European Journal of Molecular & Clinical Medicine

Abstract

Background: Abnormal uterine bleeding may be defined as bleeding pattern that differs in frequency, duration and amount from a pattern observed during a normal menstrual cycle or after menopause.
Aims : To study accuracy of Transvaginal Sonography in relation to endometrial biopsy in depicting endometrial changes in DUB and to formulate an effective protocol for the first line evaluation of all cases of DUB at the out-patient level.
Materials and methods: This study on ultrasound diagnosis of DUB with histopathological correlation in 50 patients between 18-45 yrs. The study was aimed to study accuracy of TVS in relation to endometrial biopsy in depicting endometrial changes in DUB. TVS and endometrial sampling was done as outpatient procedure 2-3‘days prior to date of menstruation or on day of menstruation. The relevant clinical findings and investigations were recorded in the proforma which is enclosed. A master sheet showing all details of the cases is also enclosed.
Results: The incidence of DUB in age groups of 18-45 years is high. Menorrhagia was noted in 44% , Polymenorrhagia in 20% by histopathology. In cases of normal endometrium, proliferative endometrium noted in 52%, secretory endometrium in 12% , menstrual endometrium in 12% .Simple hyperplasia was noted in 14%, Cystoglandular hyperplasia in 6%. Out of 6 patients with ET 1 – 4.9 mm , endometrial parenchyma is menstrual on TVS and HPE . Out of 4 patients with ET 15 and above endometrium show hyperplasia on TVS and HPE . The sensitivity , specificity ,PPV and NPV of TVS findings in comparision to Histopathology as Proliferative phase :- 88.8% , 100% , 100% , 88.46% . Secretory phase :- 100% , 86%, 53% , 93% . Menstrual phase :-100% , 100% ,100%, 100%. Hyperplasia :- 70% , 100% ,100% ,93.02% . Surgery is done in 22% of cases , all are above 35 years.
Conclusions: Endo-vaginal scan when combined with endometrial sampling is an valuable tool for the preliminary screening, diagnosis, management all cases of DUB. Therefore, we strongly recommend the routine use of endovaginal scan with endometrial sampling in the clinical and laboratory evaluation of all cases.