BIOCHEMICAL, HORMONAL AND ULTRASONOGRAPHIC EVALUATION OF ABNORMAL UTERINE BLEEDING

AbstractObjectives: To evaluate patients with abnormal uterine bleeding by biochemical, hormonal methods and ultrasonography to reach a definitive diagnosis and to effectively initiate correct treatment.Methods: Three hundred women in the age group of 14-60 years with complaint of abnormal uterine bleeding were evaluated by biochemical, hormonal methods and ultrasonography. Results of ultrasonographic findings were analyzed with histopathological confirmation.Results: Out of 11 (3.66%) patients with biochemical abnormality, ultrasonographic abnormality (tubo ovarian mass) was found only in 2 patients and hormonal abnormality was not found in any patient. Out of 101 (33.67%) patients with hormonal abnormality, ultrasonographic abnormality was found only in 21 patients (2 cases of polycystic ovaries, 19 cases of endometrial hyperplasia) and biochemical abnormality was not found in any patient. On ultrasonography 32% had normal appearance, 24% had myoma, 21% had endometrial hyperplasia, 14% had endometrial polyp, 1% had both hyperplasia & polyp, 4% had adenomyosis, 1% had polycystic ovarian disease, 2% had tubo ovarian mass and 1% had atrophy (in post menopausal age group). In 20 patients with IUCD in situ, ultrasonography was not done. These lesions could not be diagnosed by biochemical or hormonal methods. The sensitivity, specificity, positive predictive value and negative predictive value of ultrasonography in detection of all kind of pathologies was 91.9%, 76.9%, 92.5% and 75.4% respectively.Conclusion: Biochemical, hormonal and ultrasonographic methods should not be used independently, but are complementary to each other to diagnose most of the cases of abnormal uterine bleeding.Keywords: Abnormal uterine bleeding, Hormonal profile, Ultrasonography.