International Journal of Innovative Research in Medical Science (IJIRMS) Volume 07, Issue 11, November 2022, https://doi.org/10.23958/ijirms/vol07-i11/1531 www.ijirms.in 604 Original article A Retrospective Study on Diagnosing Efficacy of Transvaginal Sonography Versus Hysteroscopy in Abnormal Uterine Bleeding Dr. Priyanka Chaudhary *1 , Dr. Poonam Singh 2 , Dr Rehana Najam 3 , Dr Shubhra Shrivastava 4 , Dr Astha Lalwani 2 1 Junior Resident (JRIII), 2 Professor, 3 Professor & Head of Department, 4 Assistant Professor, 2 Professor Department of Obstetrical and Gynaecology, Teerthanker Mahaveer Medical College and Research Centre, Delhi Road, Moradabad, UP, India *Corresponding author- Dr. Priyanka Chaudhary; priyankachoudhary1130@gmail.com Received 13 October 2022; Accepted 28 October 2022; Published 03 November 2022 Abstract Background: Around 33% of females that presents to gynecological OPD have abnormal uterine bleeding (AUB). Out of various causes of AUB, the most common causes that were encountered includes endometrial polyps & hyperplasia, leiomyomas and annovulation. By diagnosing the etiology of abnormal uterine bleeding accurately, the prevalence of hysterectomies can be reduced. So, in this study the effectiveness of transvaginal sonography versus hysteroscopy was compared in the diagnosis of AUB. Methods: A total number of 64 patients in perimenopausal age group with AUB were enrolled in the study. All the patients were subjected to TVS & Hysteroscopy for the assessment of uterine cavity which was followed by endometrial sampling and then the sensitivity & specificity of both the modalities were statistically analysed. Results: In our study, mostly patients were presented with heavy menstrual bleeding(n=26) followed by frequent bleeding, intermenstrual bleeding & irregular menstrual bleeding. On TVS, 12 patients had normal uterine cavity, adenomyosis,fibroids, polyp, cystic ovaries were seen in 19,18,10, & 5, in women with AUB .On Hysteroscopy, uterine cavity was found normal in 15 females followed by endometrial polyp, fibroids & cerebroid appearance was seen in, 12, 12, 4 patients respectively and on histopathology, endometrial hyperplasia (n=20)was most commonly seen followed by polyp, proliferative & secretory endometrium. Both TVS & Hysteroscopy findings were statiscally significant. Conclusion: Both Hysteroscopy & transvaginal sonography has the ability to determine the abnormalities of endometrium with different accuracy. Hence the patients who were presented with AUB should undergone TVS as primary measure, followed by hysteroscopy in the same sitting for diagnostic & therapeutic procedure whenever required Keywords: Transvaginal sonography, Hysteroscopy, Abnormal uterine bleeding Introduction Abnormal uterine bleeding is a type of bleeding that arises from uterine corpus varying in duration, amount, frequency and cyclicity [1] . Its prevalence fluctuates between 10% to 30% and varies in different population [2] . Abnormal uterine bleeding most commonly occurs in perimenopausal age group which may be due to anatomic changes, hormonal imbalance, systemic diseases, infections or complications of pregnancy. FIGO in 2018 has developed a newer classification (PALM- COEIN) for the etiology of AUB where PALM stands for structural causes while COEIN stands for non-structural causes [3] . Majority of problems that happens to perimenopausal women were due to anovulatory cycles, endometrial hyperplasia & benign uterine neoplasia while in postmenopausal women, the most common cause of AUB was atrophy of vagina & endometrium and hormonal therapy, only 10% bleeding occurs due to carcinoma of endometrium [4] . Transvaginal sonography provides detailed assessment of anatomic abnormalities of the uterus and endometrium pathologies like endometrial polyps, adenomyosis, leiomyomas, endometrial hyperplasia & malignancy [5] . Hysteroscopy is although invasive but plays a very important role in the diagnosis and management of patients with intracavitary lesions. However, there are risk of perforation, cervical laceration, infections and creation of false passage. It is typically more challenging & expensive than TVS [6] . With the advancement in the technology, both TVS & Hysteroscopy, they come in the workup of AUB patients but still there is dilemma when we compare the efficacy of the two. Hence the present study is undertaken to compare the diagnostic efficacies of both the modalities in the patients of AUB. Aim To determine the role of TVS and hysteroscopy in the evaluation of AUB Objectives 1. To study the role of TVS in the diagnosis of AUB 2. To study the role of Hysteroscopy in AUB