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Abnormal uterine bleeding is an important cause of ill health and accounts for almost 20 % of all gynaecological visits. Dilatation and curettage has been the diagnostic gold standard for evaluating AUB but it is inaccurate and imprecise. Transvaginal ultrasound facilitates the diagnosis of polyps, submucosal fibroids and endometrial hyperplasia with high sensitivities. Hysteroscopy when combined with directed endometrial biopsy has high sensitivities and specificity in identifying benign and malignant intrauterine disease. Aims of the study: To study the efficacy of transvaginal sonography and hysteroscopy in detecting endometrial pathology 2. To compare transvaginal sonography and hysteroscopy findings with histopathological results after dilatation and curettage. Materials and Methods: It was a prospective study which included 100 women who visited AJIMS with complaints of AUB in the peri and postmenopausal age group. All 100 women underwent TVS and hysteroscopy followed by D&C. Results were statistically analyzed to detect the diagnostic accuracy of TVS and hysteroscopy in comparison with the histopathology report. Results: It was found that the sensitivity, specificity, positive predictive value and negative predictive value of TVS in detecting endometrial pathology was 67.1%, 72.2%,91.1%, 34.2% respectively and that of hysteroscopy was 85.5%,77.8%94.2% and 56% respectively. Conclusion: As TVS is relatively easier and non invasive, it should be offered in all patients for the diagnosis of endometrial pathologies. In cases where risk of endometrial pathology is high, hysteroscopic guided D&C can be done to achieve optimum results.

international journal of clinical obstetrics and gynaecology

A comparitive study of transvaginal ultrasonography and hysteroscopy with histopathological examination in detecting endometrial pathology in peri-menopausal and post-menopausal bleeding