Is dilatation and curettage obsolete for diagnosing intrauterine disorders in premenopausal patients with persistent abnormal uterine bleeding?
BACKGROUND
To determine the predictive value of dilatation and curettage (D&C) for diagnosing intrauterine disorders in patients with persistent abnormal uterine bleeding.


METHODS
An observational descriptive study was performed in a large university-affiliated teaching hospital. The suspicion of intrauterine disorders described in theater-reports involving D&C was compared with the hysteroscopical findings in 131 premenopausal patients with persistent complaints of abnormal uterine bleeding who were referred by other gynecologists within six months after D&C. Pre-test probability (prevalence), post-test probabilities (predictive values) and likelihood-ratio's were calculated.


RESULTS
The pre-test probability for all intrauterine disorders was 0.49. The post-test probabilities for a 'suspect' and a 'not suspect' D&C were 0.61 and 0.46 respectively with an overlap of confidence-intervals. The corresponding likelihood-ratio's were 1.69 and 0.87 respectively.


CONCLUSIONS
D&C findings were of no value in the prediction of the presence or absence of intrauterine disorders in this population with persistent complaints.
Emanuel
M H
MH
Department of Obstetrics and Gynecology, Spaare Hospital, Haarlem, The Netherlands.
Wamsteker
K
K
Lammes
F B
FB
D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D011237:Predictive Value of Tests; D017697:Premenopause; D014591:Uterine Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D014592:Uterine Hemorrhage / Q000209:etiology*