Transvaginal sonography versus saline contrast sonohysterography in evaluation of abnormal uterine bleeding


  • Rashmi Vohra Department of Obstetrics and Gynecology, MM Medical College Mullana, Ambala, Haryana, India
  • Rita Mittal Department of Obstetrics and Gynecology, IGMC Shimla, Himachal Pradesh, India
  • Anupa Sood Department of Obstetrics and Gynecology, MM Medical College, Solan, Himachal Pradesh, India



AUB, SCSH, Sensitivity, Specificity, TVS


Background: To evaluate TVS and SCSH as a screening method in case of AUB and to correlate he findings of TVS and SCSH with hysterectomy specimen.

Methods: Present study was conducted in department of obstetrics and gynaecology, Kamla Nehru Hospital for mother and child, IGMC, Shimla for a period of one year. A total of 150 patients with AUB were subjected to TVS and SCSH in same sitting irrespective of their phase of menstrual cycle. All the cases were subjected to hysterectomy within 2 weeks and operative findings were noted. Data was collected and findings analysed.

Results: Overall sensitivity of SCSH was found to be 97.6% while that of TVS was 95.1%. The overall specificity of SCSH was found to be 99.6% and that of TVS was 98.2%. PPV, NPV and DA for SCSH was more than that of TVS i.e., 98.9% vs 97.4%, 99.7% vs 99.3% and 99.4% vs 98.7%.

Conclusions: SCSH represents a new and promising technique for investigation of the uterine cavity. It is safe, minimally invasive, easy, cost effective and reliable method to diagnose the cause of AUB.


Laughead MK, Stones LM. Clinical utility of saline solution infusion sonohysterography in a primary care obstetric-gynecologic practice. Am J Obstet Gynecol. 1997;176(6):1313-6.

Karimzadeh MH, Firouzabadi RD, Goharzad F. Diagnostic value of saline contrast sonohysterography comparing with hysteroscopy for detecting endometrial abnormalities in women with abnormal uterine bleeding. Iranian Journal of Reproductive Medicine. 2011;9(3):199-202.

Williams CD, Marshburn PB. A prospective study of transvaginal hydrosonography in the evaluation of abnormal uterine bleeding. Am J Obstet Gynecol. 1998;179:292-8.

Reddi RP, Lakshmikantha G. Transvaginal sonography and saline infusion sonohysterography in the evaluation of abnormal uterine bleeding. J Obstet Gynecol India. 2010;60(6):511-15.

Bronz L, Suter T, Rusca T. The value of transvaginal sonography with and without saline instillation in the diagnosis of uterine pathology in pre- and postmenopausal women with abnormal bleeding or suspect sonographic findings. Ultrasound Obstet Gynecol. 1997;9:53-8.

Parsons AK. Lense JJ. Sonohysterography for endometrial abnormalities: preliminary results. J Clin Ultrasound. 1993;21:87-95.

Dueholm M, Forman A, Jensen ML, Laursen H, Kracht P. Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding. Ultrasound Obstet Gynecol. 2001;18(1):54-61.

Rudra S, Duggal BS, Bharadwaj D. Prospective Study of Saline Infusion Sonography and Office Hysteroscopy. MJAFI. 2009;65:332-5.

Schwarzler P, Concin H, Bosch H. An evaluation of sonohysterography and diagnostic hysteroscopy for the assessment of intrauterine pathology. Ultrasound Obstet Gynecol. 1998;11:337-42.

Dijkhuizen FP, de Vries LD, Mol BW, Brolmann HA, Peters HM, Moret E, et al. Comparison of transvaginal ultrasonography and saline infusion sonography for the detection of intracavitary abnormalities in premenopausal women. Ultrasound Obstet Gynecol. 2000;15:372-6.

Guven MA, Bese T, Demirkiran F. Comparison of hydrosonography and transvaginal ultrasonography in the detection of intracavitary pathologies in women with abnormal uterine bleeding. Int J Gyneco Cancer. 2004;14(1):57-63.

Ryu J, Kim B, Lee J, Kim S, Lee SH. Comparison of transvaginal ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding. Korean J Radiol. 2004;5:39-46.

Aslam M, Ijas L, Tariq S, Shafqat K, Nisa M, Ashraf A, Kazmi T. Comparison of transvaginal sonography and saline contrast sonohysterography in women with abnormal uterine bleeding: Correlation with hysteroscopy and histopathology. International Journal of Health Sciences, Qassim University 2007;1(1):17-24.

Kim S, Rhim C. The value of transvaginal sonography and sonohysterography in the determination of the cause of abnormal uterine bleeding. J of Women’s Medicine. 2009;2(2):70-7.

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






Original Research Articles