Punithavathi, P (2006) Combined role of Transvaginal Ultrasonogram and Aspiration Cytology of endometrium in post menopausal uterine bleeding: A Prospective study. Masters thesis, Madras Medical College, Chennai.
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Abstract
This present prospective study analyzing the combined role of trans vaginal sonography and aspiration cytology of endometrium in postmenopausal bleeding was carried out at Government Kasturbha Gandhi Hospital, Madras Medical College during the period of October 2003 to November 2005. A total of 150 patients were included in the study All the patients underwent an initial assessment with trans vaginal sonography followed by aspiration cytology of endometrium and fractional curettage with the aim of obtaining a pathological diagnosis. All patients with abnormal findings and those coming under the category described earlier, subsequently underwent hysterectomy. The final diagnosis obtained after hysterectomy was designated as the gold standard against which the findings of transvaginal sonography and aspiration cytology of endometrium were compared and analysed for statistical significance. Observations in the study includes: Patients in the study group ranged from 40-70 years with 69.3% of them belonging to 50-60 years. • The study encompasses parous women with majority of them belonging to low socio economic status. • Most of the women (88.7%) had presented with in 6 months of onset of Complaints. • Both trans vaginal sonography and aspiration cytology of endometrium produce statistically significant results while evaluating post menopausal bleeding (p=0.000). • Trans vaginal sonogram showed a sensitivity of 76% and specificity of 92%. • Aspiration cytology of endometrium in diagnosing pathology showed a sensitivity of 84.6% and specificity of 97.1% which is equal to that of traditional fractional curettage. • Aspiration cytology missed out the diagnosis of intraluminal pathology because of its blind nature. • Combining both transvaginal sonogram and aspiration cytology of endometrium in diagnosing endometrial pathology has better accuracy. • Though transvaginal sonography identifies endometrial hyperplasia, tissue diagnosis was necessary in these cases But it obviates the need for endometrial sampling in those cases where endometrium was less than 4 mm thickness. CONCLUSION: Transvaginal sonography is initially used to evaluate patients with post menopausal uterine bleeding. • With more than 4 mm endometrial thickness as cut off, patients can be subjected to aspiration cytology of endometrium. • Being an office procedure .aspiration cytology of endometrium ,it is better than traditional D&C in diagnosing endometrial pathology. • Aspiration cytology of endometrium is still unable to identify focal pathology which needs other diagnostic modalities such as saline infusion sonography or hysteroscopy. • Hence the combination of trans vaginal sonography and aspiration cytology of endometrium can be used in diagnosing post menopausal bleeding as an out patient procedure.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Prospective study ; transvaginal ultrasonogram ; aspiration cytology ; endometrium ; post menopausal uterine bleeding. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 03 Dec 2017 06:31 |
| Last Modified: | 05 Dec 2017 00:50 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4153 |
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