Indian Journal of Obstetrics and Gynecology Research

Correlation of endometrial thickness by Trans-Vaginal Sonography [TVS] and histopathology in women with abnormal peri-menopausal and postmenopausal bleeding – A prospective study

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Article Type : Original Article

Author Details: P. Thulasi, Balakrishnan R., Shanthi M.

Volume : 5

Issue : 1

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 44

Article End Page : 48

Abstract

Abnormal Uterine Bleeding (AUB) affects 50% of peri-menopausal women. It is common during the extremes of reproductive life, following pregnancy and also during lactation. About 10-15% of women experience AUB sometime during reproductive years of their lives.Irrespective of their age most of the women experience abnormal uterine bleeding at some or the other time.
Objectives of the study: To ascertain the effectiveness of trans-vaginal ultrasound (TVS) to determine the endometrial thickness and its correlation with histopathology in abnormal uterine bleeding.
Materials and Methods: This was a prospective study carried out in the department of Obstetrics and Gynecology with contribution from the department of Radiodiagnosis also, at P K Das Institute of Medical Sciences over a period of one year. The study included 75 women in the peri-menopausal and postmenopausal period who had presented with chief complaints of abnormal uterine bleeding. Patients were selected from OPD. Trans-vaginal sonography was done. Endometrial thickness was measured and was correlated with histopathology report after dilatation and curettage.
Results: The age distribution of patients, clinical presentation, endometrial thickness by trans-vaginal ultrasound, endometrial hyperplasia as estimated by endometrial thickness and various histopathological patterns of endometrium on 75 patients were analyzed. Majority of the patients were between 40-45 years in the present study. Among 75 patients, menorrhagia was present in 30 cases [40 %]. Endometrial thickness between 8 to 10 mm was seen in 35 patients (46.66%), endometrial thickness between 10 to 15 mm was seen in 15 cases (20%), whereas, only 4 cases (5.33%) had endometrial thickness more than or equal to 15mm. Endometrial hyperplasia was seen in 30 patients (40%) followed by proliferative endometrium in 25 patients (33.33%). Among 30 patients of endometrial hyperplasia, only 2 patients (6.66%) had atypical hyperplasia. Majority 66.66% had simple hyperplasia.
Conclusion: In peri-menopausal and postmenopausal AUB, trans-vaginalsonography should be the first investigation of choice. In peri-menopausal women, dilatation and curettage is recommended if endometrial thickness exceeds 10mm to rule out any hyperplastic process. Endometrial thickness of 5 mm should be taken as the upper limit for postmenopausal women.

Keywords: Abnormal Uterine Bleeding (AUB), Endometrium, Trans-vaginalsonography (TVS), endometrial thickness, histopathology, endometrial hyperplasia.

Doi No:-10.18231/2394-2754.2018.0010