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Study Papers | Obstetrics and Gynecology | India | Volume 12 Issue 5, May 2023
Correlation of Thickened Endometrium on USG and Histopathological Spectrum in Perimenopausal and Post - Menopausal Women
Dr. Triza Kumar Lakshman | Dr. L Niharika | Dr. Ravindra S Pukale
Abstract: Background: Abnormal uterine bleeding (AUB) is a bleeding pattern that differs in frequency, duration, and amount from a pattern observed during a normal menstrual cycle if bleeding occurs after menopause it is labelled as PMB. AUB can affect up to 50% of perimenopausal women. In India, the reported prevalence of AUB is around 17.9%. Aims & Objectives: To correlate the transvaginal ultrasound (TVUS) findings of endometrial thickness and histological patterns of the endometrium in order to evaluate the cause of PMB to correlate the transvaginal ultrasonographic (TVUS) findings of endometrial thickness and structural abnormality if any histopathological patterns of the endometrium. Materials & Methods: This is a prospective study comprised of 100 AUB women who are > 40 years of age in the peri and post - menopausal with PMB (Post - Menopausal Bleeding) attending the OPD. Clinical examinations of all the women were performed. After doing a TVUS analysis of the endometrial pattern and thickness, a D&C was performed. In perimenopausal women, the cut - off number for endometrial thickness was larger than 8 mm, perimenopausal despite prolonged heavy menstrual bleeding in women and ? 5 mm in postmenopausal women. All the tissue specimens were sent for histopathological examination. Results: 100 cases in total were reviewed, with 36% of them being menopausal and 64% of them being in the perimenopausal age range. Menorrhagia (54%) in perimenopausal women and PMB (34% in postmenopausal women) were reported to be the two most prevalent menstrual complaints. About 92% of the cases were multigravida. The most frequent uterine pathology found in 33% of cases was a fibroid uterus. In almost 53% of cases, the endometrial thickness was between 10 and 14.9 mm. Proliferative endometrium was the HPE result that was seen most frequently (37%), and endometrial malignancy was found in 2% of patients. Conclusion: Because of its practicality, accuracy, and non - invasiveness, TVUS should be the investigation of choice in perimenopausal women with AUB. A histological examination of the endometrium is necessary to rule out unusual alterations or endometrial cancer in individuals with endometrial thickness greater than 8 mm in perimenopausal despite prolonged heavy menstrual bleeding and 5 mm in postmenopausal women.
Keywords: Abnormal uterine bleeding, PMB, TVUS, HPE
Edition: Volume 12 Issue 5, May 2023,
Pages: 2258 - 2263