DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150714

Evaluation of abnormal uterine bleeding by transvaginal sonography, sonohysterography and correlation with endometrial histopathology

Parul Sinha, Uma Gupta, Basma Waris, Aditi Dubey

Abstract


Background: Abnormal uterine bleeding (AUB) in reproductive-age women is common, leading to one-third of outpatient visits by this population and this proportion crosses the two-third threshold in peri or post-menopausal group. Annually 5-10% of women of reproductive age seek medical care for AUB, which negatively impacts quality of life. The aim of the present study was to study the role of transvaginal sonography (TVS) and sonohysterography (SHG) in abnormal uterine bleeding.

Methods: The present study was carried out at Department of Obstetrics and Gynaecology, Era’s Lucknow Medical College, Lucknow in collaboration with Department of Radiology and Pathology, Era’s Lucknow Medical College, Lucknow. It was a prospective study carried out over a period of 1 year. Detailed history regarding their present complaints, menstrual history along with thorough examination was noted on the proforma designed for the study. Those with active and heavy bleeding underwent TVS and D&C for diagnostic and therapeutic purposes in the same sitting. However others without active bleeding underwent TVS, SIS in mid cycle and D&C in premenstrual period.

Results: The present study was carried out at Department of Obstetrics and Gynaecology, Era’s Lucknow Medical College, Lucknow in collaboration with Department of Radiology and Pathology, Era’s Lucknow Medical College, Lucknow. It was a prospective study carried out over a period of 1 year. Detailed history regarding their present complaints, menstrual history along with thorough examination was noted on the proforma designed for the study. Those with active and heavy bleeding underwent TVS and D&C for diagnostic and therapeutic purposes in the same sitting. However others without active bleeding underwent TVS, SIS in mid cycle and D&C in premenstrual period.

Conclusions: The findings in present study show a relative supremacy of SIS over TVS in diagnosis of uterine abnormalities in cases of abnormal uterine bleeding.


Keywords


Abnormal uterine bleeding, Endometrial histopathology, Sonohysterography, Transvaginal sonography

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References


Cannon MJ. Endometrial resection for treatment of abnormal uterine bleeding. Obstet Gynecol. 2000;102:453-62.

Webster SD, Canon Z. Cytohistological correlation in patients with dysfunctional uterine bleeding. Biomed Sci Intrum. 2000;36:367-72.

Bradley LD, Skaznik-Wikiel ME. Investigation of Abnormal Uterine Bleeding in Peri- and Postmenopausal Women. Menopause Management. 2008;6:13-22.

Kjerulff KH, Erickson BA, Langenberg PW. Chronic gynecological conditions reported by US women: findings from the National Health Interview Survey, 1984 to 1992. Am J Public Health. 1996;86:195-9.

Frick KD, Clark Ma, Steinwachs DM, Langenberg P, Stovall D, Munro MG, Dickersin K; STOP-DUB Research Group. Financial and quality-of-life burden of dysfunctional uterine bleeding among women agreeing to obtain surgical treatment. Women’s Health Issues. 2009;19(1):70-8.

Cote I, Jacobs P, Cumming D. Work loss associated with increased menstrual loss in the United States. Obstetrics & Gynecology. 2002;100:683-7

Farquhar CM, Steiner CA. Hysterectomy rates in the United States 1990-1997. Obstet Gynecol. 2002;99:229-34.

Mihm LM, Quick VA, Jonathan RN, Cohnors AF, Connors AF, Finnerty JJ. The accuracy of endometrial biopsy and saline sonohysterography in the determination of the cause of abnormal uterine bleeding. Am J Obstet Gynaecol. 2002;186:858-66.

Islam A, Ghazala. Trnasvaginal sonography; Its specificity and sensitivity in abnormal uterine bleeding. Prof. Med. J. 2009;16(1):127-34.

Dasgupta Subhankar, Chakraborty Barunoday, Karim Rejaul, Aich Ranen Kanti, Mitra Pradip Kumar, Ghosh Tarun Kumar. Abnormal Uterine Bleeding in Peri-Menopausal Age: Diagnostic Options and Accuracy. J. Obs. Gyn. 2011:184-94.

Aslam M, Ijaz L, Tariq S, Shafqat K, Meher-un-Nisa, Ashraf R, Kazmi T. Comparison of Transvaginal Sonography and Saline Contrast Sonohysterography in Women with Abnormal Uterine Bleeding: Correlating with Hysteroscopy and Histopathology. International Journal of Health Sciences, Qassim University. 2007;1(1):17-24.

Mathew M, Gowri V, Rizvi SG. Saline infusion sonohysterography - an effective tool for evaluation of the endometrial cavity in women with abnormal uterine bleeding. Acta Obstet Gynecol Scand. 2010;89(1):140-2.

Yildizhan B, Yildizhan R, Ozkesici B, Suer N. Transvaginal ultrasonography and saline infusion sonohysterography for the detection of intra-uterine lesions in pre- and post-menopausal women with abnormal uterine bleeding. J Int Med Res. 2008;36(6):1205-13.

Epstein, E., Ramirez, A., Skoog, L. and Valentin, L. Transvaginal sonography, saline contrast sonohysterography and hysteroscopy for the investigation of women with postmenopausal bleeding and endometrium > 5 mm. Ultrasound Obstet Gynecol. 2001;18:157–62.