Endometrial thickness cut-off value by transvaginal ultrasonography for screening of endometrial pathology in postmenopausal women with bleeding

Authors

  • Gaganpreet Kaur Gill Department of Obstetrics and Gynecology, AIMSR Bathinda, Punjab, India
  • Navdeep Kaur Department of Obstetrics and Gynecology, PGIMER Satellite Centre, Sangrur, Punjab, India
  • Misha Gupta Department of Obstetrics and Gynecology, AIMSR Bathinda, Punjab, India
  • Uma Shankar Department of Obstetrics and Gynecology, PGIMER Satellite Centre, Sangrur, Punjab, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20250869

Keywords:

Cut off value, Endometrial thickness, Hysteroscopy, PMB, TVS

Abstract

Background: Postmenopausal bleeding is defined as blood loss occurring at least 12 months after menopause. Aims and objectives were to assess the clinical usefulness and diagnostic accuracy of ultrasonographic measurement of endometrial thickness (ET) in women with postmenopausal bleeding.

Methods: It was a prospective study that took place at Government Medical College and Rajindra Hospital Patiala. from June 2018 to May 2019. The study was carried out in 60 patients presenting with postmenopausal bleeding to the OPD of department of obstetrics and gynecology, Government Medical College and Rajindra Hospital, Patiala. Patients with post-menopausal bleeding were included in the study. The endometrial thickness (ET) was measured on TVS. Hysteroscopy was done. Findings were recorded as atrophic endometrium, endometrial hyperplasia, endometrial polyp, fibroid, and endometrial carcinoma (obvious intrauterine growth with necrotic tissue). Endometrial biopsies were taken in all patients. Histopathological examination was done and was considered as the final diagnosis. Data collected was analysed using Microsoft Excel Office software 2019 version 19.11 and Epi info (CDC Atlanta) version 7.2.3.1.

Results: The best diagnostic accuracy for TVS was obtained at endometrial thickness of 4 mm.

Conclusions: TVS is useful for detecting endometrial pathology with a cut-off value for ET of 4 mm having a high sensitivity. Role of endometrial thickness cannot be undermined for detecting patients at high risk especially with comorbid conditions.

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Author Biographies

Gaganpreet Kaur Gill, Department of Obstetrics and Gynecology, AIMSR Bathinda, Punjab, India

Assistant Professor Department of Obs and Gynae AIMSR Bathinda Punjab

Navdeep Kaur, Department of Obstetrics and Gynecology, PGIMER Satellite Centre, Sangrur, Punjab, India

Department of Obs and Gynae 

PGIMER Satellite Centre Sangrur

Uma Shankar, Department of Obstetrics and Gynecology, PGIMER Satellite Centre, Sangrur, Punjab, India

Department of Obs and Gynae AIMSR Bathinda 

References

DC Dutta's Textbook of Obstetrics. J South Asian Feder Obs Gynae; 2023.

Mindy S, Kyle J, Howard A. Operative hysteroscopy. In: Howard W. Jones Ill and John A. Rock, eds. Te Linde’s Operative Gynaecology. 11th edn. Philadelphia: Wolters Kluwer; 2015:307-336.

Tandulwadkar S, Deshmukh P, Lodha P, Agarwal B. Hysteroscopy in postmenopausal bleeding. J Gynecol Endosc Surg. 2009;1(2):89-93. DOI: https://doi.org/10.4103/0974-1216.71614

Wurnig C, Schatz K, Noske H, Hemon Y, Dahlberg G, Josefsson G et Al. Subcutaneous low-dose epoetin beta for the avoidance of transfusion in patients scheduled for elective surgery not eligible for autologous blood donation. Eur Surg Res. 2001;33(5-6):303-10. DOI: https://doi.org/10.1159/000049723

Wang HY, Quan S, Zhang RL, Ye HY, Bi YL, Jiang ZM, et al. Comparison of serum anti-Mullerian hormone levels following hysterectomy and myomectomy for benign gynecological conditions. Eur J Obstet Gynecol Reprod Biol. 2013;171(2):368-71. DOI: https://doi.org/10.1016/j.ejogrb.2013.09.043

Hacker NF, Moore JG. Essentials of Obstrics and Gynaecology. 3rd edn. Philadelphia PA: WB Saunders; 1998:635.

Padubiri VG, Daftary SN. Perimenopause, menopause, premature menopause and postmenopausal bleeding. In: Howkins and Bourne Shaw’s Textbook of Gynecology. 16th edn. Elsevier; 2015:76-77.

Karlsson B, Granberg S, Wikland M, Ylöstalo P, Torvid K, Marsal K, et al. Transvaginal ultrasonography of the endometrium in women with postmenopausal bleeding- a Nordic multicenter study. Am J Obstet Gynecol. 1995;172(5):1488-94. DOI: https://doi.org/10.1016/0002-9378(95)90483-2

Gull B, Karlsson B, Milsom I, Granberg S. Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol. 2003;188(2):401-8. DOI: https://doi.org/10.1067/mob.2003.154

Tinelli R, Tinelli FG, Cicinelli E, Malvasi A, Tinelli A. The role of hysteroscopy with eye-directed biopsy in postmenopausal women with uterine bleeding and endometrial atrophy. Menopause. 2008;15(4):737-42. DOI: https://doi.org/10.1097/gme.0b013e31815b644e

Kaur M, Singh R, Sharma M. Endovaginal sonographic evaluation of postmenopausal uterine bleeding. J Clin Diagn Res. 2010;4(2):2175-82

Sousa R, Silvestre M, Sousa LA, Falcão F, Dias I, Silva T, et al. Transvaginal ultrasonography and hysteroscopy in postmenopausal bleeding: a prospective study. Acta Obstet Gynecol Scand. 2001;80(9):856-62. DOI: https://doi.org/10.1080/j.1600-0412.2001.080009856.x

Malhotra N, Malhotra J, Saxena R, Bora NM. Endoscopic surgery in gynaecology. In: Jeffcoate’s Principles of Gynecology. 9th edn. Jaypee Brothers Medical Publishers (P) Ltd; 2019:944-950

Pantaleoni D. On endoscopic examination of the cavity of the womb. Med Press Circ. 1869;8:26.

Gracia AL. Office hysteroscopic evaluation of postmenopausal bleeding. OBG Manage. 2019;31(8):36-42.

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Published

2025-03-27

How to Cite

Gill, G. K., Kaur, N., Gupta, M., & Shankar, U. (2025). Endometrial thickness cut-off value by transvaginal ultrasonography for screening of endometrial pathology in postmenopausal women with bleeding. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(4), 1244–1250. https://doi.org/10.18203/2320-1770.ijrcog20250869

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Original Research Articles