Comparative Study of Transvaginal Sonography, Hysteroscopy, and Endometrial Biopsy in Abnormal Uterine Bleeding (Code-T0061)

Introduction: Abnormal uterine bleeding (AUB) is a common gynecological complaint that can be indicative of underlying pathologies such as endometrial hyperplasia, fibroids, or malignancies. Accurate diagnosis is essential for effective management. This study aims to compare the diagnostic efficacy of transvaginal sonography (TVS), hysteroscopy, and endometrial biopsy in patients presenting with AUB.

Aim and Objectives: 

1. To know incidence of AUB in gynae cases.
2. To evaluate the cause of abnormal uterine bleeding using transvaginal sonography, hysteroscopy and endometrial biopsy to achieve the greatest diagnostic accuracy.
3. To determine the sensitivity and specificity of transvaginal sonography , hysteroscopy and endometrial biopsy in detection various of various uterine pathology.

Methods: This prospective study included 150 women presenting with AUB, who underwent TVS, hysteroscopy, and endometrial biopsy. The results from each diagnostic modality were compared against histopathological findings as the gold standard. Sensitivity, specificity, and diagnostic accuracy were calculated for each technique.

Results: Hysteroscopy demonstrated the highest sensitivity (92%) and specificity (85%) in detecting structural abnormalities, followed by TVS with a sensitivity of 84% and specificity of 78%. Endometrial biopsy showed a sensitivity of 89% and specificity of 91% for detecting endometrial pathology. TVS was more effective in identifying fibroids and polyps, while hysteroscopy and endometrial biopsy were more reliable in detecting endometrial hyperplasia and carcinoma.

Conclusion: Hysteroscopy and endometrial biopsy provide superior diagnostic accuracy for structural and endometrial abnormalities compared to TVS. A combination of these modalities offers the best approach for evaluating AUB, ensuring accurate diagnosis and effective treatment planning.

Keywords: Abnormal uterine bleeding, Transvaginal sonography, Hysteroscopy, Endometrial biopsy, Diagnostic accuracy, Sensitivity.