Role of saline infusion sonography in abnormal uterine bleeding

Background: To describe the diagnostic efficacy of Saline Infusion Sonography(SIS) in Abnormal Uterine Bleeding(AUB). Methods: This is a hospital based observational descriptive study conducted in 121 women visiting the OPD with complain of AUB in any form, between September 2011-August 2012. SIS was done using Crooke’s cannula followed by Diagnostic Hysteroscopy(DH) the following day. Results obtained were analysed.Results: 61% of the cases of AUB were diagnosed to have some abnormality by hysteroscopy as compared to 51 % by SIS. The sensitivity of SIS was greatest(100%) for Mullerian anomalies, 75% for endometrial hyperplasia, 69% for endometrial polyps, 68.75% for submucous myomas and 66.67% for endometritis. The specificity was greatestfor endometrial hyperplasia and adhesions(100%), 99% for submucous myomas, 98.3% for endometritis, 95.7% for endometrial polyps and mullerian anomalies. It had a 100% positive predictive value for endometrial hyperplasia, 92% and 83% for submucous myomas and endometrial polyps respectively. The overall sensitivity and specificity of SIS in our setting was67.56% and 93.6% respectively. The diagnostic efficacy of SIS for Endometrial hyperplasia, Endometritis, Endometrial Polyps, Mullerian abnormalities, Submucus fibroid and Adhesions was 96.69%, 97.53%,89.25%,95.86%,95.04% and 98.34% respectively.Conclusions: We found Saline Infusion Sonography to be an easy and safe procedure, though being less sensitive, it cannot replace hysteroscopy as a whole. Though hysteroscopy is a gold standard, saline infusion sonography is an easy, safe procedure for diagnosing intracavitary pathologies in low resource setting and despite being less sensitive, it can still reduce the number of hysteroscopies