DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20201198

Co-relation of endometrial thickness by transvaginal sonogram with histopathology pattern in abnormal uterine bleeding: a study from South India

Chippy Tess Mathew, Uma Maheswari, Karthikeyan Shanmugam

Abstract


Background: Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period (around 80 ml). Bleeding that occurs erratically or excessive menstrual bleeding is called abnormal uterine bleeding (AUB). The causes of AUB are many and varied. Initial investigations include transvaginal ultrasound and histopathologic assessment of the endometrium. Objective of this study was to evaluation of endometrial thickness with trans-vaginal ultrasound and its correlation with histopathology by dilatation and curettage in abnormal uterine bleeding. To determine the efficacy of transvaginal ultrasound in evaluating the endometrial thickness. To correlate the endometrial thickness by transvaginal ultrasound with endometrial histopathology in women with AUB.

Methods: It is a retrospective observational study. All reproductive and perimenopausal age group women who underwent dilatation and curettage for abnormal uterine bleeding during the period June 2014-June 2016 was taken and analyzed and correlated with their endometrial thickness measured with Transvaginal ultrasound.

Results: Around 478 patients who underwent endometrial sampling over a period of two years were analyzed. Maximum number of patients were in the fourth decade and the overweight category 36.6%. Proliferative endometrium was the most common histopathologic picture (44.76%). Detection of precancerous lesions were-5.87% and endometrial cancer was 1.05%.

Conclusions: An ET of 8 mm and above gave 100% sensitivity and negative predictive value for precancerous and cancerous lesions.


Keywords


Abnormal uterine bleeding, Dilatation and curettage, Endometrial hyperplasia and cancer, Endometrial thickness, Transvaginal ultrasound

Full Text:

PDF

References


Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM COIEN) for causes of abnormal uterine bleeding in non-gravid women of reproductive age. FIGO Working Group on Menstrual Disorders. Int J Gynaecol Obstet. 2011;113:3-13.

Shobhitha GL, Kumari VI, Priya PL, Sundari BT. Endometrial study by TVS and It’s correlation with histopathology in abnormal uterine bleeding. J Dental Med Sci. 2015;14(4):21-32.

Mahapatra M, Mishra P. Clinicopathological evaluation of abnormal uterine bleeding. J Health Res Rev. 2015;2:45-9

Meena N, Meena S. Correlation between histology and bleeding pattern in a case of AUB and risk factors analysis of AUB in reproductive age group. JMSCR. 2017;5(7):24629-34.

Betha K, Malvatu L, Talasani S Distribution of causes of abnormal uterine bleeding using new FIGO classification system-PALM COEIN: a rural tertiary-based study. Int J Reprod Contracept Obstet Gynecol. 2017;6(8):3523-7.

Kazemijaliseh H, Ramezani Tehrani F, Behboudi-Gandevani S, Khalili D, Hosseinpanah F, Azizi F. A Population-based study of the prevalence of abnormal uterine bleeding and its related factors among Iranian reproductive-age women: An updated data. Arch Iran Med. 2017;20(9):558-63.

Sharma AS, Gupta S. Analysis of body mass index in patients with abnormal uterine bleeding. Inter J Clin Obstet Gynaecol. 2019;3(1):92-5

Puvitha RD, Elavarasan T, Shruthi MS, Shylaja S. Histopathological study of endometrium in abnormal uterine bleeding an experience in a tertiary care centre of rural south India. Nat J Basic Med Sci. 2017;8:1.

Kalaiselvi PSJ. Thenmozhi G. A study on endometrial thickness by endovaginal sonography with histopathology in perimenopausal women in a tertiary care centre. Indian J Res. 2017;6(10):33-6.

Tabata T, Yamawaki T, Yabana T, Ida M, Nishimura K, Nose Y. Natural history of endometrial hyperplasia Arch Gynecol Obstet. 2001;265(2):85-8.

Takai IU, Bukar M, Mayun AA, Ugwa EA, Audu BM. Aisha abdurrahman endometrial hyperplasia: a 2 decade retrospective analysis of histopathological pattern at a university teaching hospital in Northern Nigeria Sub-Saharan. Afr J Med. 2016;3:171-5.

Getpook C, Wattanakumtornkul S. Endometrial thickness screening in premenopausal women with abnormal uterine bleeding. J Obstet Gynaecol Res. 2006;32(6):588-92 .

Özdemir S, Çelik Ç, Gezginç K, Kıreşi D, Esen H. Evaluation of endometrial thickness with transvaginal ultrasonography and histopathology in premenopausal women with abnormal vaginal bleeding. Arch Gynecol Obstet. 2010;282(4):395-9.

Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia: a long-term study of “untreated” hyperplasia in 170 patients. Cancer. 1985;56:403-12.

Palmer JE, Perunovic B, Tidy JA. Endometrial hyperplasia. The Obstet Gynaecol. 2008;10(4):211-6.

Cheung AP. Ultrasound and menstrual history in predicting endometrial hyperplasia in polycystic ovary syndrome. Obstet Gynecol. 2001;98:325-31.

Giannella L, Cerami LB, Setti T, Bergamini E, Boselli F. Prediction of endometrial hyperplasia and cancer among premenopausal women with abnormal uterine bleeding. BioMed Res Inter. 2019;2019.

No GT. Management of Endometrial Hyperplasia. 2016. Available at: ttps://www.rcog.org.uk/globalassets/documents/guidelines/green-top-guidelines/gtg_67_endometrial _hyperplasia.pdf. Accessed on 01st February 2020.