الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Abnormal uterine bleeding is a common but complicated clinical presentation. A reported 25 percent of gynecologic surgeries involve abnormal uterine bleeding.
Until recently, routine office endometrial biopsy and transvaginal ultrasonography (US) were the only tests available for diagnosis. They were often inadequate for evaluation as focal lesions are more likely to be missed at routine endometrial biopsy because of sampling errors and under diagnosed at transvaginal US because of limitations of the double-layer thickness evaluation.
Hysterosonography, an US technique in which the endometrial cavity is distended with saline, enables the radiologist to reliably distinguish focal from diffuse endometrial pathologic conditions.
To understand the clinical importance of hysterosonography, this study attempted to determine its role in clinical decision making in patients with abnormal uterine bleeding.
The study was carried on 36 married females of different age groups referred from El-Shatby Maternity Hospital Alexandria Main University Hospital, complaining of abnormal uterine bleeding, after exclusion of intact or complicated pregnancies and pelvic inflammatory diseases.
All patients were subjected to the following:
• History taking:
• Ultrasonography: transabdominal and transvaginal pelvic ultrasound were performed. Each image was evaluated for endometrial visibility, thickness, homogeneity, cysts, and displacement by submucosal fibroids
• Saline infusion sonography: performed by instilling 10-50 ml of sterile saline into the endometrial cavity through a Foleys catheter while a transvaginal scan is being obtained.
• Endometrial biopsy and histopathological analysis
Correlation between sonohysterographic findings and histopathological finding was performed:
One patient failed to continue the sonohysterographic study due to stenosed internal os, five patients couldn’t be followed up by histopathology and only 30 patients continued the study.
All patients were given a preliminary diagnosis by transvaginal ultrasound based on the endometrial thickness and echogenicity then by hysterosonographic examination demonstrating the presence of intrauterine focal lesions and their sonographic characters. Transvaginal sonography has proven its value as a first line investigative modality in the evaluation of patients with abnormal uterine bleeding. Hysterosonography in which the endometrial cavity is distended with saline, allows evaluation of the single layer of the endometrial lining and enables the radiologist to reliably distinguish focal from diffuse endometrial pathologic conditions, and provides the referring physician with valuable information that will help to determine the next step in case management. However, as concluded following histopathologic confirmation of the diagnosis, it was found that hysterosonography was less accurate for the prediction of the final endometrial pathology.