Evaluating the Accuracy of USG Diagnosis of Heavy Menstrual Bleeding in Gyn OPD: A
Comparative Study with Clinical and Histopathological Findings
Submission: 01 June 2025 | Acceptance: 29 August 2025 | Publication: 19 October 2025
1Dr Hafsa Mubashir, 2Dr Adila Ashraf, 3Dr. Nazia Suleman, 4Fazilat Jamala, 5Mansoor Ali, 6Taimoor Ghori
1Assistant professor of gynaecology, Sialkot medical college Sialkot.
2Assistant Professor, Gynae n Obs, Ali Fatima hospital
3 Consultant gynaecologist, Life Care Hospital, Maternity Home and Pain Clinic, Assistant Professor Abu Ummara Medical and Dental college Lahore
4North West General Hospital & Research Center
5UHS Lahore
6PIMS Islamabad
ABSTRACT:
Background: Heavy menstrual bleeding (HMB) is a common gynecological concern affecting women’s quality of life. Accurate finding is important for effective management. While ultrasonography (USG) is widely used for evaluation, its diagnostic accuracy compared to clinical and histopathological findings remains a subject of debate.
Aim: This research intended to assess accuracy of USG in diagnosing heavy menstrual bleeding by comparing its findings with clinical assessment and histopathology.
Methods: A comparative study was conducted at Mayo Hospital, Lahore, from October 2023 to September 2024. A total of 50 women presenting having HMB in the Gyn OPD were enrolled. Each patient underwent clinical evaluation, transvaginal ultrasonography (TVS), and histopathological examination of endometrial biopsy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of USG were calculated by means of histopathology as the gold standard. Results: Among the 50 participants, USG detected abnormalities in 42 (84%) cases, while histopathology confirmed pathological findings in 38 (76%) cases. USG showed a sensitivity of 89.5%, specificity of 66.7%, PPV of 81.0%, and NPV of 80.0%. The most commonly perceived pathology was endometrial hyperplasia (40%), followed by fibroids (24%) and endometrial polyps (12%). Clinical assessment alone had very lesser diagnostic accuracy, having the sensitivity of 76.3% and specificity of 54.2%.
Conclusion: Ultrasonography proved to be a highly sensitive tool for diagnosing HMB-related pathologies, although its specificity remained moderate. While USG is a valuable non-invasive diagnostic modality, histopathology remains essential for definitive diagnosis, particularly in cases requiring targeted treatment. Combining clinical assessment with USG can enhance diagnostic accuracy and improve patient management.
Keywords: Heavy menstrual bleeding, ultrasonography, histopathology, gynecology, endometrial pathology, diagnostic accuracy