Relationship Between Transvaginal Ultrasound Endometrial Thickness, Body Mass Index And Endometrial Pathology In Women With Post-Menopausal Bleeding

Background: Post-menopausal bleeding (PMB) is the most distressing problem in females Endometrial thickness (EMT) as assessed by transvaginal ultrasound (TVS) aids in diagnosing endometrial pathology. This study analyses usefulness of TVS as a diagnostic tool in the evaluation of PMB.Methods: A prospective study was conducted in 100 patients. Correlation of EMT by TVS was compared with gold standard of histopathological examination (HPE) of the endometrium by fractional curettage (FC).Results: Mean age was 56.9±8.03 years and mean parity status was 2.83±1.45. Mean duration after menopause to presentation of bleeding per vaginum was 5.7±3.85 years. As per the receiver operating characteristic curve (ROC) analysis, an EMT of 10.8 mm had a high negative predictive value (99.1%) for malignancy with moderate specificity (62.79%) and high sensitivity (92.3%).Conclusions: TVS can be easily performed and is less expensive and a useful diagnostic tool in the evaluation of PMB with a cut off value of 10.8 mm EMT gives a high sensitivity (92.3%) and moderate specificity (62.79%).

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Ultrasonographic Visualization of the Ovaries to Detect Ovarian Cancer According to Age, Menopausal Status and Body Type

Diagnostics ◽

10.3390/diagnostics12010128 ◽

2022 ◽

Vol 12 (1) ◽

pp. 128

Author(s):

Edward J. Pavlik ◽

Emily Brekke ◽

Justin Gorski ◽

Lauren Baldwin-Branch ◽

Rachel Miller ◽

...

Keyword(s):

Ovarian Cancer ◽

Body Mass Index ◽

Body Mass ◽

Transvaginal Ultrasound ◽

Menopausal Status ◽

Obese Patients ◽

Body Type ◽

Body Habitus ◽

Menopausal Women ◽

Post Menopausal

Because the effects of age, menopausal status, weight and body mass index (BMI) on ovarian detectability by transvaginal ultrasound (TVS) have not been established, we determined their contributions to TVS visualization of the ovaries. A total of 29,877 women that had both ovaries visualized on their first exam were followed over 202,639 prospective TVS exams. All images were reviewed by a physician. While visualization of both ovaries decreased with age, one or both ovaries could be visualized in two of every three women over 80 years of age. Around 93% of pre-menopausal women and ~69% of post-menopausal women had both ovaries visualized. Both ovaries were visualized in ~72% of women weighing over 300 lbs. and in ~70% of women with a BMI over 40. Conclusions: Age had the greatest influence on the visualization of the ovaries. The ovaries can be visualized well past the menopause. Body habitus was not limiting to TVS ovarian imaging, and TVS should be considered capable of imaging one or both ovaries in two of every three women over 80 years of age. Thus, older and obese patients remain good candidates for TVS exams.

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Post-menopausal bleeding – Is transvaginal ultrasound a useful first-line investigation in tamoxifen users?

Post Reproductive Health ◽

10.1177/2053369118755190 ◽

2018 ◽

Vol 24 (2) ◽

pp. 72-78 ◽

Cited By ~ 2

Author(s):

A Abdaal ◽

Y Mushtaq ◽

L Khasati ◽

J Moneim ◽

F Khan ◽

...

Keyword(s):

