Test Characteristics of Sonohysterography in Detection of Intrauterine Abnormalities in Infertile Patients

Abstract

Test Characteristics of Sonohysterography in Detection of Intrauterine Abnormalities in Infertile Patients

Prateep           Hannidhikul          MD

Vivat                Bhuttarechval      MD

Phongthorn    Virojchaiwong      MD

Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

Objective: To evaluate the test characteristics of sonohysterography in detection of intrauterine abnormalities in infertile patients.

Study design: Diagnostic test.

Setting: Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

Subjects: Sixty four infertile women attending at infertile clinic, Department of Obstetrics and Gynecology from June 1998 to June 2000.

Methods: Compared the results between sonohysterography and hysteroscopy which were performed in the same setting. Transvaginal sonography would be done first, followed by sonohysterography and hysteroscopy sequentially; the results from the study were illustrated by 2 x 2 table

Main outcome measures: The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), accuracy, false positive and false negative of sonohysterography.

Results: The prevalence of this study was 32.82%.  When the results of sonohysterography are compared with those of hysteroscopy, sensitivity and specificity were reported in the form of 95% confidence interval (95% CI) equivalent to 90.48% (83.29-97.67) and 93.02% (86.78-99.26) respectively.  When predictive values were concerned, the PPV of sonohysterography was 86.36% (77.95-94.77) that of NPV was 95.24% b(90.03-100.00).  Besides, it was found that the accuracy was 92.18% (85.64-98.72).  False positive and false negative were 6.97 %( 0.74-13.20) and 9.52% (2.33-16.71) respectively.

Conclusion: Sonohysterography was a simple and fast method in detecting intrauterine abnormalities in infertile patients.  However, the false negative value was still high which was unacceptable at present.  Thus, this study indicates that sonohysterography was a test in detecting the abnormalities but cannot replace the hysteroscopy which was the gold standard.

Key words: sonohysterography, intrauterine abnormality, infertile

Vajira Med J 2001 ; 45 : 107 - 117