TRANSVAGINAL SONOGRAPHY

ITS SPECIFICITY & SENSITIVITY IN ABNORMAL UTERINE BLEEDING

Abstract

O b j e c t i v e : (1) To evaluate predictive values of non-invasive transvaginal sonography in abnormal uterine bleeding. (2)
Correlate results of transvaginal sonography with hysteroscopy and biopsy in abnormal uterine bleeding. D e s i g n : Descriptive study. (Validity
study for TVS). Setting: Gyny/Obs Deptt, Military Hospital Rawalpindi. Period: One year - from January 2006 to December 2006. S u b j e c ts
& M e t h o d s : Women of any age presenting with abnormal uterine bleeding. Total number of cases included were two hundred. Patients were
evaluated in OPD by taking detailed gynaecological history. Clinical examination was carried out to find any local source of bleeding from
genital tract. Pap smear was taken at that time. Transvaginal ultrasound was performed in OPD basis. The results were noted on a predesigned
proforma. Routine investigations were performed on outpatient basis at the time of patient selection which included complete blood
picture, urine analysis, random blood sugar, renal function tests and hepatitis B and C screening. Then the patients were admitted for
hysteroscopy and histopathology. Hysteroscopic findings were noted on the proforma. Later histopathology report was also entered into
proforma. Hysteroscopy and biopsy were considered gold standard in our study. Thus the procedure was considered 100% accurate and
sensitivity, specificity, PPV and NPV for TVS were calculated. Results. It was found that at less than 14 mm endometrial thickness no
serious pathology was found. Sensitivity, specificity, negative predictive value and positive predictive value for TVS was found as follows;
1.For endometrial hyperplasia 100%, 93%, 100%, 79% respectively. 2. For endometrial polyp 100%, 97%, 100%, 25% respectively. 3. For
carcinoma 100%, 99%, 100%, 33% respectively. 4. For proliferative endometrium 79%, 100%, 78% and 100%. 5. For secretary phase
endometrium 100%,96%. 100%,79%respectively. 6.Forsub mucus fibroid 100%, 98%, 100%, 60% respectively. C o n c l u s i o n : .Difference
between values of hysteroscopy and TVS is not very significant so TVS should be used as 1s t line investigation. At less than 14mm
endometrial thickness no major pathology is detected.