title: Transvaginal sonography and saline infusion sonohysterography in the evaluation of abnormal uterine bleeding.
abstract: OBJECTIVE
  To evaluate the accuracy of transvaginal sonography (TVS) and saline infusion sonohysterography (SIS) in diagnosing submucous fibroids and endometrial polyps in the patients of abnormal uterine bleeding (AUB).
  
  
  METHODS
  Prospective, comparative study.
  
  
  METHODS
  Postgraduate Institute of Medical Sciences, Rohtak.
  
  
  METHODS
  Fifty patients with AUB underwent TVS and SIS prior to hysterectomy.
  
  
  METHODS
  Comparison of diagnosis of submucous fibroids and endometrial polyps at TVS and SIS with the final diagnosis at hysterectomy ie 'gold standard'.
  
  
  RESULTS
  Both procedures were helpful in detecting submucous fibroids and endometrial polyps. However, SIS was found to be more useful (sensitivity 89.5%, specificity 100%, likelihood ratios of the presence and absence of submucous fibroids of infinity and 0.1 respectively) than TVS (sensitivity 70% and specificity 96.6% and likelihood ratios of 21.2 and 0.3 respectively) for submucous polyps. Saline infusion sonohysterography was also more accurate for endometrial polyps (sensitivity 100%, specificity 97.8%) than TVS (sensitivity 66.6%, specificity 100%). With SIS and TVS, the post-test probability with negative test was 0% and 4%, respectively, thus suggesting that no endometrial polyp would be missed on SIS.
  
  
  CONCLUSIONS
  Saline infusion sonohysterography is more accurate in diagnosing submucous fibroids and endometrial polyps in the patients of abnormal uterine bleeding than is TVS. TVS should be included in the standard protocol for the management of AUB. Saline infusion sonohysterography should be reserved for those patients who have centrally located fibroids as they may be submucous.
authors.affiliation: Department of Obstetrics and Gynaecology, PGIMS, Rohtak, India.
authors.forename: Smiti
authors.initials: S
authors.lastname: Nanda
authors.forename: Nivedita
authors.initials: N
authors.lastname: Chadha
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Sen
authors.forename: Krishna
authors.initials: K
authors.lastname: Sangwan
mesh_terms: D000328:Adult; D019160:Endosonography; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011127:Polyps / Q000150:complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology*; D014594:Uterine Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D012965:Sodium Chloride