Comparative Study of Transvaginal Sonography and Hysteroscopy for the Detection of Endometrial Lesions in Women with Abnormal Uterine Bleeding in Perimenopausal Age Group

Aim:The aim of the study is to compare the diagnostic accuracy of transvaginal ultrasound and hysteroscopy correlated with histopathology in evaluation of endometrial lesions in perimenopausal women with abnormal uterine bleeding. Settings and design:A cross-sectional study done in Department of Gynecology, from August 2015 to June 2017. Materials and methods:A total of 100 perimenopausal women with abnormal uterine bleeding (AUB) were included in the age group 40 to 55 years.Transvaginal ultrasound (TVS), hysteroscopy and endometrial biopsy were performed on all patients.Findings were compared with histopathogical examination taken as gold standard.Results: Menorrhagia was most common bleeding pattern seen in 44% cases.The TVS findings in correlation with HPE where fibroid and hyperplasia with polyp were 100% diagnosed while hyperplasia, polyp and normal findings were diagnosed 53.33%, 88.89% and 53.33% respectively.Hysteroscopy findings in correlation with HPE where fibroid, hyperplasia and hyperplasia with polyp were 100% diagnosed while polyp and normal findings were diagnosed 83.33%, 73.33% respectively.Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of TVS and hysteroscopy were 82.05%, 72.73%, 91.43%, 53.33%, 80% and 89.74%, 100%, 100%, 73.33%, 92% respectively. Conclusion:We conclude that TVS is a good diagnostic initial modality for the diagnosis of endometrial lesions in AUB.But hysteroscopy should be done as a basic investigation even in cases where TVS is normal and endometrial biopsy should be taken where hysteroscopy shows normal findings.