Detection and frequency of abnormal endometrial pathologies in reproductive-aged females via saline infusion sonohysterography (SIS)

ABSTRACT

Objective. Assess the diagnostic efficacy of SIS in identifying various endometrial abnormalities, including polyps, fibroids, hyperplasia, and other structural irregularities, reproductive age women.
Materials and Methods. A cross-sectional study was conducted on 240 married women aged 18 to 42 years, suffering from abnormal uterine bleeding or reproductive problems. Using the SIS ultrasound technique performed by a trained radiologist and diagnostic hysteroscopy without using anesthesia or antibiotics. In the city of Mosul from July 2023 to April 2024, and focusing on women with suspected uterine lesions or endometrial thickness ≥12 mm.
Results. The results from 239 cases with various diagnoses showed: endometrial hyperplasia 13.8%, fibroids 14.6%, normal 46.5%, polyps 23.4%, and uterine septum 1.7%, with significant statistical significance (P < 0.001). For young women (19-30 years), the diagnosis rates were as follows: endometrial hyperplasia 1.4%, fibroids 13.0%, normal cases 56.1%, polyps 27.3%, and uterine septum 2.2%. Among them, fibroids were more common in cases of Miscarriage was 25% and infertility was 20.7%, while normal cases represented a large percentage of vaginal infections, 65.2%. Analyzing results by age helps determine prevalence differences across age groups, assess age’s impact on uterine health, identify age-related risks, and guide tailored healthcare interventions and future research.
Conclusions. The study emphasized the role of SIS technology in diagnosing endometrial lesions and abnormalities in women of reproductive age. SIS was distinguished by its ability to reliably differentiate between pathological conditions localized and diffuse in the endometrium, which helped in understanding the causes of infertility, persistent bleeding, and infection.