Background: Abnormal uterine bleeding (AUB) is an important cause of ill health in perimenopausal women. Accurate diagnosis of the causative factor of AUB in this age group is of utmost importance so that appropriate management can be established.
Objectives: The purpose of our study was to determine the diagnostic accuracy of transvaginal ultrasonography (TVS) and hysteroscopy (HYS) compared with histopathology in women with perimenopausal bleeding.
Study design: This is a nonrandomized, purposive sampling and prospective study.
Setting: This study was carried out in the Department of Obstetrics and Gynaecology of Dr Susheela Tiwari Memorial Hospital, Haldwani, Nainital district of Uttarakhand.
Materials and methods: We included those patients of perimenopausal age group who attended the gynecology department with the complaint of AUB during 18 months of our study period and in whom we were able to do all the three diagnostic modalities from January 2014 to July 2015.
Results: In the present study, mean age of patients was 49.56 ± 4.48 years. Maximum patients (41.05%) were in age group of 41 to 45 years, while the least number (9.5%) of patients were in the age group 35 to 40 years. In our study, >5 mm was the cutoff for postmenopausal patients, and >12 mm was for perimenopausal patients. Accuracy rates of HYS for diagnosing all lesions were better than TVS. Both sensitivity and specificity were found to be more for HYS.
Conclusion: Our results showed that HYS is a powerful tool for evaluating the endometrial cavity for focal abnormalities, such as endometrial polyps or submucosal fibroids. Hysteroscopy with directed biopsy is the “gold standard” approach for the most accurate evaluation of the endometrium to rule out endometrial carcinoma.
Clinical significance: The TVS can be used as a routine firststep diagnostic technique, but HYS followed by histopathology should be considered as a gold standard for evaluation of abnormal vaginal bleeding.
Keywords: Abnormal uterine bleeding, Histopathology, Hysteroscopy, Transvaginal ultrasonography.
How to cite this article: Gupta M, Jain G, Shukla S. Comparison of Transvaginal Ultrasonography with Hysteroscopy taking Endometrial Biopsy as Gold Standard in Perimenopausal Patients with Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc 2016;4(2):93-96.
Source of support: Nil
Conflict of interest: None
Date of submission: 06 May 2016
Date of acceptance: 17 June 2016
Date of publication: July 2016