Transvaginal Ultrasound for Diagnosing Endometrial Hyperplasia in Perimenopausal Women with Abnormal Uterine Bleeding

Aim: To determine the diagnostic accuracy of transvaginal ultrasonography for endometrial hyperplasia in perimenopausal women presenting with abnormal uterine bleeding, taking histopathology as gold standard. Study design: This was a cross-sectional observational study. Place and duration of study: It was conducted in the Department of Obstetrics and Gynaecology; Sharif Medical City Hospital affiliated with Sharif Medical and Dental College, Lahore from January 2015 to December 2017. Methodology: Perimenopausal patients with age between 45-55 years, complaining of abnormal uterine bleeding (AUB) and who gave consent, were included in this study. Patients with history of hormone therapy in last six months/ symptoms suggestive of acute pelvic inflammatory disease, having clinically abnormal cervix/uterus larger than 12 week size or having abnormal result of previous endometrial biopsy/ cervical smear were excluded from this study. Results: A total of 200 patients were included in this study. Among participants, 118 (59%) patients fulfilled our criteria for diagnosing endometrial hyperplasia on TVS (screen positive) and 82(41%) were screen negative. Histopathology revealed endometrial hyperplasia in 49% (n 98) patients and atypical hyperplasia in 19.5% (n 39).Out of 118 TVS positive patients for hyperplasia, 92 were found to be true positive with hyperplasia being confirmed on histopathology and 26 were found to be false positive with hyperplasia being absent on histopathology. Conclusion: TVS has 84% diagnostic accuracy for detecting endometrial hyperplasia. We can recommend TVS for prediction of endometrial hyperplasia in perimenopausal females with AUB as an early and first line assessment tool.