Correlation Between Endometrial Thickness By Ultrasonography and Histopathology in Abnormal Uterine Bleeding

Sujana G Sujana G,Sheela Vasudevan,Aswathy Chandramohan,Divya Anthony,Vivek Gerorge

doi:10.21276/apalm.2747

Abstract

Background : Abnormal uterine bleeding (AUB) is the most common presenting complaint of patients in Gynaecology Outpatient department. Early diagnosis of endometrial hyperplasia through ultrasongraphic measurement of endometrial thickness and definite diagnosis by histopathologic examination will help the clinicians to give appropriate treatment to the patients. The objective of this study was to correlate the histopathology findings in abnormal uterine bleeding with endometrial thickness by ultrasonography. Methods : This was a prospective study done from Nov 2016 to June 2018.A total of 382 cases of AUB presenting above 40 years of age were included. Endometrial thickness was measured by ultrasonography. Histopathological findings were studied and compared with the endometrial thickness. Statistical analysis were done using chi square test. Results : A total of 382 cases were analysed. Maximum number of cases were from peri menopausal age group (68.32%). Majority of the cases were due to non organic causes(85.34%). 46.86% of patients had endometrial thickness of 5-10mm followed by endometrial thickness of 11-15mm in 39.01%. Disordered proliferative endometrium was the most common pattern (38.34%) in our study followed by secretory endometrium (35.58%) and menstrual endometrium (18.71%). These findings were found to be statistically significant. Conclusion : A thorough histopathological work up and clinical correlation is mandatory in cases of abnormal uterine bleeding above 40 years to find out organic lesions. Careful screening can detect precursor lesions like endometrial hyperplasia and early cases of endometrial carcinoma which has excellent prognosis and it will help in further management.

Highlights

Perimenopause is the phase, preceding the onset of menopause, generally occurring around 40 years of age during which the regular menstrual cycle of a woman changes from normal cycles to a pattern of irregular cycles.[1]
The current study was a descriptive study on 382 patients above 40 years of age who presented with Abnormal uterine bleeding (AUB) in Department of Gynaecology and Pathology during the study period from Nov 2016 to June 2018
In our study the age interval of 40-49 years were taken as perimenopausal age group and ≥ 50 years were included in the postmenopausal age group

Summary

Introduction

Perimenopause is the phase, preceding the onset of menopause, generally occurring around 40 years of age during which the regular menstrual cycle of a woman changes from normal cycles to a pattern of irregular cycles.[1] Menopausal transition includes a period of about 4–5 years before menopause, sometimes even several months, characterized by varying degrees of somatic and psychological changes that reflect the changes in the ovarian cycle.[1] In some women, the most significant symptom is an irregular menstrual period, which must be carefully evaluated to determine whether it is the consequence of low oestrogen levels or an associated pathology.[1]. Diagnosis of endometrial hyperplasia throughultrasongraphic measurement ofendometrial thickness and definite diagnosis by histopathologic examination will help the clinicians to give appropriate treatment to the patients.The objective of this study was to correlate the histopathology findings in abnormal uterine bleeding with endometrial thickness by ultrasonography

Objectives

Methods

Results

Discussion

Conclusion