Abnormal uterine bleeding is one of the commonest reasons of women consulting gynecologist. Approximately 33% of all admission to gynecologist is due to abnormal uterine bleeding . Management of these patients include prompt diagnosis of caused AUB. Intracavitary pathology like polyp, fibroid, hyperplasia of endometrium are the commonest pathology for AUB. Invasive procedure like office hysteroscopy (OH) is considered as gold standard for diagnosis of AUB. Considering its cost, skill and accessibility SIS may prove effective alternative to office hysteroscopy.
Trans vaginal sonography (TVS) is widely used diagnostic tool for all gynaecological conditions. Our current study aims to compare the accuracy of saline infusion sonography (SIS) with TVS and office hysteroscopy in the diagnosis of AUB.
Method: The prospective observational study was conducted in the department of OBGY of ACPM Medical College Dhule. 100 patients of AUB evaluated by TVS, SIS and office hysteroscopy to diagnose etiological factors like endometrial hyperplasia, submucous fibroid or polyp.
Results: In our study sensitivity and specificity of TVS SIS and OH were 65%, 89%; 87%, 91; 87, 91% respectively. Similarly PPV and NPV of TVS SIS and OH were 88%, 68%; 92, 86%; 92, 86% respectively.
Conclusion: For diagnosis of intracavitary lesion in case of AUB, SIS is definitely cost effective non invasive investigation with almost equal accuracy when compared with office hysteroscopy. Therefore we recommend that SIS should be first line investigation in case of AUB.