Journal of Postgraduate Medicine, Education and Research

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VOLUME 53 , ISSUE 4 ( October-December, 2019 ) > List of Articles

Original Article

Diagnostic Value of Outpatient Endometrial Aspiration and Transvaginal Sonography vs Inpatient Hysteroscopy in Evaluation of Abnormal Uterine Bleeding

Vinita Sarbhai, Tanvisha Singla

Keywords : Abnormal uterine bleeding, Endometrial aspiration, Hysteroscopy, Transvaginal sonography

Citation Information : Sarbhai V, Singla T. Diagnostic Value of Outpatient Endometrial Aspiration and Transvaginal Sonography vs Inpatient Hysteroscopy in Evaluation of Abnormal Uterine Bleeding. J Postgrad Med Edu Res 2019; 53 (4):143-146.

DOI: 10.5005/jp-journals-10028-1335

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Objective: The objective of this study was to compare the efficacy of outpatient and inpatient procedures, and to assess whether hysteroscopy offers any additional benefit when compared to a combination of endometrial biopsy and vaginal ultrasound. Materials and methods: A total of 50 patients aged >18 years who presented with abnormal uterine bleeding were included in this study. Endometrial aspiration with Pipelle cannula and transvaginal sonography on an outpatient basis and hysteroscopy under anesthesia were performed. The findings of endometrial aspiration and transvaginal sonography were correlated with hysteroscopy-guided biopsy. Results: There is good sensitivity and negative predictive value of combined EA and TVS (i.e., 84.62% and 88.89%, respectively), while low specificity and positive predictive value (i.e., 51.61% and 42.31%, respectively), which is comparable to hysteroscopy, which has diagnostic accuracy values of sensitivity (84.62%), negative predictive value (90%), positive predictive value (45.83%), and specificity (58.06%). Conclusion: The combination of TVS and pipelle sampling enhances the diagnostic yield, and hence can be used as first-line investigation as they complement each other, and can be used to triage the patients for hysteroscopy, which is the gold standard and has the added advantage of combining see and treat in skilled hands many cases.


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  1. Longacre T, Atkins K, Kempson R, et al. The uterine corpus. In Sternberg's Diagnostic Surgical Pathology. Lippincott William & Wilkins; 2005. pp. 2184–2277.
  2. Creasman WT. Endometrial cancer: incidence, prognostic factors, diagnosis, and treatment. Semin Oncol 1997;24(Supp 1): S1-140–S1-150.
  3. Dijkhuizen FP, Brolmann HAM, Potters AE, et al. The accuracy of transvaginal ultrasonography in the diagnosis of endometrial abnormalities. Obstet Gynecol 1996;87:345–349. DOI: 10.1016/0029-7844(95)00450-5.
  4. Vessey M, Clarke J, McKenzie I. Dilatation and curettage in young women. Health Bull (Edinb) 1979;39:59–62.
  5. Ferry J, Farnsworth A, Webster M, et al. The efficacy of the pipelle endometrial biopsy in detecting endometrial carcinoma. Austr N Z J Obstet Gynaecol 1993;33:76–78. DOI: 10.1111/j.1479-828x.1993.tb02060.x.
  6. Dubinsky TJ. Value of sonography in the diagnosis of abnormal vaginal bleeding. J Clin Ultrasound 2004;32(7):348–353. DOI: 10.1002/jcu.20049.
  7. Bradley H, Nezhat F. Hysteroscopy. In: Nezhat C. ed. Nezhat's operative gynecologic laparoscopy and hysteroscopy. New York: Cambridge University Press; 2008. pp. 577–579.
  8. Tahir MM, Bigrigg MA, Browning JJ, et al. A randomized controlled trial comparing transvaginal ultrasound, outpatient hysteroscopy and endometrial biopsy with inpatient hysteroscopy and curettage. Br J Obstet Gynecol 1999;106:1259–1264. DOI: 10.1111/j.1471-0528.1999.tb08179.x.
  9. Hunter DC, Mc Clure N. Abnormal uterine bleeding: an evaluation of endometrial biopsy, vaginal ultrasound and outpatient hysteroscopy. Ulster Med J 2001;70:25–30.
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