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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. (Validitystudy 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 wereevaluated in OPD by taking detailed gynaecological history. Clinical examination was carried out to find any local source of bleeding fromgenital tract. Pap smear was taken at that time. Transvaginal ultrasound was performed in OPD basis. The results were noted on a predesignedproforma. Routine investigations were performed on outpatient basis at the time of patient selection which included complete bloodpicture, urine analysis, random blood sugar, renal function tests and hepatitis B and C screening. Then the patients were admitted forhysteroscopy and histopathology. Hysteroscopic findings were noted on the proforma. Later histopathology report was also entered intoproforma. Hysteroscopy and biopsy were considered gold standard in our study. Thus the procedure was considered 100% accurate andsensitivity, specificity, PPV and NPV for TVS were calculated. Results. It was found that at less than 14 mm endometrial thickness noserious 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. Forcarcinoma 100%, 99%, 100%, 33% respectively. 4. For proliferative endometrium 79%, 100%, 78% and 100%. 5. For secretary phaseendometrium 100%,96%. 100%,79%respectively. 6.Forsub mucus fibroid 100%, 98%, 100%, 60% respectively. C o n c l u s i o n : .Differencebetween values of hysteroscopy and TVS is not very significant so TVS should be used as 1s t line investigation. At less than 14mmendometrial thickness no major pathology is detected.