Validity of Hysteroscopy and Transvaginal Sonography in Evaluating Abnormal Uterine Bleeding- A Retrospective StudyCorrespondence Address :
Associate Professor, Department of Obstetrics and Gynaecology, OPD Building, AIIMS Patna, Phulwarisharif, Patna, Bihar, India.
Introduction: Abnormal Uterine Bleeding (AUB) affects 14-25% of women of reproductive age group and accounts for 66% of hysterectomies. Accurate diagnosis of the cause of AUB will reduce the hysterectomy burden, but the ideal evaluating tool to accurately diagnose the cause of the same is debatable.
Aim: To evaluate the diagnostic accuracy of transvaginal sonography and hysteroscopy in the evaluation of abnormal uterine bleeding, using histopathological diagnosis as gold standard.
Materials and Methods: This retrospective descriptive study was conducted on patients who underwent transvaginal sonography and hysteroscopy for evaluation of abnormal uterine bleeding from January 2017 to January 2020. Data including demographic details, sonographic details, pre-operative diagnosis, anaesthesia used, operative notes, complications and histopathological diagnosis were obtained from clinical record sheet of the patients. Sensitivity, specificity, diagnostic accuracy of TVS and hysteroscopy was calculated using MedCalc software version 19.2.6.
Results: A total of 214 patients were enrolled in the study. Hysteroscopy reported >95% diagnostic accuracy for all intrauterine pathology compared to TVS which revealed diagnostic accuracy of 73.13% for polyp, 77.1% for endometrial hyperplasia and 73.6% for all other pathology. Hysteroscopy revealed strong to almost perfect correlation with histopathological diagnosis for all pathology compared to TVS which demonstrated weak correlation for various intrauterine pathology.
Conclusion: Hysteroscopy should be used as initial evaluating tool in AUB as it is simple and minimal-invasive with high diagnostic accuracy.
Endometrial hyperplasia, Intrauterine adhesions, Intrauterine pathology, Uterine polyp
Date of Submission: Oct 19, 2020
Date of Peer Review: Dec 18, 2020
Date of Acceptance: Jan 22, 2021
Date of Publishing: Apr 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? No
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 20, 2020
• Manual Googling: Jan 22, 2021
• iThenticate Software: Feb 06, 2021 (4%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)