title: Comparative evaluation of perimenopausal abnormal uterine bleeding by transvaginal sonography, hysteroscopy and endometrial biopsy.
abstract: To evaluate the causes of abnormal uterine bleeding in perimenopausal women and to achieve the greatest diagnostic accuracy with the least risk, a cross-sectional study was done among 85 patients between the ages 40 and 55 years. Transvaginal sonography, hysteroscopy and histopathological examination of endometrium were done in all the cases. Kappa statistics was calculated to show the agreement between the different investigations. Considering histopathological report to be the gold standard, for diagnosis of hyperplastic endometrium, transvaginal sonography and hysteroscopy showed fair agreement (k=0.34) and good agreement (k=0.51) and hysteroscopic diagnosis of polyp showed strong agreement (k=0.81). Sensitivity, specificity, positive predictive value, negative predictive value for diagnosis of hyperplastic endometrium were 43.75%, 95.65%, 70% and 88% respectively whereas in polyp by transvaginal sonography they were 50%, 89.16%, 100%, 98.67% respectively; by hysteroscopy these were 50%, 95.78%, 70%, 90.36% respectively in hyperplasia and 71.43%, 100%, 100%, 94.67% respectively in polyp. Transvaginal sonography is most important for diagnosis of anatomical lesion. Hysteroscopy is most specific and sensitive for diagnosis of polyp but less specific for endometrial hyperplasia.
authors.affiliation: Department of Obstetrics and Gynaecology, RG Kar Medical College and Hospital, Kolkata.
authors.forename: Sima
authors.initials: S
authors.lastname: Mukhopadhayay
authors.forename: Subir Kumar
authors.initials: SK
authors.lastname: Bhattacharyya
authors.forename: Rajendra Prasad
authors.initials: RP
authors.lastname: Ganguly
authors.forename: Kajal Kumar
authors.initials: KK
authors.lastname: Patra
authors.forename: Nabendu
authors.initials: N
authors.lastname: Bhattacharya
authors.forename: Sanyasi Charan
authors.initials: SC
authors.lastname: Barman
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods; D003430:Cross-Sectional Studies; D016889:Endometrial Neoplasms / Q000473:pathology*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D047648:Perimenopause; D014463:Ultrasonography; D014591:Uterine Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D014592:Uterine Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D014621:Vagina / Q000000981:diagnostic imaging* / Q000473:pathology