Application of Transvaginal Ultrasonography Hysteroscopy in Diagnosis Abnormal Uterine Bleeding

Background: Abnormal uterine bleeding is the most common presenting menstrual complaint in women of perimenopausal age group. Most frequently used diagnostics tests to investigate the causes of abnormal bleeding are Transvaginal ultrasonography (TVS) and endometrial biopsy. Uterine curettage is an invasive procedure and is performed with anaesthesia. TVS is a non-invasive method that has been used to evaluate the endometrium and uterine cavity. The objectives of this study were to measure and evaluate the role and accuracy of endometrial thickness by transvaginal ultrasonography study to detect endometrial pathology in perimenopausal women presenting with Abnormal Uterine Bleeding. To correlate the transvaginal sonographic results with the Histopathological findings to discriminate normal from pathological endometrium.Methods: Prospective study including 150 perimenopausal women with abnormal uterine bleeding. Endometrial thickness was measured by TVS and then D and C was performed for all the patients.Results: Out of 150 women, 128 (85.3%) had normal and 22 (15%) had an abnormal endometrium. 43.3% were of 41-45 years and 65.3% patients presented with complaint of heavy menstrual bleeding. Majority of the patients in the study group were para 2 or more. Fibroid uterus (24%) was the commonest uterine pathology detected on TVS. 53.3% of patients had endometrial thickness in the range 10-14.9 mm. Most common finding on HPE was secretory endometrium (44.6%). Endometrial carcinoma was found in 3%. Endometrial thickness <14mm was associated with least abnormal endometrial pathology.Conclusions: Endometrial thickness of less than 14 mm need not be indicated for D and C in perimenopausal abnormal uterine bleeding. In perimenopausal women with AUB, TVS should be the investigation of choice due to its convenience, accuracy and non- invasiveness.

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A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1034/j.1600-0412.2003.00191.x ◽

2003 ◽

Vol 82 (6) ◽

pp. 493-504 ◽

Cited By ~ 116

Author(s):

Cynthia Farquhar ◽

Alec Ekeroma ◽

Susan Furness ◽

Bruce Arroll

Keyword(s):

Systematic Review ◽

Premenopausal Women ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Ultrasonography

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Hysterosonography and Transvaginal Ultrasonography for Detection of Intrauterine Lesions in Women with Abnormal Uterine Bleeding

Annals of King Edward Medical University ◽

10.21649/akemu.v23i1.1510 ◽

2017 ◽

Vol 23 (1) ◽

Author(s):

Iqbal Hussain Dogar ◽

Mahjabeen Masood ◽

Mahesh Gautam ◽

Mahjabeen Tariq

Keyword(s):

Sensitivity And Specificity ◽

Imaging Modality ◽

Transvaginal Ultrasound ◽

Abnormal Uterine Bleeding ◽

Vital Role ◽

Uterine Bleeding ◽

Endometrial Polyp ◽

Transvaginal Ultrasonography ◽

Detection And Identification ◽

Line Imaging

Abnormal Uterine bleeding (AUB) is one of the frequent complaints of female patients of all ages. AUB is present in 33% of women referred to gynecologists and this increases to 69% in perimenopausal and postmenopausal women. About 10 % of postmenopausal bleeding results from endometrial cancer and imaging is the mainstay for its identification. Imaging plays a vital role in differentiating structural lesions like endometrial carcinomas, myomas and polyps which require surgical management from functional disorders requiring medical management. Transvaginal Ultrasonography (TVUS) is the first line imaging modality for AUB after selecting the patients with inconclusive pelvic ultrasonographic results. Hysterosonography (HSG) also plays a pivotal role.Objectives: To compares between TVUS and HSG in the detection and identification of intrauterine lesions in patients with abnormal uterine bleeding, and comparing the sensitivity and specificity of the respective methods in the detection of such lesions.Methods: Thisstudy was conducted in Department of Radiology, Mayo Hospital Lahore. Fifty women presented with history of abnormal uterine bleeding were included in this study. Pregnancy was ruled out by transabdominal scan. Transvaginal ultrasound and hysterosonography were performed in all the patients. All the data were coded and analyzed using SPSS version 20.Results: Out of 50 patients, 10 patients had intramyometrial fibroid, 11 had submucosal fibroid, endometrial polyp was found in 17 patients and 2 patients had thickened endometrium (thickness > 8mm). The sensitivity and specificity of TVUS was found to be 83.2% and 82.7% respectively whereas HSG showed sensitivity and specificity of 95.4% and 91.5% respectively. In the detection of the submucosal fibroid and endometrial polyp, HSG showed highest sensitivity and specificity as compared totransvaginal ultrasound.Conclusion: Both the TVUS and HSG have comparable sensitivity and specificity in the detection of endometrial disease in patients presented with abnormal uterine bleeding however HSG is more sensitive in the detection of polyps.

