COMPARATIVE STUDY OF TRANSVAGINAL ULTRASOUND WITH HISTOPATHOLOGY IN DIAGNOSING ENDOMETRIAL PATHOLOGY IN POSTMENOPAUSAL BLEEDING

BACKGROUND Endometrial biopsy is considered the standard for detecting endometrial pathology, but since it is an invasive and blind procedure transvaginal ultrasound has been recommended as a less invasive substitute for detecting endometrial disease. METHODS This cross-sectional study was done in 100 patients to evaluate the efficacy of transvaginal ultrasound as a non-invasive investigative procedure for excluding endometrial pathology in patients with postmenopausal bleeding. All these patients underwent transvaginal sonography and dilatation and curettage. RESULTS In diagnosing endometrial pathology transvaginal sonography showed a sensitivity of 71.79%, specificity of 100%, positive predictive value of 100% and negative predictive value of 50%. A cut-off of 4mm endometrial thickness was taken for defining normality. No cases of endometrial malignancy were missed when 4mm was taken as the cut-off. The sensitivity of transvaginal sonography in detecting premalignant lesions was 75.76%, specificity was 82.35%, positive predictive value was 89.29% and negative predictive value was 63.64%. CONCLUSION The study concludes that transvaginal sonographic measurement of endometrial thickness can be used to exclude endometrial pathology in postmenopausal bleeding.