Transvaginal Ultrasound versus Saline Infusion Ultrasound for the Characterization of Intrauterine Lesions in Premenopausal Women with Abnormal Uterine Bleeding

Abstract

Rana Hatem Matrood Alkhazraji, Mohammed Habeeb Hachim and Alaq Saeed Abdulhussain.

Background: Abnormal uterine bleeding is among common health issues seen in premenopausal women. The use of invasive techniques such as hysteroscopy and dilatation and curettage are associated with surgical risks, use of anesthesia, severe post-operative pain and are coasty. Therefore, the use of non-invasive technique is preferred by both patients and the treating clinicians. Although, transvaginal sonography has been proved to be good diagnostic tool in categorizing causes of abnormal uterine bleeding, saline infusion sonography nowadays gains better reputation because of better endometrial surface visualization.
Aim of the study: The current study was aiming at comparing the sensitivity and specificity of saline infusion sonography to transvaginal sonography.
Patients and methods: The current prospective study was carried out between 1st of January 2018 and 30th of June 2019 at the gynecological outpatient clinic in maternity and children teaching hospital/ Al-Diwaniyah. At the end of the study, authors were able to recruit 80 women with abnormal uterine bleeding with an age range of 25 to 45 years. Women with obvious infection, pregnant women, those with known adnexal abnormality and those who fail to complete both saline infusion and transvaginal ultrasound procedures were excluded from the study. All women were subjected to transvaginal sonography, saline infusion sonography and dilatation and curettage. Results: When endometrial biopsy was considered as the gold standard, no abnormal pathology (36.25%), polypoid lesion (35%), endometrial hyperplasia (8.75%), submucosal leiomyoma (20%) were found among our study population. With reference to pathological results, and when compare TVS &SIS; we found that SIS was more sensitive and highly specific than TVS with sensitivity of 79.56 and specificity of 98.85 respectively, and it was statistically significant.
Conclusion: saline infusion sonography is more sensitive, more specific and more accurate that transvaginal sonography in characterizing organic pathology in premenopausal women with abnormal uterine bleeding.