الفهرس 
AbstractOnly 14 pages are availabe for public view
 |  | from | 102 |  |  |
| | | from | 102 | | |
Abstract
Abnormal uterine bleeding (AUB) is one of the most common reasons for women seeking gynecological advice. Other than dysfunctional uterine bleeding (DUB), intrauterine abnormalities are the leading cause of AUB. More than 40% of affected women with AUB are reported to have intrauterine abnormalities, Peri-menopause includes the period beginning with the first clinical, biological and endocrinological features of the approaching menopause and ending twelve months after the last menstrual period, Saline-infusion sonohysterography (SIS) has emerged as an attractive and minimally invasive procedure that can be of help in the evaluation and detection of pelvic pathology. Its main limitations are that it does not permit satisfactory evaluation of small-localized lesions, and it does not allow easy differentiation between endometrial and myometrial
abnormalities.
The aim of the present study is assessment of the endometrium in abnormal uterine bleeding in perimenopausal women by 2DSIS and hysteroscopy with endometrial biopsy to compare the efficacy of those methods in detecting endometrial lesions.
100 patients were included in this study, they are subjected to general and local examination with full investigations, 2DSIS then hysteroscopy supported by histopathology as a golden test.
2DSIS could detect fibroid in 28 cases (28%), hyperplasia in 29 cases (29%), polyps in 33 cases (33%) and no identified pathology in 26 cases (26%). Mixed cases (more than one lesion) in 16 cases (16%).
Hysteroscopy supported by histopathology (golden test) could detect fibroid in 28 cases (28%), hyperplasia in 32cases (32%), polyps in 37 cases (37%), no identified pathology in 18cases (18%), 2 cases had a trophic endometrium (2%), one case had endometrial cancer (1%), and 18 mixed cases (18%).
In cases of fibroids: SIS had a sensitivity 89%, specificity 95%, ppv 89%, npp 95% and diagnostic accuracy was 94% there was highly agreed with Golden test (hysteroscopy supported by histopathology) and SIS about the fibroid diagnosis, the agreement was significant.
In cases of hyperplasia: SIS sensitivity 78%, specificity 94%, positive predictive value 86%, negative predictive value 90% and diagnostic accuracy were 89%. There was moderatly agreed between Golden test and SIS about diagnosis of the endometrial hyperplasia,the agreement was significant.
In cases of polyps: SIS has a sensitivity 89%,specifity 100%ppv 100% npv 94% accuracy 96%.% there was highly agreed between the Golden test and SIS about diagnosis of endometrial polyp, the agreement was significant.
In cases of no abnormalities detected: SIS, had sensitivity100%, specificity90.2%,, positive predictive value 69%, negative predictive value100% and diagnostic accuracy was 92% there was highly agreed between the golden test and SIS about the no identified pathology, the agreement was significant.
In cases of all lesions: SIS has a sensitivity 85.5 %, specificity 96.8% and
accuracy 94.7 %.