AUGUST 2024
Ultrasound-Guided Diagnosis of Heavy Menstrual Bleeding in Gynaecology Outpatient Department: A Comprehensive Evaluation of Diagnostic Accuracy, Clinical Correlates, and Management Strategies
1Ali Raza, 2Dr. Adila Ashraf, 3Mohib Ali, 4Mobeen Ali, 5Umar, Khan, 6Hadi Raza
PIMS, Assistant Professor, Gynae n Obs, Ali Fatima hospital, PIMS, PIMS, PIMS,PIMS
Correspondence : Ali Raza, PIMS
Abstract
Background: HMB is a gynaecological complaint characterized by excessive menstrual blood loss that interferes with women’s physical, emotional and social functioning. Proper diagnosis of HMB is important in outpatient practice in order to prevent unnecessarily manoeuvrings. Ultrasound (USG) has taken a centrality as the diagnostic tool of choice in evaluating HMB given its tactical advantages of being non-invasive and affording real-time imaging of the pelvic structure.
Aim: This work is set to assess the efficiency of USG to diagnose HMB in a genecology OPD environment with special reference to its diagnostic yield, purpose and inclusion in regular practice.
Method: Hence, an observational retrospective/prospective study was carried out at a genecology Outpatient Department of a tertiary care hospital with women complaining of HMB. The assessments which were taken by the patient before the test included medical history, physical examination, and USG- Transabdominal and Transvaginal. Information was gathered regarding the participants’ age, gender, length of illness, presence of any significant comorbidity, USG findings, and diagnostic sensitivity and specificity as well as PPV and NPV of the diagnostic test.
Results: The study consisted of 250 women with the average age of 38 years. Data obtained in the current study hence pointed out that the commonest cause of abnormal bleeding in the campus was identified as uterine fibroids 40 %, endometrial polyps 15 %, adenomyosis 10 %, and endometrial hyperplasia 8 %. The diagnostic efficiency was high with sensitivity and specificity of target pathology varying between 55% and 92% and 78% to 98% respectively. Authors also found the clinical symptoms association with USG to be significant and established proficient diagnostic correlation comparable with that of hysteroscopy.
Conclusion: Specifically, USG is useful in the diagnosis of HMB in the genecology OPD context, demonstrated significant diagnostic performance for detecting and characterizing principally pathological findings of the uterus and adnexa. It is useful in improving the overall patient care and management since patient’s condition is detected and managed on time. To provide the best and quick female health care, USG has to be incorporated in the everyday gynaecological practice for women on HMB.
Keywords: Heavy Menstrual Bleeding, Ultrasound, Diagnosis, Gynaecology Outpatient Department, Uterine Pathologies, Diagnostic Accuracy.