Correlation of endometrial thickness, cycle day and histopathology in women with abnormal uterine bleeding.
OBJECTIVE
To correlate the endometrial thickness measured by transvaginal sonography (TVS), cycle day and menstrual status with histopathology in women with abnormal uterine bleeding and to evaluate the accuracy of transvaginal sonography in detecting intrauterine abnormalities as compared to hysteroscopy.


METHODS
This prospective study was conducted in the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital between January 1998 and July 2002. Transvaginal sonography was performed in 160 women with abnormal uterine bleeding, followed within 48 hours by hysteroscopy and endometrial biopsy. Statistical analysis was performed by MacNamar's chi-square test and the various correlations were calculated.


RESULTS
No statistically significant association was found between endometrial thickness and cycle day with histopathology. None of the women with endometrial thickness of <5 mm had atypia or malignancy. There was a highly significant association between menstrual status and histology. Transvaginal sonography and hysteroscopy were in agreement in 73.7% of the patients.


CONCLUSIONS
An endometrial thickness of <5 mm in women with postmenopausal bleeding could mean that curettage can be avoided. No definite cut-off value could be assigned for the menstruating women. Transvaginal sonography is a good initial screening tool in the evaluation of women with abnormal uterine bleeding. Hysteroscopy and histological examination is indicated in cases of abnormal or inconclusive sonograms or if complaints persist after a normal sonogram. Transvaginal sonography seems to be an effective procedure to exclude endometrial and intrauterine abnormalities.
Machado
Lovina S
LS
Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Al-Khod, PO Box 38, Code 123, Muscat, Sultanate of Oman. norman@omantel.net.om
Mathew
Mariam
M
Al-Hassani
Alia
A
Vaclavinkova
Vlasta
V
D000328:Adult; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008595:Menorrhagia / Q000000981:diagnostic imaging* / Q000473:pathology*; D008597:Menstrual Cycle; D008796:Metrorrhagia / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D047648:Perimenopause; D017698:Postmenopause; D011446:Prospective Studies; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging