Investigating women with postmenopausal bleeding: The utility of endometrial thickness in transvaginal ultrasound.

Abstract

Australian clinical guidelines recommend further investigation in females with postmenopausal bleeding (PMB) and endometrial thickness (ET) of ≥4mm on transvaginal ultrasound (TVUS). However, the literature indicates that an ET of ≥3mm as an upper limit is a more sensitive predictor of endometrial malignancy (EM) in females with PMB. To assess whether Australian guidelines for PMB with an upper limit of 4mm ET on ultrasound investigation, is sensitive enough for malignancy detection. A retrospective study was performed on tissue results in PMB presentations to the Gold Coast Hospital and Health Service between 2011 and 2015. Twenty point nine percent of women with PMB had a malignancy. With an upper limit of 4mm in ET on ultrasound, malignancy was present in 22% of participants. [Correction added on 10 July 2020, after first online publication: percentage of women with PMB that had a malignancy has been amended to twenty point nine percent.] CONCLUSIONS: A limit of 3mm for ET in PMB, along with office endometrial biopsy, should be considered to ensure timely diagnoses.