The role of transvaginal colour Doppler sonography in evaluation of abnormal uterine bleeding.
BACKGROUND
Treatment of abnormal uterine bleeding understands a prompt diagnostic procedure, for the sake of defining the etiological factor of disease. The abnormal uterine bleeding is more common in the perimenopausal than in the postmenopausal women, and it is more frequent sign of an endometrial proliferative or hyperplastic changes. Fewer percentages of women with unexpected and/or acyclic and prolonged bleeding have endometrial cancer.


METHODS
Seventy-one (71) patients with abnormal uterine bleeding, older than 40 years, of which 10 were in post-menopause, have been tested. Prior to explorative curettage and histopathological analysis, ultrasonographic and hemodynamic studies, at the uterine blood vessels level (uterine artery bilaterally) had been performed by transvaginal colour Doppler method.


RESULTS
Histopathological results indicated four types of represented changes, on the basis of how the patients were divided into the groups: I, proliferative endometrium--20 patients; II, endometrial adenocarcinoma--23 patients; III, various forms of endometrial hyperplasia--26 patients, IV, atrophic endometrium--2 patients. Significant statistical difference in the endometrial thickness was established between groups I and II, and endometrial cancer was not found in less than 8 mm thick endometrium. By analysing hemodynamic parameters, significantly lower PI values were obtained in the group of patients with pathologically altered endometrium, compared to other groups.


CONCLUSIONS
Transvaginal colour Doppler has significant role in the diagnostic process for evaluation of abnormal uterine bleeding in perimenopausal and postmenopausal women. Doppler sonography can help in differentiating physiological from malignant endometrial changes and in deciding on the most efficient therapeutical regime.
Dragojević
Svetlana
S
Obstetrics and Gynaecology Clinic Narodni front, Narodnog fronta 62, 11000 Belgrade, Serbia and Montenegro. stefand@eunet.yu
Mitrović
Ana
A
Dikić
Srdjan
S
Canović
Fadil
F
D000328:Adult; D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging / Q000502:physiology; D001783:Blood Flow Velocity; D004717:Endometrium / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011673:Pulsatile Flow; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D014655:Vascular Resistance