Background and objective: Abnormal uterine bleeding due to endometrial abnormalities is a common diagnostic challenge facing the radiologist and referring gynecologist. This study was aimed to compare the diagnostic performance of transvaginal ultrasound, transabdominal ultrasound and diagnostic curettage in the detection of endometrial pathologies in symptomatic women. Methods: A prospective comparison study of transvaginal ultrasound, transabdominal ultrasound and diagnostic curettage was conducted for evaluation of endometrial pathology in Maternity Teaching Hospital, Erbil city,Kurdistan region of Iraq, from September13 th , 2013 to September14 th , 2014. The study included 100 women presenting with abnormal uterine bleeding.Ultrasound findings were compared with histopathological results. The statistical package for the social sciences (version 17) was used for data entry and analysis. Results: The mean age (± SD) of sample size was 47 ±8.57 years. The mean parity was 5.17 ± 2.71. The highest percentages of women were in age group 40-59 years (73%). Of the total sample, more than half (52%) had regular cycles, 25% had irregular cycles and 23% were in menopausal state. In more than half of cases the indication for ultrasounds was for menorrhagia, followed by postmenapousal and intermenstrual bleeding (23% and 21%, respectively). Of 98 women (2 women were excluded from analysis), 19% had atrophic endometrium and 67% had endometrial hyperplasia in histopathological finding. Transvaginal ultrasound sensitivity and specificity were 100% and 92.9%, respectively while transabdominal ultrasound sensitivity and specificity were 92.8% and 65%, respectively. Conclusion:Transvaginal ultrasound scanning is an excellent tool for the determination of whether further investigation with histopathological examination of endometrial biopsy is necessary or not for women presented with abnormal uterine bleeding.
Introduction Postmenopausal bleeding refers to vaginal bleeding that occurs after twelve months of amenorrhea in a woman of the age where the menopause can be expected. 1 It can also be defined as the time in a woman's life when the woman stops having a menstrual period permanently and is no longer fertile. 2 However, it can be applied to younger women following premature ovarian failure or premature menopause. 3 Vaginal bleeding is a common post menopausal complaint representing 5% of all gynecology outpatient consultations. 4 The incidence of postmenopausal bleeding is 10% in the general population immediately after menopause. 5 The causes of postmenopausal bleeding include endometrial atrophy (approximately 75% of cases), 3 endometrial polyps, submucosal fibroids, endometrial hyperplasia (simple, complex and atypical), endometrial carcinoma (approximately 10%), and estrogen withdrawal. 6 Non-gynecological causes include trauma, systemic diseases like hypertension, hypothyroidism, and bleeding disorders. 3 Endometrial abnormalities are common diagnostic challenges facing the radiologist and referring specialist gynecologist. Ultrasound is the primary imaging modality in this workup; findings if further investigations done like sonohysterography, hysterosalpingography, magnetic resonance imaging, and computed tomography are often correlated Background and objective: Post-menopausal bleeding due to endometrial abnormalities is a common diagnostic challenge facing the ultrasonogists and referring gynecologists. This study aimed to detect the validity of transvaginal ultrasound to detect endometrial pathologies and its sensitivity and specificity for determining endometrial carcinoma in women with postmenopausal bleeding. Methods: A diagnostic accuracy study of transvaginal ultrasound and diagnostic curettage was conducted for evaluation of endometrial pathology in the College of Medicine, Hawler Medical University from October2016to January 2018. The sample size included 55 women with post-menopausal vaginal bleeding. The ultrasound findings were compared with histopathological results of endometrial biopsy. Results: Out of 55 women, 49.09% had endometrial atrophy, 29.09% had endometrial hyperplasia, 16.36% had endometrial polyp, 3.64% had endometrial carcinoma, and 1.82% had hyperplasia with atypia according to histopathological findings. The sensitivity of ultrasound in detecting cancer was 66.7%, the specificity was 100%, the positive predictive value (PV) was 100%, and the negative predictive value was 98.1%. The total agreement rate was 98.2%. Conclusion: Transvaginal ultrasound is an excellent diagnostic tool to determine whether further investigation with histopathological examination of endometrial biopsy is necessary for postmenopausal vaginal bleeding.
Background and objective: Polycystic ovarian cyst is the most common and complex reproductive endocrinopathy affecting females of childbearing age. This study aimed to investigate the sonographic prevalence of polycystic ovary morphology among women of reproductive age group, and correlate it with age, menstrual disturbances, fertility problems, obesity, and hormonal profile. Methods: This study was carried out in the Rizgary Teaching Hospital and private clinic in Erbil city, Kurdistan region of Iraqfrom 1 st August 2016 to 1 st June 2017. A total of 782 women were included in this study. Inclusion criteria were any woman attending to pelvic ultrasound for whatever the cause other than pregnancy. The prevalence of polycystic ovary morphology was determined depending on Rotterdam's criteria; correlation with clinical history and biochemical indices was done. Results: Of the total study sample of 782 women, 147 (18.8%)had polycystic ovarian cyst. The highest prevalence (32.7% and 43%) was among the age group 18-27 years and participants with high body mass index (31-≥40).There was a statistically significant correlation between menstrual cycle irregularities and serum prolactin andserum testosterone. The highest polycystic ovary prevalence was found among participants with a history of amenorrhea and oligomenorrhoea, 92.3% and 75.2%, respectively. Conclusion: We observed that polycystic ovary is an age-related disease and the prevalence of the disease decreases with age. The highest prevalence was seen among the age group of 18-27 years and least in the age group of 38-47 years. No patients with polycystic ovary were found above 48 years.
* Department of surgery, college of medicine, Hawler medical university, Erbil, Iraq. * Department of obstetric and gyenecology, college of medicine, Hawler medical university, Erbil, Iraq.
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