Seema Pandey1, Mamta Kumari2, Amrita Chaurasia3, Gyan Prakash4
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.
