Abstract:
Abnormal uterine bleeding is a common problem which makes women seek medical
treatment. Although most of these women do not have any structural lesions some of them
do have. Even though hysteroscopy and guided biopsy is the accepted gold standard to
diagnose these lesions, majority of the Sri Lankan women are unable to enjoy it due to the
lack of facilities. Saline infusion sonography is thought to be a successful alternative in the
detection of structural lesions. This study was done to compare it's effectiveness with that of
hysteroscopy and histology. To decide on the sensitivity, specificity, positive and negative
predictive values and positive and .negative likelihood ratios of saline infusion sonography.
Premenopausal women over the age of 40 years, presenting with abnormal uterine bleeding
were selected for the study . They underwent saline infusion sonography, hysteroscopy and
endometrial biopsy. Above parameters were calculated for saline infusion sonography
taking hysteroscopy and histology as the gold standard. When analyzed including
endometrial hyperplasia as pathology in calculations the sensitivity of SIS was 58.1 percent
; the specificity was 97.9 percent ; positive predictive value was 92.6percent and the
negative predictive value was83.9percent . When the calculation. was done excluding
hyperplasia the sensitivity 85.2 percent ; the specificity was 100 percent ; positive predictive
value was 96.6 percent. Saline infusion sonography is as effective as hysteroscopy in
detecting structural endometrial lesions
