Abstract

Background: Post-menopausal bleeding is a warning sign that accounts for about 5% of all outpatient gynaecologic visits and is a common indication for referral to rapid access clinics because of the fear of underlying malignancy. Endometrial malignancies differ from other malignancies in that early symptomization is common, allowing early cure. Patients and Methods: During the study period, 100 women with post-menopausal bleeding having inclusion criteria were evaluated in Al Hussein University Hospital. For each patient full history, general, abdominal and pelvic examination was performed. Routine pre-operative investigations were done. Patients were divided into four groups: Group 1 included 29 patients with endometrial polyp. Group 2 included 34 patients with endometrial hyperplasia. Group 3 included 21 patients with atrophic endometrium. Group 4 included 16 patients with endometrial carcinoma. Results: As regards the predictive value of BMI, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. When discussing the predictive value of blood glucose level, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. It is worth to mention that the predictive value of endometrial thickness, in the study, was with high statistical significance in comparison between the endometrial carcinoma group and all other benign groups providing the highest specificity and sensitivity. At the last the predictive value of uterine artery velocimetry, in the study, was with high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. Conclusion: BMI, blood glucose level, endometrial thickness and uterine artery velocimetry indices, improve the prediction of endometrial carcinoma in women with post-menopausal bleeding.

Highlights

  • Postmenopausal bleeding (PMB) is defined as bleeding recurring in menopausal women at least 1 year after cessation of cycles [1]. PMB may be associated with a number of different conditions, it must always be investigated because many causes are premalignant and malignant

  • It is worth to mention that the predictive value of endometrial thickness, in the study, was with high statistical significance in comparison between the endometrial carcinoma group and all other benign groups providing the highest specificity and sensitivity

  • Aim of the Work This study aims to assess the prognostic value of body mass index (BMI), serum glucose, endometrial echo pattern and uterine artery Doppler velocimetry as a predictor for endometrial pathology in women with postmenopausal bleeding

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Summary

Introduction

Postmenopausal bleeding (PMB) is defined as bleeding recurring in menopausal women at least 1 year after cessation of cycles [1]. PMB may be associated with a number of different conditions, it must always be investigated because many causes are premalignant and malignant. The most common premalignant and malignant causes are complex hyperplasia with atypia and carcinoma of the endometrium. These disorders are present in as many as 1/3 of the patients evaluated for PMB in many series [2]. Results: As regards the predictive value of BMI, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. When discussing the predictive value of blood glucose level, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups.

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