Original Research Article
Year: 2018 | Month: December | Volume: 8 | Issue: 12 | Pages: 121-126
Role of Hysteroscopy Vs Transvaginal Sonography in Diagnosis of Abnormal Uterine Bleeding
Dr. Preeti Baghel1, Dr. Surekha Janjgir2, Dr. Manju Sharma3, Dr. Seema Mehta3
1Senior Resident, 2Third Year Resident, 3Senior Professor,
Department of Obstetrics & Gynecology, Mahila Chikitsalaya, SMS Medical College, Jaipur
Corresponding Author: Dr. Preeti Baghel
ABSTRACT
Introduction: Abnormal uterine bleeding has a wide range of diagnostic possibilities and confusion is generated when review and reports fail to outline the diagnostic evaluation of the underlying problem. Goal of clinical management is primarily dependent upon attaining a correct etiological diagnosis. Hysteroscopy allows direct visualisation of the uterine cavity and is used as an office technique in the evaluation of endometrial and endocervical disorders. Recently TVS has permitted the use of higher frequency ultrasound waves at greater proximity to the uterus
Aim: To analyze the place of hysteroscopy and TVS to evaluate abnormal uterine bleeding and to correlate hysteroscopic findings with that of TVS findings which help in provisional/ final diagnosis.
Materials and Methods: 60 patients fulfilling inclusion and exclusion criteria selected from the gynaecological O.P.D. and those admitted in gynaecological ward of MCSG,SMS Medical College, Jaipur, with complaint of abnormal uterine bleeding who were in reproductive, premenopausal and postmenopausal phase of life. All the patients underwent transvaginal sonography followed by hysteroscopy and further management was done according to the abnormality detected. Proportion and percentages were used for categorical variables Statistical analysis done by using χ2 test.
Observations: The study shows that out of 60 patients 35% were normal and 65% were found abnormal on TVS whereas on hysteroscopy 21.66% were normal and 78.4% were found abnormal in cases of AUB. Hysteroscopy has sensitivity (92%) and NPV (69.23%) than that of TVS 78%. and 47.6% respectively. TVS has higher specificity and PPV (100%) in AUB cases than hysteroscopy 90% and 97.8% respectively.
Conclusion: Hysteroscopy is superior to TVS in detecting endometrial polyp and hyperplasia. Hysteroscopy shows 100% validity for Submucous fibroid. TVS has better than hysteroscopy for detecting adenomyosis. TVS is superior to hysteroscopy in investigating PMB.
Key words: Hysteroscopy, transvaginal sonography, TVS, Abnormal uterine bleeding.