Rubina Iqbal, Fareeha Khan, Samina Khurshid, Rani Ferzana, Fehmeen Tariq.
Diagnostic Accuracy of Transvaginal Ultrasound with Histopathological findings in Postmenopausal Bleeding.
Pak J Med Health Sci Jan ;12(3):1262-5.

Background: Postmenopausal bleeding (PMB) is bleeding from the vagina that occurs after a woman has stopped having regular menstrual periods due to menopause. Depending on the endometrial cancer prevalence, a strategy with TVS as an initial investigation is cost effective. TVS is a reliable tool for prediction of endometrial carcinoma as cause of PMB but in studies mentioned above has contradiction. So resolve this controversy, we conducted this study. Aim: To determine the diagnostic accuracy of transvaginal ultrasound for detection of endometrial malignancy in females presenting with PMB taking histopathology as gold standard. Methodology : This cross sectional study was done on 159 cases with PMB. Then TVS was done by a single radiologist. Patients were labeled as positive if ET > 4mm on TVS. Endometrial sampling was taken by dilatation and curettage. Endometrial sample was sent for histopathology to pathology laboratory of hospital for confirmation of endometrial cancer. Results : The mean age of the patients was 65.56+/-6.11 years. The mean PMB duration was 8.69 +/-4.63 months. The mean duration of menopause was 9.59+/-6.45 years. The sensitivity of TVS was 86.3% with specificity of 93.0%, PPV was 91.3%, NPV was 88.9% and diagnostic accuracy was 89. 9% taking histopathology as gold standard. Conclusion : Our study concluded that the TVS is safe, acceptable and easily available procedure for detection of endometrial malignancy in females presenting with PMB.

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