic at Department of OBG, Tirunelveli Government medical college hospital from January 2018– July 2019. (17) months. Specific investigations like abdominal ultrasonography, thyroid profile, platelet count, bleeding time, clotting time, prothrombin time, etc were done whenever required. Informed consent was taken from all the study patients. Prior to Fractional curettage, endometrial aspiration was done using plastic disposable pipelines of 3 mm diameter.Results: The sensitivity of the cytology in detecting carcinoma of the endometrium was 83.3%. The specificity of cytology is 100%. Hence the test is highly specific in diagnosis. The positive predictive value is also 100% and the negative predictive value is 99%.Conclusions: It can also detect a few of the endometrial pathologies like endometrial hyperplasia, atrophy, and atypia. It is office Procedure. reduction in associated surgical risks, expense, post-operative pain, and need for operative anesthesia as seen in fractional curettage.

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.

scholarly journals Transvaginal ultrasonography is the diagnostic method for evaluation of abnormal uterine bleeding

2012 ◽  
Vol 1 (1) ◽  
pp. 11-13
Author(s):  
Kulsum Haq ◽  
Shabnom Ferdous Chowdhury ◽  
Maksuda Mannan ◽  
Rokshana Ivy ◽  
K Shahneela Tasnim
Keyword(s):  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Transvaginal Ultrasonography ◽  
Transvaginal Sonography ◽  
Dysfunctional Uterine Bleeding ◽  
Histopathologic Evaluation

Objective: The objective of this study is to assess the utility of transvaginal ultrasonography in patients presenting abnormal uterine bleeding Materials and methods: Between July 2000 to December 2000, 50 patients underwent transvaginal sonography (TVS) for abnormal uterine bleeding. All patients had transvaginal sonography before histopathology. On TVS, the sonographic appearance of the endometrium was classified according to the following parameters: normal or abnormal thickness, homogeneous or heterogeneous echogenicity, bulbous contour, discontinuous, or obscured. A comparison was performed between TVS with histopathology. Results: The most common causes for the abnormal uterine bleeding were leiomyoma in TVS (42.0%). Other causes were dysfunctional uterine bleeding (28.0%). adenomyosis (6.0%), endometrial polyp (4.0%), thin atrophic endometrium (8.0%), endometrial hyperplasia (8.0%), and endometrial carcinoma (4.0%). After histopathologic evaluation 40.0% patients had leiomyoma, 24.0% DUB, 10.0% adenomyosis, 8.0% endometrial polyp, 8.0% thin atrophic endometrium, 6.0% endometrial carcinoma and 4.0% endometrial hyperplasia. Comparing the TVS with histopathologic findings, TVS had a sensitivity of 94.3%, specificity of 80.0%. accuracy of 90.0%, PPV of 91.6% and NPV of 85.7%. Conclusion: TVS is an easy, safe, rapid and tolerable procedure. It has an excellent diagnostic accuracy in the diagnosis of uterine pathology responsible for abnormal uterine bleeding. Abbreviation: TVS transvaginal sonography; AUB abnormal uterine bleeding; DUB dysfunctional uterine bleeding, PPV positive predictive value, NPV Negative predictive value. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12168 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.11-13

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 Transvaginal Ultrasonography Is the Diagnostic Method for Evaluation of Abnormal Uterine Bleeding

2012 ◽  
Vol 2 (1) ◽  
pp. 10-12
Author(s):  
Kulsum Haq ◽  
Shabnom Ferdous Chowdhury ◽  
Maksuda Mannan ◽  
Rokshana Ivy ◽  
K Shehneela Tasnim
Keyword(s):  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Dysfunctional Uterine Bleeding ◽  
Medical College ◽  
Common Causes ◽  
Histopathologic Evaluation ◽  
Histopathologic Findings

Objective: The objective of this study is to assess the utility of transvaginal iiltrasonography in patients presenting abnormal uterine bleeding. Materials and methods: Between July 2000 to December 2000, 50 patients underwent transvaginal sonography (TVS) for abnormal uterine bleeding. All patients had transvaginal sonography before histopathology. On TVS, the sonographic appearance of the endometrium was classified according to the following parameters: normal or abnormal thickness, homogeneous or heterogeneous echogenicity, bulbous contour, discontinuous, or obscured. A comparison was performed between TVS with histopathology. Results: The most common causes for the abnormal uterine bleeding were leiomvoma in TVS (42.0%). Other causes were dysfunctional uterine bleeding (28.0%), adenomyosis (6.0%). endometrialpolyp (4.0%), thin atrophic endometrium (8.0%), endometrial hyperplasia (8.0%). and endometrial carcinoma (4.0%). After histopathologic evaluation 40.0% patients had leiomvoma, 24.0% DUB, 10.0% adenomyosis, 8.0% endometrial polyp, 8.0% thin atrophic endometrium, 6.0% endometrial carcinoma and 4.0% endometrial hvperplasia. Comparing the TVS with histopathologic findings, TVS had a sensitivity of 94.3%, specificity of 80.0%, accuracy of 90.0%, PPVof91.6% andNPVof 85.7%. Conclusion: TVS is an easy, safe, rapid and tolerable procedure. It has an excellent diagnostic accuracy in the diagnosis of uterine pathology responsible for abnormal uterine bleeding. Abbreviation: TVS transvaginal sonographv; AUB abnormal uterine bleeding; DUB dysfunctional uterine bleeding, PPV positive predictive value, NPV Negative predictive value. Journal of Shaheed Suhrawardy Medical College Vol 2No.1 June 2010 page 10-12 DOI: http://dx.doi.org/10.3329/jssmc.v2i1.12344

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