Najeeb Riffat, Awan Azra Saeed, Bakhtiar Umber, Akhter Sadia
Department of Obstetrics and Gynaecology, Islamic International Medical College Trust Railway Hospital, Westridge, Rawalpindi, Pakistan.
J Ayub Med Coll Abbottabad. 2010 Jan-Mar;22(1):87-90.
Abnormal uterine bleeding (AUB) is a common problem which prompts more than 20% of all visits to outpatient clinics, and may account for more than 25% of all hysterectomies. The objective of this study was to determine the role of transvaginal ultrasonography in women of perimenopausal age group presenting with abnormal uterine bleeding.
This descriptive study was conducted in Department of Obstructs and Gynaecology, Railway General Hospital, Rawalpindi. One hundred and forty-one women who attended the gynaecology clinic with abnormal uterine bleeding (menorrhagia, intermenstrual bleeding, or postcoital bleeding) between 40-47 years of age from January 2006 and April 2007 were included in this study. The mean age was 44 years.
Among 141 women endometrial lesions were detected in 77 cases on histopathology after Dialatation and Curettage (D&C), while 57 (40.42%) of these were confirmed on transvaginal ultrasongraphy as an endometrial pathology prior to this invasive procedure. Among the 64 remaining patients, showing normal proliferative endometrium on histopathology, 46 cases (71.87%) showed no abnormality on tranvaginal examination.
Transvaginal sonography can be safely used as an initial investigation in the management of abnormal uterine bleeding as it is a noninvasive procedure for the detection of endometrial pathology. The incidence of detection of an abnormal pathology by ultrasongraphy is high when focal lesions as fibroids, polyps or foreign body is concerned. Dilatation and curettage being a blind procedure requires hospitalization and general anaesthesia which can be safely replaced by an alternate valid, safe and non-invasive technique for evaluating the endometrial pathology in women of perimenopausal age group with abnormal uterine bleeding.
异常子宫出血（AUB）是一个常见问题，在所有门诊就诊中占比超过20%，在所有子宫切除术中可能占比超过25%。本研究的目的是确定经阴道超声检查在围绝经期异常子宫出血女性中的作用。
本描述性研究在拉瓦尔品第铁路总医院妇产科进行。纳入了2006年1月至2007年4月期间40至47岁因异常子宫出血（月经过多、经间期出血或性交后出血）到妇科门诊就诊的141名女性。平均年龄为44岁。
在141名女性中，刮宫术后组织病理学检查发现77例存在子宫内膜病变，其中57例（40.42%）在该侵入性手术前经阴道超声检查确诊为子宫内膜病变。在其余64例组织病理学显示增殖期子宫内膜正常的患者中，46例（71.87%）经阴道检查无异常。
经阴道超声检查可安全地用作异常子宫出血管理的初步检查，因为它是检测子宫内膜病变的非侵入性方法。当涉及肌瘤、息肉或异物等局灶性病变时，超声检查发现异常病变的发生率很高。刮宫作为一种盲视操作需要住院和全身麻醉，对于围绝经期异常子宫出血女性，一种有效的、安全的、非侵入性的评估子宫内膜病变的替代技术可以安全地取代刮宫。
