Doppler Study of Uterine Artery and Ultrasonography of Endometrial Thickness in Perimenopausal and Postmenopausal Bleeding

Abstract

Background: Transvaginal color Doppler sonography of the uterine artery has been reported useful for evaluation of abnormal uterine bleeding in peri-/post-menopausal women. It may differentiate physiological from malignant endometrial changes. Objective: Evaluating the endometrial thickness and uterine artery Doppler as an initial diagnostic tool to identify patients with abnormal endometrial pathology. Methods: This is a prospective case control study consisted of total 50 women with peri-(n = 35) and post-(n = 15) menopausal bleeding, with 20 women consisting control group (no bleeding) (peri-(n = 10) and post-menopausal (n = 10)). Double layer endometrial thickness and uterine-artery-Doppler waveforms were measured, with the latter being S/D ratio, RI and PI. These were related to histological findings (endometrial biopsy). Result: Patients with abnormal uterine bleeding (both peri- and postmenopausal) had a significantly higher mean endometrial thickness than the control women. Study group showed a significantly lower value of all Doppler indices (S/D ratio, RI and PI). In study group, patients with malignant endometrial pathology showed significantly thicker endometrium and significantly lower Doppler indices than those with benign pathology. Conclusion: The combination of endometrial thickness and uterine artery color Doppler pattern might predict uterine endometrial malignancy, although whether it can discriminate (screen) patients requiring endometrial biopsy is not evident. Further study is needed.