Ultrasound assessment of endometrial thickness in women with endometrial bleeding
Journal
ULTRASOUND in Obstetrics & Gynecology
Date Issued
2022-09
Author(s)
Bashkim Ismaili
Dimitar Georgiev
Mladen Risteski
Abstract
Objectives: Dysfunctional endometrial bleeding is often during
the menopausal transition as a result of hormonal changes
during this period. In postmenopaus, there should be no uterine
bleeding. Postmenopausal bleeding occurs in approximately 90%
of patients with endometrial cancer, but only 9% of women
with postmenopausal bleeding have endometrial cancer. The aim
of this study is to determine the histopathological changes of
the endometrium that occur in women with perimenopausal and
postmenopausal bleeding and the association with endometrial
thickness and anteroposterior diameter of the uterus.
Methods: This study involved 120 patients with fractionated
explorative curettage due to abnormal uterine bleeding. The
examined group was divided in two subgroups: 60 women in
perimenopausis and 60 women in postmenopausis. Anamnestic
data were taken from all respondents. Ultrasound measurement
of anteroposterior diameter of uterus and endometrial thickness
were made with endovaginal ultrasound probe.
Results: The most common pathological change of the endometrium
was an endometrial polyp (in 45% of the respondents). 26.7%
of perimenopausal women had dysfunctional uterine bleeding.
Endometrial adenocarcinoma was present in 3% of perimenopausal
and in 5% of postmenopausal women. The average value of
the anteroposterior diameter of the uterus was 50.7 mm in
perimenopausal, 37.3 mm in postmenopausal group, and the
difference of 13.4 mm was statistically significant (p < 0.0001).
The average thickness of the endometrium was 13.6 mm in
perimenopausal, 10.3 mm in postmenopausal group, and the
difference of 3.3 mm was statistically significant (p = 0.00011).
Conclusions: Fractionated explorative curettage is an effective
method for timely and effective diagnosis of pathological changes of the endometrium in women with abnormal uterine bleeding
Perimenopausal patients had significantly higher anteroposterior
diameter of the uterus and thicker endometrium than those in the
postmenopausal period.
the menopausal transition as a result of hormonal changes
during this period. In postmenopaus, there should be no uterine
bleeding. Postmenopausal bleeding occurs in approximately 90%
of patients with endometrial cancer, but only 9% of women
with postmenopausal bleeding have endometrial cancer. The aim
of this study is to determine the histopathological changes of
the endometrium that occur in women with perimenopausal and
postmenopausal bleeding and the association with endometrial
thickness and anteroposterior diameter of the uterus.
Methods: This study involved 120 patients with fractionated
explorative curettage due to abnormal uterine bleeding. The
examined group was divided in two subgroups: 60 women in
perimenopausis and 60 women in postmenopausis. Anamnestic
data were taken from all respondents. Ultrasound measurement
of anteroposterior diameter of uterus and endometrial thickness
were made with endovaginal ultrasound probe.
Results: The most common pathological change of the endometrium
was an endometrial polyp (in 45% of the respondents). 26.7%
of perimenopausal women had dysfunctional uterine bleeding.
Endometrial adenocarcinoma was present in 3% of perimenopausal
and in 5% of postmenopausal women. The average value of
the anteroposterior diameter of the uterus was 50.7 mm in
perimenopausal, 37.3 mm in postmenopausal group, and the
difference of 13.4 mm was statistically significant (p < 0.0001).
The average thickness of the endometrium was 13.6 mm in
perimenopausal, 10.3 mm in postmenopausal group, and the
difference of 3.3 mm was statistically significant (p = 0.00011).
Conclusions: Fractionated explorative curettage is an effective
method for timely and effective diagnosis of pathological changes of the endometrium in women with abnormal uterine bleeding
Perimenopausal patients had significantly higher anteroposterior
diameter of the uterus and thicker endometrium than those in the
postmenopausal period.
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