Background: Endometrial abnormalities are significant causes of abnormal uterine bleeding (AUB). Transvaginal sonography (TVS) can depict the various causes for abnormal uterine bleeding with better clarity, when compared to a trans abdominal scan. The disadvantage is that TVS depicts all the endometrial causes of abnormal uterine bleeding as endometrial thickening either focal or diffuse or as endometrial irregularities. Saline infusion sonography (SIS) or sonohysterography is an innovative technique by which instillation of fluid into endometrial cavity distends the endometrial cavity, separating the two layers and better depicting the endometrial lesion.

Materials and Method: A prospective study was conducted in 53 patients with abnormal uterine bleeding and infertility, in the department of Radiodiagnosis, Government Medical college, Thrissur during the period of June 2009 to May 2010

Results: 50 patients with abnormal uterine bleeding were included in the study among them 11were in postmenopausal group. In 3 patients sonohysterography was unsuccessful due to cervical stenosis and patulous cervix. The overall sensitivity, specificity, positive predictive value and negative predictive value of the procedure in this study were 92.8%, 81.8%,86% 90% respectively.

Conclusion: Sonohysterosalpingography can distinguish focal from diffuse pathology reliably and has become a crucial imaging test in the triage of postmenopausal bleeding and in premenopausal patients with dysfunctional uterine bleeding or infertility.

Keywords: Abnormal Uterine bleeding, Sonohysterosalpingography, endometrial polyp, endometrial hyperplasia.

1. Bree RL, Bowerman RA, Bohm-Velez M, etal. US evaluation of the uterus in patients with postmenopausal bleeding: a positive effect on diagnostic decision making. Radiology 2000;216;260-264.
2. Yildizhan B, Yildizhan R, Oz Kesici B, Suer N, Transvaginal ultrsonography and saline infusion sonohysterography for the detection of intrauterine lesion in pre and postmenopausal women with abnormal uterine bleeding. Jour. of international medical research. 2008,vol 36, 1205-1213.
3. Mathew M, Gowri V, Rizvi SG. Saline infusion sonohysterography - an effective tool for evaluation of the endometrial cavity in women with abnormal uterine bleeding. Acta obstet and gynecol. Scand. 2010; 89 (1) 140-2
4. Pasrija Trivedi SS, Narula MK. Prospective study of saline infusion sonoh-ysterography in evaluation of perimen-opausal and postmenopausal women with abnormal uterine bleeding. J.Obstet Gynaec Res.2004.Feb;30(1): 27-33
5. Nass Duce M, Oz U, Ozer C, Yildiz A, Apaydin FD, Cil F. Diagnostic value of sonohysterography in the evaluation submucoal fibroids and endometrial polyps. The Aust. and New zealand Journ. of obstet. and gynecol. vol- 43, (6),448-452. Dec. 2003.
6. Nass Duce M, Oz U, Ozer C, Yildiz A, Apaydin FD, Cil F. Diagnostic value of sonohysterography in the evaluation submucoal fibroids and endometrial polyps. The Aust. and New zealand Journ. of obstet. and gynecol. vol- 43, (6),448-452. Dec. 2003.
7. Zael Y, Cohen SB , Oren M , Seidman DS , Zolti M , Achiron R , Goldenberg M. Sonohysterography for the diagnosis of residual trophoblastic tissue. J Ulttrasound Med. 2001 Aug 20 (8) ; 877-81.
8. Igal wolman, Eran Altman, Faith G, Amster R, Jaffna A. Combined clinical and ultrasonographic work-up for the diagnosis of retained products of conception. Fertil Steril 2009 Feb 25.
9. Alcazar JL, Errasti R, Zomosa A. Saline infusion sonohysterography in endometrial cancer. Assessment of malignant cell dissemination risk. Acta Obstet. Gynaecol. second 2000;79:321-2.
10. Dessole S , Rubattu G, Farina M, Risks and usefulness of sonohysterography in patients with endometrial carcinoma. Am J Obstet. Gynecol.2006; 194:362
11. Johanna R. Jorizzo, Gioia J.Riccio, Michael Y.M.Chen, J.Jeffrey Carr. Sonohysterography: The Next step in the evaluation of the abnormal endometrium.  Radiographics.1999;19: S117-130.

Dr Abhilash Babu T.G

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.