Endometrial Thickness ◽

Transvaginal Ultrasound ◽

Outcome Data ◽

Tamoxifen Treatment ◽

First Line ◽

Tamoxifen Group ◽

History Of ◽

Post Menopausal ◽

Endometrial Pathology

Objective To evaluate the role of transvaginal ultrasound triage in women with a history of tamoxifen treatment who present with post-menopausal bleeding. Study design A retrospective review was undertaken of patients who presented with symptoms of post-menopausal bleeding and underwent ultrasound triage. Endometrial thickness and ultrasonographic features were then correlated with hysteroscopic and histopathological outcome data. The findings and outcomes for women with a history of tamoxifen use (tamoxifen group) were compared to those who had not taken tamoxifen (non-tamoxifen group). Results A total of 614 women with post-menopausal bleeding underwent transvaginal ultrasound triage, of whom 53 had a history of current or previous tamoxifen treatment. An endometrial thickness of ≥5 mm or the presence of other abnormal features was used to triage women to further investigation by hysteroscopy and biopsy. Endometrial thickness was significantly greater in the tamoxifen group (11 mm vs. 6 mm). Nearly all of the tamoxifen group were triaged to further investigation (98.1%), compared with significantly fewer in the non-tamoxifen group (68.3%) Overall, the incidence of endometrial pathology was also significantly higher in tamoxifen patients (43.4% vs. 31.7%). Conclusion For women presenting with post-menopausal bleeding, the use of transvaginal ultrasound as a triage tool is rarely helpful in evaluating women who have a history as tamoxifen use, as most will require further investigation with hysteroscopy and biopsy. A post-menopausal bleeding protocol that omits transvaginal ultrasound for women with a history of tamoxifen use may be an appropriate and effective pathway for managing these patients.

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The relation between vitamin D level, body mass index, and post-menopausal endometrial thickness

International Journal of Clinical Obstetrics and Gynaecology ◽

10.33545/gynae.2021.v5.i3f.952 ◽

2021 ◽

Vol 5 (3) ◽

pp. 385-389

Author(s):

Dr. Mawaje Malik Manih ◽

Dr. Nawfal Azzo

Keyword(s):

Body Mass Index ◽

Vitamin D ◽

Body Mass ◽

Endometrial Thickness ◽

Post Menopausal

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Influence of body mass index on the relationship between endometrial thickness and pregnancy outcome in single blastocyst frozen embryo transfer cycles

Human Fertility ◽

10.1080/14647273.2018.1504324 ◽

2018 ◽

Vol 23 (1) ◽

pp. 32-37 ◽

Cited By ~ 3

Author(s):

David Crosby ◽

Yvonne O’Brien ◽

Louise Glover ◽

Fiona Martyn ◽

Mary Wingfield

Keyword(s):

Body Mass Index ◽

Pregnancy Outcome ◽

Embryo Transfer ◽

Body Mass ◽

Endometrial Thickness ◽

Frozen Embryo Transfer ◽

The Relationship

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Clinical and histopathological characteristics in patients with postmenopausal bleeding

Archive of oncology ◽

10.2298/aoo1301005m ◽

2013 ◽

Vol 21 (1) ◽

pp. 5-10 ◽

Cited By ~ 1

Author(s):

Aljosa Mandic ◽

Bojana Gutic ◽

Tatjana Kapicl-Ivkovic ◽

Ljiljana Segedi-Mladenovic ◽

Mihaela Mocko-Kacanski

Keyword(s):

Body Mass Index ◽

Risk Factor ◽

Endometrial Carcinoma ◽

Body Mass ◽

Transvaginal Ultrasound ◽

Significant Risk ◽

Histopathological Analysis ◽

Postmenopausal Bleeding ◽

Postmenopausal Period ◽

Increased Risk

Background: Incidence of endometrial carcinoma in Vojvodina is 15-20/100 000. In 75% cases, endometrial carcinoma is diagnosed in postmenopausal period. In 90 % of patients, the first clinical sign is postmenopausal bleeding. The aim of the study was to investigate clinical and histopathological characteristics in patients with postmenopausal bleeding. Methods: The study included 122 patients with postmenopausal bleeding. All of these patients underwent gynecological examination and vaginal ultrasound. We obtained materials for histopathological analysis by fractionate explorative curettage. Once we had definitive histopathological findings, we divided patients in two groups A (endometrial carcinoma) and B (benign changes). Results: We confirmed significant statistical differences between examined group A and B, including age (64.49 compared with 58.81 years), postmenopausal period (13.67 instead 9.11 years), and length of uterine corpus (6.41 instead 5.25 cm). Conclusion: Elderly women with longer postmenopausal interval and postmenopausal bleeding had increased risk for endometrial carcinoma. Measurement of endometrial thickness by transvaginal ultrasound appeared to be insufficient parameter for differentiating the benign from the malignant changes of endometrium. Patients with endometrial carcinoma had significantly longer corpus of uterus comparing to patients with benign changes. Body mass index was not found to be significant risk factor in development of endometrial carcinoma in the examined groups. Obesity was diagnosed in both groups, suggesting that increased body mass index is a risk factor for development of pathological changes in endometrium, which could lead to postmenopausal bleeding.

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