DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160843

A study of role of colour Doppler in evaluation of abnormal uterine bleeding at medicine and gynecology departments at a tertiary care institute of central India

Somen Bhattacharjee, Yogendra Jamra, Shiv Shankar Sharma, Neetu Dongre

Abstract


Background: Abnormal uterine bleeding (AUB) at any age in women’s life is disruptive and worrisome. The purpose of the study is to determine the effectiveness of color Doppler transvaginal ultrasonography (CDTU) in detection of intrauterine pathology in those patients with abnormal uterine bleeding.

Methods: The present study was conducted on 50 patients of AUB selected from Gynecology and Medicine OPD of M.G.M. Medical College and M.Y. and associated group of hospitals, Indore during the period of May 2012 to December 2012. All patients underwent D&C (for endometrial biopsy) to evaluate ultrasonographic findings. Ultrasonographic variables considered were: endometrial thickness, gray-scale and color Doppler sonographic findings, resistance index and pulsatility index.

Results: CDTU showed abnormal studies in 11 patients (22%) cases. Endometrial biopsy revealed abnormalities in 14 women. 91% of cases, which were having abnormal CDTU, had abnormal endometrium. 10% cases were missed by CDTU and were having abnormal HPR of which 67% had simple endometrial hyperplasia; rest 33%-cystic glandular hyperplasia. In abnormal CDTU finding group, only 9% cases had normal HPR. Color doppler effectively diagnosed all the malignant and potentially malignant states.

Conclusions: CDTU can be used to as an effective tool in woman with evaluation of AUB after TVS has been performed for visualizing endometrium.

Keywords


AUB, CDTU, Histopathological report

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References


Fritz M, Speroff L. Clinical gynaecologic endocrinology and infertility. Eighth edition. Lippincott Williams and Wilkins; 2010:592.

Marret H, Fauconnier A, Chabbert-Buffe N, Cravello L, Golfier F, Gondry J et al. Clinical practice guidelines on menorrhagia: management of abnormal uterine bleeding before menopause. Eur J Obstet Gynecol Reprod Biol. 2010;152(2):133-7.

Bakos O, Heimer G. Transvaginal ultrasonographic evaluation of endometrium related to histological findings in pre-ad perimenopausal Women. Gynecol Obstet Invest. 1998;45:199-204.

Dijkhuizen FP, Brolmann HA, Potters AE, Bongers MY, Heinz AP. The accuracy of transvaginal ultrasonography in the Diagnosis of endometrial abnormalities. Obstet Gynecol. 1996;87:345-9.

Spandorfer SD, Arrendondo-Soberon F, Loret de Mola JR, Feringbang RF. Reliability of intra-observer and intraobserver sonographic endometrial stripe thickness measurements. Fertil Steril. 1998;70:152-4.

Smith Brindman R , Kerlikowske K, Felstein VA, Subak L, Scheidler J, Segal M et al. Endovaginal ultrasound to exclude Endometrial cancer and other endometrial abnormalities. JAMA. 1998;280:1510-7.

Fleischer AC, Kalemeris GC, Machin JE, Entman SS, James AE Jr. Sonographic depiction of normal and abnormal Endometrium with histopathologic correlation. J Ultrasound Med. 1986;5:445-52.

Alcazar JL, Castillo G, Minguez JA, Galan MJ. Endometrial blood flow mapping using transvaginal power Doppler sonography In women with postmenopausal bleeding and thickened Endometrium. Ultrasound Obstet Gynecol. 2003;21:583-8.

Pascual A, Graupera B, Tresserra F, Ubeda A, Hereter L, Rodriguez I et al. Color Doppler transvaginal ultrasound for detecting intrauterine disorders in patients with abnormal uterine bleeding; Gynaecol Perinatol. 2005;14(4):157-60.

S Kayastha. Study of endometrial tissue in dysfunctional uterine bleeding. Nepal Med Coll J. 2013;15(1):27-30.

Dangal G. A study of endometrium of patient with abnormal uterine bleeding at Chitwan valley. Kathmandu Univ Med J. 2003;1:110-2.

Pillai SS. Sonographic and histopathological correlation and evaluation of endometrium in perimenopausal women with abnormal uterine bleeding. Intern J Reprod Contracep Obstetr Gynecol. 2014;3(1):113-7.

Aleem F, Predanic M, Calame R, Moukhtar M, Pennisi J. Transvaginal color and pulsed Doppler sonography of the endometrium: a possible role in reducing the number of dilatation and curettage procedures. J Ultrasound Med. 1995;14:139-45.

Alcazar JL, Galvan R. Three-dimensional power Doppler ultrasound scanning for the prediction of endometrial cancer in women with postmenopausal bleeding and thickened endometrium. Am J Obstet Gynecol. 2009;200(1):44.e1-6.