POSTMENOPAUSAL UTERINE BLEEDING

CORRELATION OF THE FINDINGS OF TRANSVAGINAL ULTRASONOGRAPHY & ENDOMETRIAL SAMPLING IN PATIENT

Abstract

Objectives: To find out the significance of the transvaginal sonography (TVS)
in postmenopausal women (PMW) with postmenopausal bleeding (PMB) and compare it with
the histopathological diagnosis at curettage, so that unnecessary operations could be avoided.
Study Design: Descriptive study. Setting: Radiological Department for TVS and H/P at the
Department of Gynecology & Obstetrics (Gynae: Unit IV) at Liaquat University Medical, Health
Sciences Hospital Jamshoro and Hyderabad. Period: September 2010 to September 2011.
Material and Methods: The present study was conducted on patients with postmenopausal
bleeding. Results: The mean age + SD of the women was 51 + 3.1 years, ranging from a
minimum of 49 to 55 years. The mean endometrial thickness was from 1.8-15mm. Transvaginal
Sonography and Histopathological Findings: Histopathological findings revealed endometrial
atrophy in 64 (57.14%) patients, Endometrial hyperplasia in 24(21.4%), endometrial polyp in
7(6.25%), Endometrial carcinoma in 8 (7.14%), Pyometra in 5(4.46%) and Fibroid uterus in
4(3.57%). With a cut off value of 4mm endometrial thickness, TVS showed a sensitivity of 100%,
specificity of 73.33%, a positive predictive value of 76.47%, a negative predictive value 100%
and an accuracy of 85.71%. At a cut off limit of 5mm endometrial thickness (endometrium
>5mm indicating pathology), the sensitivity of the present study was 92.3% and the specificity
was 86.6 %. The positive predictive value was 85.71%, the negative predictive value was 92.86
% and the accuracy was 89 %. Conclusion: TVS is a useful tool to triage post menopausal
women with bleeding and avoid un convenient invasive procedure.