Abstract
Abnormal uterine bleeding refers to any deviation of regularity, frequency, duration or amount of flow from the normal menstrual flow. It affects day to day life and can have serious impact such as anemia or may be the result of underlying malignancy. Total 43 female patients with abnormal uterine bleeding after meeting the inclusion and exclusion criteria participated in the study. Each patient underwent transvaginal sonography where uterus with uterine cavity, adnexa, cervix, vagina was studied meticulously and then they were subjected to hysteroscopy guided biopsy under anesthesia using saline as distension medium. Local pathology of uterine cavity was examined by hysteroscopy. Biospy of the endometrium or suspected lesion was curetted out and sent for histopathology. These patients were followed for HPR report which was taken as the confirmatory modality to compare the sensitivity, specificity, positive and negative predictive value of hysteroscopy with TVS. Our study showed 100% sensitivity for cervical polyp, endometrial hyperplasia, endometrial and fibroid polyp, 100% specificity for cervical polyp and fibroid polyp, 95% for endometrial polyp on hysteroscopy. TVS had a higher specificity (95%) for detecting endometrial hyperplasia when compared to hysteroscopy. For cervical and fibroid polyp there was 100% PPV and NPV on hysteroscopy and 100% PPV on TVS. Diagnostic hysteroscopy and TVS are complimentary to each other. So patients with abnormal uterine bleeding should undergo both TVS and hysteroscopy and findings should be confirmed by histopathological examination.
Keywords: Abnormal uterine bleeding, Endometrial hyperplasia, Endometrial polyp, Hysteroscopy, Submucous fibroid, Transvaginal sonography.