The merits of three-dimensional transvaginal ultrasoundin the evaluation of premenopausal women withabnormal uterine bleeding

Background/Aims: Endometrial thickening is a nonspecific finding in women with premenopausal bleeding. Though it is expected in the luteal phase of ovulatory cycle or with anovulatory bleeding, it can be due to hyperplasia, polyps, leiomyomas, or endometrial carcinoma. Three-dimensional ultrasonography is an imaging technique that allows unique ways of assessing uterine and adnexeal pathology. The objective of this study was to evaluate the effectiveness of three-dimensional transvaginal ultrasound in uterine cavity assessment in premenopausal women with abnormal uterine bleeding. Methods: This was a prospective single-blinded cohort study of ninety premenopausal women with abnormal uterine bleeding, referred over three years period to one-stop hysteroscopy clinic at Ain Shams University Hospitals in Cairo, Egypt. All women had three-dimensional transvaginal ultrasound, in their first half of their menstrual cycles, followed by outpatient hysteroscopy, performed by a different operator who was blinded to the sonographic findings. Analysis of data was performed using statistical terms sensitivity, specificity, positive predictive value, and negative predictive value. Results: In comparison to outpatient hysteroscopy in premenopausal women with abnormal uterine bleeding, the sensitivity of three-dimensional ultrasonogrphy to detect intrauterine pathology was 100%, specificity 91.7%, with positive predictive value of 97%, and negative predictive value of 100%. Conclusions: Three-dimensional transvaginal ultrasound can predict intra-uterine lesions as accurate as outpatient hysteroscopy in premenopausal women with abnormal uterine bleeding.