Publication:

Comparative study of saline infusion sonography and hysteroscopy for evaluation of uterine cavity in abnormal uterine bleeding

Background Intra-cavitary uterine pathology is the commonest cause of abnormal uterine bleeding. Hysteroscopy is considered as the gold standard for uterine cavity examination. However, in resource limited set-ups saline infusion sonography is an effective alternative to hysteroscopy. The current study aims to compare the accuracy of saline infusion sonography with hysteroscopy in identifying intra-cavitary lesions in women with abnormal uterine bleeding.

Methods 52 patients with abnormal uterine bleeding underwent saline infusion sonography followed by hysteroscopy. The parameters studied were endometrial thickness, presence of sub-mucosal fibroid and endometrial polyp.

Results Upon comparison of saline infusion sonography with hysteroscopy, for detecting endometrial hyperplasia the  sensitivity, specificity, positive and negative predictive value were 100%, 94%, 40% and 100% respectively. For endometrial polyp the sensitivity, specificity, positive and negative predictive values were 90.90%, 92.68%, 76.92% and 97.43% respectively. Similarly, the sensitivity, specificity, positive and negative predictive values for sub-mucosal fibroid were 86.36%, 83%, 79.16 % and 89.28% respectively.

Conclusions Saline infusion sonography is a less invasive alternative to hysteroscopy for diagnosis of intra-cavitary lesions in women with abnormal uterine bleeding.