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RMJ. 2017; 42(3): 379-384

Transvaginal sonography in abnormal uterine bleeding and correlation to hysteroscopy

Shazia Saeed, Syed Dawood Shah, Hazrat Ali, Saeed Khan, Naila Ehsan, Shaik Zahid Ahmed, Muhammad Samsoor Zarak, Mir Zaman Kasi.

Objective: To correlate results of Transvaginal sonography with those of hysteroscopy and biopsy in abnormal uterine bleeding to estimate the accuracy and analytical values of non-invasive transvaginal sonography in abnormal uterine bleeding.
Methodology: This cross-sectional Study was carried out at BMCH, Quetta, Balochistan, Pakistan from March 2013 to February 2014 and included 200 patients of abnormal uterine bleeding. Exclusion criteria were pregnancy, virginity, local bleeding of perineal or vaginal origin.
Hysteroscopy and biopsy and Transvaginal Ultrasound (TVS) were performed in all.
Result: The most common type of bleeding was found to be menorrhagia in 39% while the least common type was postmenopausal bleeding in 9%. Mean endometrial thickness was 11.64 mm and it was noted that at less than 14mm thickness no serious pathology was found. Sensitivity of TVS for endometrial hyperplasia was found to be 66.66% while specificity was 100%. Positive analytical value was 100% while negative value was 100%. Overall sensitivity calculated for TVS was 94.44%, specificity 98.55%, PPV was 81.93% and NPV 98.55%.
Conclusion: Sensitivity and specificity of TVS were lower than hysteroscopy and biopsy but the difference was not significant. TVS can be used as first line investigation while hysteroscopy and biopsy may be left for cases of high risk or in those cases where some positive findings could be found on TVS.

Key words: Transvaginal sonography, hysteroscopy, endometrial disease, transvaginal ultrasound

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