الفهرس 
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Abstract
Abnormal uterine bleeding is a common but complicated clinical presentation.
Abnormal uterine bleeding includes abnormal menstrual bleeding and bleeding due to other causes such as pregnancy, systemic disease or cancer. The diagnosis and management of abnormal uterine bleeding present some of the most difficult problems in gynecology.
Doppler technique has been introduced in medicine for many years, but only in the last decade, this diagnostic modality has gained an importance in obstetrics.
Transvaginal color Doppler (TVCD) sonography and pulsed-wave Doppler sonography provide a unique noninvasive method for the evaluation of normal and abnormal conditions in the female pelvis.
Transvaginal scanning permits close examination of a structure of interest within the corpus or cervix of the normal or slightly enlarged uterus. Proximity and higher-frequency probes provide improved imaging and infrastructural details not possible with the transabdominal approach.
With the advent of color Doppler analysis, additional physiologic, functional and pathologic states may be identifiable
Transvaginal ultrasonography and the Doppler technique have become available diagnostic modalities for evaluating patients with various gynecological conditions.
TVS provides valuable information in the evaluation of a wide range of gynecological disorders including evaluation of uterine and adnexal masses, inflammatory process and neoplasm.
The aim of this study is to evaluate the role of transvaginal sonographic study of the endometrium and Doppler velocimetric measurement of the uterine artery as screenining non-invasive procedures to detect endometrial pathology in cases of abnormal uterine bleeding.
This study was comparative observational cross sectional study included 120 patients.
All cases were classified into two groups
1- Group I: 60 patients with abnormal uterine bleeding.
2- Group II: 60 patients with no uterine bleeding.
All the results were compared between the two groups.
All eligible patients were properly counselled and gave informed consent before entry into the study ,detailed history was taken, general examination, abdominal examination, pelvic examination then TVUS were done ,Diagnostic dilatation and curettage to cases of abnormal uterine bleeding, colored Doppler ultrasound on uterine artery( RI and PI were done) .
The present study showed no statistical difference between patients with abnormal bleeding and patients with no bleeding as regards the age , parity and BMI (P>0.05) ( The age ranged from 45-65 years with a mean of 50.77 ± 5.82) .
TVUS showed a 72% sensitivity and 100% specificity with a PPV = 100% and a NPV = 28% with a diagnostic accuracy of 75%.
Also Colour Doppler indices (RI&PI) showed (70% & 78%) sensitivity and (70%&40%)specificity with a PPV=(92.1% &89.1%) and a NPV = (31.8% &80%).
The mean value of RI among cases with abnormal uterine bleeding (0.79)was significantly higher than that of those with no bleeding(0.84).
Conclusion and recommendations
Women with abnormal uterine bleeding had significant low RI than women with no bleeding but Colour Doppler failed to differentiate between different causes of abnormal uterine bleeding.
We recommended further studies to settle this issue especially on evaluation and prediction pathological lesions especially uterine and intrauterine lesions.
We hope to make further researches to help our patients on diagnosis their diseases without invasive techniques.