ارزش تشخيصي هيستروسونوگرافي در تعيين علل خونريزيهاي غيرطبيعي رحم در حوالي سنين يايسگي

EVALUATION OF HYSTEROSONOGRAPHY IN DETERMINING THE CAUSES OF PERIMENOPAUSAL ABNORMAL UTERINE BLEEDING

The number of women who need medical attention for perimenopausal bleeding has been increased because of the factors such as hormonal therapy after menopause. Determining the cause is essential in planning appropriate therapy. Although endometrial biopsy is still the preferred method as the first diagnostic test, hysterosonogeraphy (HSG) is a sensetive diagnostic method. 37 perimenopausal women were enrolled in a prospective study. Patients were at the range of 36-65 years old and were asked about the use of oral contraceptive, tamoxifen and the history of hyperlipidemia, hypertension and hyperglycemia. All the patients with endometrial atrophy were excluded from the study. In HSG evaluation endometrial thickness in separate walls, echogenicity smoothness and irregularity were assessed and diagnosis were made based on sonographic data. Results of HSG were compared to data issued from pathologic results obtained from surgery. HSG was achieved in 37 patients. In all patients the procedures were well tolerated by patients with no complication during or after the examination. HSG had a high sensetivity and specificity in the discrimination of normal cavity from the ones with intrauterine lesion (sensitivity=95%, specificity=94%, positive predictive value=95%, negative predictive value=94%, accuracy=95%) HSG appears as a reliable method for the investigation of abnormal uterine bleeding in perimenopausal women. It can distinguish women who just need a medical therapy from the ones who require a surigical exploration.