Pelvic Ultrasound Features of Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) can adversely affect a woman's life. This condition is experienced by almost 30% of women of reproductive age and nearly 50% of perimenopausal women. This study was conducted to assess the diagnostic value of pelvic ultrasonography in detecting structural causes of abnormal uterine bleeding, and to compare age-related differences between the ultrasonographic findings in early reproductive women, late reproductive women, and menopausal women.

In a retrospective study conducted at King Abdulaziz University Hospital, pelvic ultrasound studies were recorded from January 2018 to January 2020. A total of 711 female patients presenting with AUB were examined via pelvic ultrasound inspections, with 169 patients meeting the inclusion criteria for this study. The age groups and sonographic findings of these patients were recorded and classified into three groups.

This study demonstrated that ovarian cysts were most common in both the early and late reproductive groups (27.11% and 22.56%, respectively), followed by enlargement of the ovaries in the early reproductive group (12.96%) and enlargement of the uterus in the late reproductive group (22.56%). In the menopausal group, fibroids were the most common finding (24.67%). Despite the high prevalence of ovarian cysts across all groups, the majority were likely benign. However, the presence of uterine enlargement and fibroids warrants further investigation due to the potential clinical implications of these conditions.

This study illustrates the applicability and efficacy of pelvic ultrasound procedures in detecting all types of pathologies in the various stages of reproduction. Ovarian cysts and enlargement of the uterus among younger patients and the presence of fibroids in the menopausal cohort were among the high prevalence range of findings well visualized through the use of ultrasound.

This study establishes age-related patterns in ultrasound findings among female patients with AUB. Both the early and late reproductive groups had ovarian cysts, while fibroids were reported to be common in the menopausal group. Knowledge of the age-related distribution of these findings across all stages of the reproductive system may enable sonographers to make informed clinical decisions and enhance patient care.