TAS/TVS Versus Histopathological Diagnosis in Abnormal Uterine Bleeding: Analytical Cross Sectional Study

Aim: The aim of this study to evaluate the TAS/TVS versus histopathological diagnosis in abnormal uterine bleeding. Methods: This analytical cross sectional study was carried out in the Department of Obstetrics and Gynecology, Netaji Subhas Medical College and Hospital, Bihta, Patna, Bihar, India for 1 year. 100 females of various age groups, with a clinical diagnosis of AUB were included in this study. Patients fulfilling the inclusion criteria were selected through detailed clinical history, examination: general physical, systemic, gynecological (per speculum, per vaginal) and all general and specific investigations were carried out. Written informed consent (form attached) was taken from patient interviewed, examined and investigated as per the predesigned proforma (attached). All the patients were subjected to premenstrual dilatation and curettage and hysterosopic guided biopsy accordingly. Tissue obtained was subjected to histopathological examination. Results: 67 patients had menorrhagia as a primary complaint. Heavy Menstrual bleeding (HMB) in 35 (35%) and Heavy and Prolonged Menstrual Bleeding (HPMB) in 32 (32%), 21(21%) patients have irregular menstrual bleeding patterns, while 12(12%) patients had post- Menopausal bleeding. Histopathological examination maximum number of patients were found having Myoma in 18 cases (18%) followed by Adenomyosis in 16 cases (16%) and Myoma+ Adenomyosis existed in 16 (16%) cases. Least frequently condition was myoma with endometrial carcinoma and 1 case (1%) of Adenomyosis with endometrial carcinoma. The sensitivity and specificity of TAS for Diagnosing Polyp as compared to HPE was 52.87% and 98.56% while positive predictive value and negative predictive value were 95.10 % and 79.11% respectively. Conclusion: Transabdominal or transvaginal ultrasound is low cost primary modality for screening and should include as a first line screening method. Though the investigation and management of AUB among the non-gravid women was confusing, histopathological diagnosis proved to be the gold standard.