We studied a population of 50 patients attending the outpatient department of Calcutta National Medical College & Hospital from June 2015 to May 2016. These patients were suffering from abnormal uterine bleeding with undiagnosed causes. We tried to evaluate these patients for the presence of any endometrial pathology. Our main tools for diagnosing uterine cavitary anomalies were Saline Infusion Sonohysterography (SIS) and diagnostic Hysteroscopy. Diagnostic hysteroscopy was set as the gold standard investigation and a prospective comparative study was undertaken to compare the findings of SIS with that of hysteroscopy. Saline infusion sonohysterography was able to detect 76% of these patients to be suffering from endometrial pathology, findings of which were mostly corroborative with hysteroscopy. Polyps and fibroids were equally prevalent in lower age group whilst endometrial hyperplasia dominated the higher age group. Overall endometrial hyperplasia dominated as the most common cause of abnormal uterine bleeding. Regarding menstrual pattern, menometrorrhagia was seen mostly in women with submucous fibroids whilst other kinds of bleeding like intermenstrual bleeding, amenorrhea, spotting etc was seen mostly in women with endometrial hyperplasia. Menorrhagia dominated in women with normal hysteroscopic findings. Submucosal fibroids were seen mostly in non obese population whilst endometrial hyperplasia was far commoner in the obese population. Endometrial hyperplasia was also more commonly observed in women with history of intake of hormones. Polyps were seen to be presenting with less severe A.U.B. compared to submucous fibroids and endometrial hyperplasia as suggested by their hemoglobin estimation. Saline infusion sonohysterographic findings were almost statistically significant but the kappa values suggest that their associations with hysteroscopic findings were mostly by chance. It has a high sensitivity and specificity in detection of polyps, submucous fibroids and endometrial hyperplasia with a comparable positive as well as negative predictive value. The rates of detection of polyps, submucous fibroids and endometrial hyperplasia were also quite high. So, saline infusion sonohysterography definitely shows promise in diagnosing uterine cavity anomalies and results can be statistically significant if applied to a larger sample size.
