DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180906

Role of saline infusion sonography in evaluation of abnormal uterine bleeding

Neerja Gupta, Geeta Singh, Bharti Jain, Satakshi Garg

Abstract


Background: Abnormal uterine bleeding (AUB) is one of the most common reasons for women seeking gynaecological advice. The objective of this study was to determine the accuracy of Transvaginal sonography (TVS) and Saline Infusion Sonography (SIS) in evaluation of Abnormal Uterine Bleeding (AUB) and to compare the diagnostic accuracy after hysterectomy.

Methods: Prospective, comparative study of TVS and SIS in evaluation of AUB in patients who are being subjected to hysterectomy with uterus of less than 12 weeks.

Results: 100 patients were included in the study. 98% were of 30-50 years. Heavy menstrual bleeding was the commonest symptom (52%) and most common finding was fibroid, and Polyp followed by abnormal endometrium. The overall sensitivity and specificity when correlated with operative and HPE were 66% and 88% respectively for TVS and 82% and 95% for SIS respectively. The false positive and false negative rates were more in TVS compared to SIS. Commonest histopathology was intramural fibroid in 42% followed by sub mucus myoma in 21%, polyp 18% and endometrial hyperplasia 10%.

Conclusions: SIS is a simple highly sensitive and specific technique to detect intra uterine pathology in the evaluation of AUB when TVS findings are inconclusive.


Keywords


DH (Diagnostic Hysteroscopy), HPE (Histopathology), HMB (Heavy menstrual bleeding), SIS, TVS

Full Text:

PDF

References


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

Hill DA. Sonohysterography in the office: Instruments and technique. Contemp Obstet Gynecol. 1997;42:95110.

Saidi MH, Sadler RK, Theis VD. Comparison of sonography, sonohysterography and hysteroscopy for evaluation of abnormal uterine bleeding. J Ultrasound Med. 1997;16:587-91.

de Kroon CD, de Bock GH, Dieben SW. Saline contrast hystero-sonography in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG. 2003:110:938-47.

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.

Kazandi M, Ak┼čehirli S, Cirpan T, Akercan F, Transvaginal sonography combined with saline contrast sonohysterography to evaluate the uterine cavity in patients with abnormal uterine bleeding and postmenopausal endometrium more than 5 mm. Eur J Gynaecol Oncol. 2003;24(2):185-90.

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

Rani RP, Lakshmikantha G. Transvaginal Sonography (TVS) and Saline Infusion Sonohysterography (SIS) in the evaluation of Abnormal Uterine Bleeding (AUB). J Obstet Gynecol India. 2010;60(6):511-5.

Goyal AS, Chaudhari SJ, Shrivastava AR, Verma RN. Comparison of transvaginal sonography and saline infusion sonohysterography for the diagnosis of causes of abnormal uterine bleeding: a diagnostic accuracy study. IJRCOG. 2016;5:1566-70.

Cicinelli E, Romano F, Anastasio PS. Transabdominal sonohysterography transvaginal sonography and hysteroscopy in the evaluation of submucous myomas. Obstet Gynecol. 1995;85:42-7.

Chung PH, Parsons AK. A practical guide to the using saline infusion sonohysterography. Contemp Obstet Gynecol. 1997;42:21-34.

Bonnamy L, Marret H, Perrotin F. Sonohysterography a prospective survey of results and complications in 81 patients. Eur J Obstet Gynecol Reprod Biol. 2002:102:42-7.