TRANSVAGINAL SONOGRAPHY COMBINED WITH SALINE CONTRAST SONOHYSTEROGRAPHY IN EVALUATING THE UTERINE CAVITY IN PREMENOPAUSAL PATIENTS WITH ABNORMAL UTERINE BLEEDING

OBJECTIVES \nTo evaluate whether saline contrast sonohysterography (SCSH) improved the diagnostic accuracy of transvaginal sonography \n(TVS) for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding. \nPATIENTS AND METHODS \nThe uterine cavity was evaluated with TVS and SCSH in 60 premenopausal patients with abnormal uterine bleeding. All 58 \npatients underwent operative hysteroscopy or hysterectomy within 4 months which provided a detailed description of the \nuterine cavity and was used as the true value for exclusion of polyps and submucous myomas. \nRESULT \nOut of 60 patients, 45 had uterine abnormalities on TVS and SCSH and rest of the patients who appeared normal but had \nother abnormalities such as ovarian haemorrhagic cyst. Out of the 45 patients, 9 patients had submucous myomas and 9 were \ndiagnosed as endometrial polyp. The findings were confirmed using hysterectomy/hysteroscopy/endometrial sampling. \nCONCLUSION \nThe use of TVS without saline contrast left nine submucosal fibroids and five in nine of the polyps undiagnosed in referred \npatients with complaints of abnormal bleeding. It also helps in reducing the rate of more invasive procedures such as \nhysteroscopy. However, studies carried out for longer duration and large study population are required to validate our findings