TITLE:
Endometrial Evaluation by Transvaginal Ultrasonography Saline Infusion Sonohysterography, Hysteroscopy versus Endometrial Office Bipsy in Perimenopausal Bleeding: A Comparative Study
AUTHORS:
Mohamed Kamal, Almandouh H. Bosilah
KEYWORDS:
Perimenopausal Bleeding, Hysteroscopy, Endometrial Office Biopsy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.8,
August
24,
2020
ABSTRACT: Postmenopausal
bleeding is a very common and alarming symptom accounting for 5 percent of all
gynecological outpatients’ clinic attendances. This cross-section study was
conducted in the Department of Obstetrics and Gynecology at University Hospitals and included 176 patients
with perimenopausal bleeding who attended a patient clinic during the period
from January 2017 to May 2019. All patients were subjected to transvaginal
ultrasound, saline sonohysterography and out-patient endometrial sampling using
pipelle; all the results were compared to histopathology obtained by
hysteroscopic guided biopsy and/or hysterectomy. Result: In comparing
the validity of TVS and SHG we found highly significant decrease in malignancy
assessment in the TVS method compared to
hysteroscopic-guided biopsy. According to the validity of pipelle in detection
of malignant lesion, it was found to detect 80 cases out of 88 cases of
malignancy with sensitivity 90.9%, specificity 100% and 95.45% accuracy with
respect to histopathology by hysteroscopy guided biopsy and/or hysterectomy.
Combination tests were done between SHG and pipelle and we found that the
validity of combination tests in detecting malignancy improves the sensitivity
and specificity in detection of malignancy sensitivity = 100% and specificity =
100% and this was found to be as an effective method in detection of
malignancy. Conclusion: When SHG combined to outpatient endometrial
sampling “pipelle”, the results were the same as hysteroscopy.