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Frequency of Common Histopathological Findings among Patients Having Endometrial Thickness ≥5mm

10.53350/pjmhs211592236 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2236-2238

Author(s):

Sadia Sharif ◽

Ayesha Sajjad ◽

Amna Kazi ◽

Ayesha Masood ◽

Nazish Javaid

Keyword(s):

Body Mass Index ◽

Endometrial Carcinoma ◽

Body Mass ◽

Rural Areas ◽

Endometrial Thickness ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Ultrasonography ◽

Cross Sectional ◽

Histopathological Findings

Aim: To determine the frequency of common histopathological findings among patients having endometrial thickness >5mm and having atypical bleeding of uterus. Study design: Descriptive and cross sectional study Study settings: Department of Obstetrics & Gynaecology, Kishwer Fazal Teaching Hospital, Sheikhupura from 1st October 2020 to 31st March 2021. Methodology: One hundred and twenty patients were enrolled. Patients were aged between 45 to 60 years. Patient’s detailed demographics including age, parity, socioeconomic grade and body mass index were recorded post written informed consentreceival. Patients having endometrial thickness >5mm with abnormal uterine bleeding were included in this study.All the patients were undergone for transvaginal ultrasonography (TVS). Outcomes were histopathological findings observed. Results: The patients mean age was found to be 51.16±4.88 years with mean body mass index 27.24±4.63 kg/m2. Thirty five (29.2%) patients had parity I and 85 (70.8%) patients had parity II. Forty two (35%) patients had high socioeconomic status and 78(65%) were from low socio economic status. Majority of the patients 80(66.7%) were from rural areas. Secretory and proliferative were the most common histopathological findings found in (45.83% and 26.7%) patients. Frequency of endometrial carcinoma was found among 97(80.8%) cases. Conclusion: The most common histopathological findings were secretory and proliferative and frequency of endometrial carcinoma was too high. Endometrial anomalies can be excluded by transvaginal ultrasonography and is strongly useful in the evaluation of abnormal bleeding from the uterine. Keywords: Endometrial, Transvaginal ultrasonography, Uterine bleeding

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Transvaginal Ultrasonography and Saline Infusion Sonohysterography for the Detection of Intra-Uterine Lesions in Pre- and Post-Menopausal Women with Abnormal Uterine Bleeding

Journal of International Medical Research ◽

10.1177/147323000803600606 ◽

2008 ◽

Vol 36 (6) ◽

pp. 1205-1213 ◽

Cited By ~ 11

Author(s):

B Yildizhan ◽

R Yildizhan ◽

B Ozkesici ◽

N Suer

Keyword(s):

Sensitivity And Specificity ◽

Uterine Fibroids ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Saline Infusion ◽

Transvaginal Ultrasonography ◽

Endometrial Polyps ◽

Menopausal Women ◽

Post Menopausal ◽

Saline Infusion Sonohysterography

This prospective study investigated 79 pre- and 25 post-menopausal women with abnormal uterine bleeding who underwent conventional transvaginal ultrasonography (TVS) and saline infusion sonohysterography (SIS) and compared the results with histopathological findings obtained by dilatation and curettage, hysteroscopy or hysterectomy. Histological examination revealed normal endometrial histology in 28 patients, intracavitary polyps in 46 patients, submucosal fibroids in 18 patients, intramural fibroids in six patients and endometrial hyperplasia in six patients. The sensitivity and specificity of TVS in detecting endometrial polyps were 65.2% and 87.9%, respectively, compared with 91.3% and 93.1% for SIS. The sensitivity and specificity of TVS in detecting uterine fibroids were 95.8% and 95.0%, respectively, versus 91.6% and 98.7% for SIS. These results show that SIS is a satisfactory method of identifying lesions and that it is easy and cost-effective, and improves on the diagnostic utility of TVS. SIS is also a less invasive alternative to hysteroscopy, so should result in less morbidity in the evaluation of abnormal uterine bleeding in women.

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