Different diagnostic modalities in abnormal uterine bleeding: a comparative study

ABSTRACT

To compare the combined diagnostic reliability of sonohysterography and endometrial biopsy with fractional curettage with hysteroscopy in the initial evaluation of women with abnormal uterine bleeding. Department of obstetrics and gynecology, faculty of medicine, Al-Azhar University cross sectional study in 2004 all perimenopausal women with abnormal uterine bleeding were offered inclusion, with 100 completed the study. An endometrial biopsy was performed at the time of initial evaluation. Routine transvaginal ultrasonography was then used to measure the uterus, ovaries, and endometrial stripe thickness, followed immediately by sonohysterography to evaluate the symmetry of endometrial wall thickness and delineate any intraluminal masses. Definitive histopathologic sampling was obtained by fractional curettage with hysteroscopy and statistically compared with the diagnoses arrived at by endometrial biopsy and sonohysterography. The combination of endometrial biopsy and transvaginal sonohysterography positively correlated with the surgical findings >95% of the time, with a sensitivity and specificity of 94% and 96%, respectively [confidence interval 91% to 99%]. No patients with endometrial hyperplasia or cancer were misdiagnosed. Sonohysterography combined with endometrial biopsy is a reliable tool for evaluating women with abnormal uterine bleeding