European Journal of Molecular & Clinical Medicine

Abstract

Objective: The aim of the study wasto evaluate the validity of Transvaginalsonography(TVS) in
accurately diagnosing structural pathologiesin patients with the perimenopausal AUB (PALM
component of PALM COIEN classification) and to assess the degree of agreement between the
Transvaginal ultrasonographic(TVS) and Histopathological(HPR) findings.
Material and Method: This retrospective study was conducted in 102 women with
perimenopausal AUB attending the tertiary rural health center in North-west Maharashtra. Indoor
case records of 102 perimenopausalwomen with AUB who were subjected to TVS and later
diagnostic fractional curettage and /or hysterectomy as per institutional protocol, and in whom
HPR examination reports were available were included in study. Data was collected and
tabulated as per ethically approved format. Kappa Statistical test and Z test of difference between
proportions was applied to assess the degree of agreement between the TVS and HPR findings
Results:In the present study 36% Leiomoyoma, 24% Endometrial Hyperplasia & 10%
Adenomyosis were diagnosed as cause of Perimenopausal AUB on TVS. However on HPR
examination 41% Endometrial Hyperplasia,33% Leiomoyoma,,16% Adenomyosis & 5%
malignancies were responsible for AUB. TVS had 97% specificity, 50% sensitivity& 92%
Positive predictive value(PPV) in diagnosing Endometrial hyperplasia .TVS had 89%
specificity& sensitivity and 92% Negative predictive value(NPV)to diagnose Leiomyoma.
Kappa test and Z test showed statisticallygood coorelation over chance for leiomyoma andFair
coorelation over chance for diagnosing Endometrial Hyperplasia