The efficacy of transvaginal ultrasonography and office hysteroscopy in evaluation of abnormal uterine bleeding

Authors

  • Sona Reddy M. R. Department of Obstetrics and Gynecology, Shri B. M. Patil Medical College, Hospital and Research Institute, Vijayapura, Karnataka, India
  • Mudanur R. Subhashchandra Department of Obstetrics and Gynecology, Shri B. M. Patil Medical College, Hospital and Research Institute, Vijayapura, Karnataka, India
  • Neelamma B. Patil Department of Obstetrics and Gynecology, Shri B. M. Patil Medical College, Hospital and Research Institute, Vijayapura, Karnataka, India
  • Rajasri G. Yaliwal Department of Obstetrics and Gynecology, Shri B. M. Patil Medical College, Hospital and Research Institute, Vijayapura, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231787

Keywords:

Abnormal uterine bleeding, Heavy menstrual bleeding, Hysteroscopy, Office hysteroscopy, Transvaginal ultrasonography

Abstract

Background: Abnormal uterine bleeding (AUB) is a prevalent issue in women of child bearing age group. AUB can be uncomfortable and have a considerable impact on health-related quality of life. AUB is reported to occur in 9 to 14% women between menarche and menopause and reported prevalence in India is around 17.9%.

Methods: It is a prospective observational study done in 75 patients with abnormal uterine bleeding attending the gynaecology outpatient department (OPD) at Shri B. M. Patil Medical College, Vijayapura, Karnataka. Patient was thoroughly examined and then transvaginal sonography (TVS) was done after obtaining consent. This was followed by office hysteroscopy(OH) and endometrial biopsy was taken for histopathological examination. Data were gathered and examined and cost analysis of each procedure was done.

Results: The most frequent presenting symptom was heavy menstrual bleeding (49.3%). For proliferative and secretory endometrium, the sensitivity of TVS was 81.48% and for the detection of polyps, endometrial hyperplasia, and submucous fibroid it was 45.45%, 42.86%, 100% respectively. The sensitivity of OH for detection of polyps, endometrial hyperplasia, and submucous fibroid which was 46.15%, 100%, 100% respectively. The p value was <0.05 which shows the statistical significance of both tests. TVS demonstrated low correlation for intracavitary diseases. OH was costlier when compared to TVS.

Conclusions: TVS has more sensitivity and accuracy in detecting intramural pathologies. OH had showed greater diagnostic accuracy in identifying intra cavitary pathologies of uterus and doing intervention in the same setting.

References

Mahapatra M, Mishra P. Clinicopathological evaluation of abnormal uterine bleeding. J Health Res Rev. 2015;2:45-9.

Singh A, Anant M. The evaluative role of diagnostic hysteroscopy and ultrasonography in abnormal uterine bleeding. Int J Res Med Sci. 2017;5(3):1002-6.

Krishnamoorthy N, Fatima Shanthini N. Role of transvaginal sonography and hysteroscopy in abnormal uterine bleeding: Does the diagnostic yield increase by combining transvaginal sonography, hysteroscopy and biopsy? Int J Reprod Contracept Obstet Gynaecol. 2017;3(4):919-23.

Bosteels J, van Wessel S, Weyers S, Broekmans FJ, D’Hooghe TM, Bongers MY, et al. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database Syst Rev. 2018;12(12):CD009461.

Pal L, Lapensee L, Toth TL, Isaacson KB. Comparison of office hysteroscopy, transvaginal ultrasonography and endometrial biopsy in evaluation of abnormal uterine bleeding. JSLS: J Soc Laparoendosc Surgeons. 1997;1(2):125.

Sinha P, Yadav N, Gupta U. Use of hysteroscopy in abnormal uterine bleeding: An edge over histopathological examination. J Obstet Gynecol India. 2018;68(1):45-50.

Kathuria R, Bhatnagar BE. Correlation between D and C, USG and hysteroscopy findings in diagnosing a cause for abnormal uterine bleeding. Indian J Clin Practice. 2014;25(5):466-70.

Krishnamoorthy N. Role of transvaginal sonography and hysteroscopy in abnormal uterine bleeding: does the diagnostic yield increase by combining transvaginal sonography, hysteroscopy and biopsy? Int J Reprod Contracept Obstet Gynecol. 2014;3(4):919-24.

El-Khayat W, Sleet ME, Mahdi EY. Comparative study of transvaginal sonography and hysteroscopy for the detection of pathological endometrial lesions in women with perimenopausal bleeding. Middle East Fertil Soc J. 2011;16(1):77-82.

Kumari M, Gupta AS. A prospective comparative study to evaluate the efficacy of ultrasonography and hysteroscopy and their correlation with the histopathology of endometrium in a case of abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynaecol. 2017;4(6):1926-35.

Rustagi M, Barsode SD, Taralekar V, Mehendale S. Hysteroscopic Evaluation and Histopathological Findings in Abnormal Uterine Bleeding. Int J Obstet Gynaecol. 2020;8(1):45-50.

Bhosle A, Fonseca M. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. Bombay Hospital J. 2010;52(1):69-72.

Wanderley MS, Monteiro ÁM, Brito VMdF, Paravidine SLM. Accuracy of transvaginal ultrasonography, hysteroscopy and uterine curettage in evaluating endometrial pathologies. Rev Bras Ginecol Obstet. 2016;38(10):506-11.

Towbin NA, Gviazda IM, March CM. Office hysteroscopy versus transvaginal ultrasonography in the evaluation of patients with excessive uterine bleeding. Am J Obstet Gynecol. 1996;174(6):1678-82.

Fedele L, Bianchi S, Dorta M, Brioschi D, Zanotti F, Vercellini P. Transvaginal ultrasonography versus hysteroscopy in the diagnosis of uterine submucous myomas. Obstet Gynecol. 1991;77:745-8.

Neumann T, Astudillo J. Hysteroscopy study in patients with abnormal uterine bleeding. Rev Chil Obstet Gynecol. 1994;59(5):349-52.

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Published

2023-06-19

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Original Research Articles