The New Indian Journal of OBGYN. 9(2):338-343
Comparative assessment of histopathology of the endometrium with transvaginal sonography, color doppler, and hysteroscopy in perimenopausal bleeding
Medhavi Sharma, Vinod Choudhary
ABSTRACT
Background: Abnormal uterine bleeding (AUB) is a common gynecological presentation in outpatient clinic, but is often complex and difficult to diagnose. Objectives: The present study was undertaken to compare the diagnostic efficacy of trans-vaginal sonography (TVS), color doppler, and hysteroscopy with histopathology of endometrium in perimenopuasal bleeding cases. Method: 105 patients with AUB in the perimenopuasal and post-menopausal age group (40-73) were underwent USG-TVS and color doppler, and followed by dilatation and curettage and endometrium was sent for histopathological examination. Correlation of ultrasonographic & color doppler findings with histopathology finding was done. Results: 53.33% patients presented with perimenopausal bleeding and 46.66% postmenopausal bleeding. According to USG examination, maximum patients (62.5%) had endometrial thickness <12mm in perimenopausal group while in postmenopausal group only 10(20.4%) had <5mm and >5mm in 79.6%. On color doppler examination, 10(12.04%) patients were having lower RI compare to normal range (<0.3), of which 3 were in perimenopausal and 7 in postmenopausal age group. On hysteroscopy examination, endometrium was hyperplastic in 12 (11.42%), irregular growth 7 (6.66%), unhealthy cheesy 2(1.90%), cystic hyperplasia 1(0.95%). On HPR examination, simple hyperplasia was found in 51(48.57%) patients followed by atrophied 16(15.23%), endometrial carcinoma 8(7.61%), cystic mass 7(6.66%) and complex hyperplasia with (3.81%) and without atypia (3.81%). The prediction of endometrial carcinoma by TVS, color doppler showed sensitivity 80%, specificity 97.2%, positive predictive value 80% and negative predictive value 100%. Conclusion: Color doppler USG was as effective as histopathology examination in diagnosis of endometrial carcinoma. Thus we can avoid endometrial biopsy for diagnosis of endometrial malignancy if USG findings were normal.