Vaginosonographic measurement of endometrial thickness in the evaluation of amenorrhea.
The progestin-induced withdrawal bleeding test has often been used in patients with amenorrhea to assess endogenous estrogen (E) production. The endometrial thickness measured by vaginal ultrasonography with a 5 MHz transducer is also dependent on E stimulation of the endometrium. In this study, 70 consecutive patients were evaluated with both the progestin-induced withdrawal bleeding test and a measurement of the endometrial thickness by vaginosonography. An endometrial thickness of 1.5 mm or less was selected to predict absence of bleeding after a progesterone (P) challenge test. This resulted in a sensitivity of 94% with a 95% confidence interval (CI) of 0.70 to 1.00 and a specificity of 93% with a 95% CI of 0.82 and 0.98. The positive and negative predictive values were 79% and 98%, respectively. This study shows that the endometrial thickness measured by vaginosonography can predict the results of the P challenge test in patients with amenorrhea.
Morcos
R N
RN
Department of Obstetrics and Gynecology, St. Elizabeth Hospital Medical Center, Youngstown, Ohio 44501.
Leonard
M D
MD
Smith
M
M
Bourguet
C
C
Makii
M
M
Khawli
O
O
D000328:Adult; D000568:Amenorrhea / Q000209:etiology*; D000858:Anovulation / Q000000981:diagnostic imaging; D003271:Contraceptive Agents, Female; D004717:Endometrium / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D004967:Estrogens / Q000096:biosynthesis; D005260:Female; D006801:Humans; D008525:Medroxyprogesterone / Q000031:analogs & derivatives / Q000494:pharmacology; D017258:Medroxyprogesterone Acetate; D008598:Menstruation / Q000187:drug effects; D010049:Ovarian Diseases / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011374:Progesterone / Q000097:blood; D014463:Ultrasonography
D003271:Contraceptive Agents, Female; D004967:Estrogens; D011374:Progesterone; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone