A Clinico-pathological Study of Transvaginal Endometrial Thickness Measurement in Asymptomatic Postmenopausal Patients and Patients with Postmenopausal Bleeding

2019 ◽  
pp. 1
Author(s):  
Ayse Filiz Gokmen Karasu ◽  
Seda Ates ◽  
Tugba Gurbuz ◽  
Nurhan Sahin ◽  
Taha Takmaz ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Thickness Measurement ◽  
University Hospital ◽  
Postmenopausal Bleeding ◽  
Pathological Study ◽  
Endometrial Polyps ◽  
Endometrial Sampling ◽  
Proliferative Endometrium

<p><strong>Objective:</strong> We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.</p><p><strong>Study Design:</strong> This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&amp;C (dilatation &amp; curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.</p><p><strong>Results:</strong> Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient group</p><p><strong>Conclusion:</strong> Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.</p>

scholarly journals Co-relation of endometrial thickness by transvaginal sonogram with histopathology pattern in abnormal uterine bleeding: a study from South India

2020 ◽  
Vol 9 (4) ◽  
pp. 1416
Author(s):  
Chippy Tess Mathew ◽  
Uma Maheswari ◽  
Karthikeyan Shanmugam
Keyword(s):  
Precancerous Lesions ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Sampling ◽  
Dilatation And Curettage ◽  
Number Of Patients ◽  
Fourth Decade ◽  
Proliferative Endometrium

Background: Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period (around 80 ml). Bleeding that occurs erratically or excessive menstrual bleeding is called abnormal uterine bleeding (AUB). The causes of AUB are many and varied. Initial investigations include transvaginal ultrasound and histopathologic assessment of the endometrium. Objective of this study was to evaluation of endometrial thickness with trans-vaginal ultrasound and its correlation with histopathology by dilatation and curettage in abnormal uterine bleeding. To determine the efficacy of transvaginal ultrasound in evaluating the endometrial thickness. To correlate the endometrial thickness by transvaginal ultrasound with endometrial histopathology in women with AUB.Methods: It is a retrospective observational study. All reproductive and perimenopausal age group women who underwent dilatation and curettage for abnormal uterine bleeding during the period June 2014-June 2016 was taken and analyzed and correlated with their endometrial thickness measured with Transvaginal ultrasound.Results: Around 478 patients who underwent endometrial sampling over a period of two years were analyzed. Maximum number of patients were in the fourth decade and the overweight category 36.6%. Proliferative endometrium was the most common histopathologic picture (44.76%). Detection of precancerous lesions were-5.87% and endometrial cancer was 1.05%.Conclusions: An ET of 8 mm and above gave 100% sensitivity and negative predictive value for precancerous and cancerous lesions.

scholarly journals Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding

2017 ◽  
Vol 6 (9) ◽  
pp. 4081
Author(s):  
Jiten Sharma ◽  
Bhishan Dhiman ◽  
Nishi Sud ◽  
Anupriya Kaushik
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Uterine Bleeding ◽  
Postmenopausal Bleeding ◽  
Endometrial Sampling ◽  
Combined Use ◽  
Vaginal Ultrasonography

Background: All women with postmenopausal uterine bleeding mandate examination for endometrial diseases especially endometrial carcinoma. In current scenario, hysteroscopy has replaced traditional Dilatation and Curettage as diagnostic procedure of choice. However, office endometrial sampling with pipelle combined with vaginal ultrasonography being easier and less expensive is recommended. Aim and objectives of the study was to evaluate the combined use of vaginal ultrasonography and office endometrial sampling for the diagnosis of endometrial disease in postmenopausal women with uterine bleeding.Methods: One hundred consecutive postmenopausal women presenting with uterine bleeding were enrolled in the study. Vaginal ultrasonography was used to measure the endometrial thickness. Endometrial sampling was done using endometrial biopsy pipelle, as office procedure, in the OPD examination room. The sample was sent for Histopathological Examination (HPE), The accuracy of vaginal ultrasound and pipelle was measured.Results: In 21% patients, endometrial carcinoma was found, endometrial hyperplasia in 26%, atrophic endometrium in 18%, endometrial polyp in 10% and no specific pathology in 20%. Endometrial thickness measured by Transvaginal ultrasound ranged from 1mm to 28mm with mean of 10.16mm and median of 11.5mm. The mean endometrial thickness in subgroup without disease was 5.26±3.8mm, with benign disease 12.8±3.1mm and in carcinoma 16.97±5.6mm. All cases with carcinoma had endometrial thickness exceeding 5mm (range 5.7mm to 28mm).Conclusions: The study illustrates that by combined use of Trans Vaginal Sonography (TVS) and office endometrial sampling, sufficient diagnostic information was obtained for women with postmenopausal bleeding, obviating the need for more invasive diagnostic procedures.

Value of endometrial thickness assessed by transvaginal ultrasound for the prediction of endometrial cancer in patients with postmenopausal bleeding

2017 ◽  
Vol 296 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Amelie Schramm ◽  
Florian Ebner ◽  
Emanuel Bauer ◽  
Wolfgang Janni ◽  
Ulrike Friebe-Hoffmann ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Postmenopausal Bleeding

scholarly journals Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Laban ◽  
Sherif H. Hussain ◽  
Alaa S. Hassanin ◽  
Waleed M. Khalaf ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Final Analysis ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Predictive Values ◽  
Endometrial Volume ◽  
Sensitivity Specificity

The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223;P=0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

P–691 How predictive is endometrial thickness for live birth after fresh and frozen-thawed embryo transfer when no cut-off is employed?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Turkgeldi ◽  
B Shakerian ◽  
S Yildiz ◽  
I Keles ◽  
B Ata
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Endometrial Thickness ◽  
Treatment Success ◽  
University Hospital ◽  
Registration Number ◽  
Fresh Frozen ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract Study question Does endometrial thickness (EMT) predict live birth (LB) after fresh and frozen-thawed embryo transfer (ET) and is there a lower EMT cut-off for ET? Summary answer Once intracavitary pathology and inadvertent progesterone exposure is excluded, EMT is not predictive for LB. EMT is not linearly associated with probability of LB. What is known already EMT is commonly used as a marker of endometrial receptivity and in turn, assisted reproductive technology treatment success. ET is often cancelled or postponed if EMT is below an arbitrary cut-off. However, the available evidence on the relationship between EMT and LB rates is conflicting and too dubious to hold such strong stance. An overwhelming majority of the studies on the subject are retrospective, they use different arbitrary cut off values ranging between 6 to 9 mm with heterogeneous stimulation and transfer protocols. Study design, size, duration Records of all women who underwent fresh or frozen-thawed ET in Koc University Hospital Assisted Reproduction Unit between October 2016 - August 2019 were retrospectively screened. All women who underwent fresh or frozen-thawed blastocyst transfer during the study period were included. Every woman contributed to the study with only one transfer cycle for each category, i.e., fresh ET and frozen-thawed ET. Participants/materials, setting, methods After ruling out endometrial pathology, EMT was measured on the day of ovulation trigger for fresh ET cycles, and on the day of progesterone commencement for frozen-thawed ET. ET was carried out, regardless of EMT, if there was no suspicion of inadvertent progesterone exposure, i.e., due to follicular phase progesterone elevation in fresh or premature ovulation in frozen ET cycles. Main results and the role of chance 560 ET cycles, 273 fresh and 287 frozen-thawed, were analyzed. EMT varied from 4mm to 18mm. EMT were similar between women who achieved a LB and who did not after fresh ET [10.5 (9.2 – 12.2) mm and 9 (8 – 11) mm, respectively, p = 0.11]. Ovarian stimulation characteristics and proportion of women who received a single embryo were similar (69% vs 68.3%, respectively, p = 0.91). Women who achieved a LB was significantly younger than those who did not [35 (32–38) and 37 (33–41), respectively, p &lt; 0.01]. Women who had a LB and who did not after frozen-thawed ET had similar EMT of 8.4 (7.4 – 9.7) mm and 9 (8 – 10) mm, respectively (p = 0.38). Women who achieved a LB were significantly younger than those who did not [32 (29–35) vs 34 (30–38) years, p = 0.04]. The proportion of women who received a single ET was similar between women who achieved a LB and who did not after a FET [86/95 (90.5%) vs 181/192 (94.3%), respectively, p = 0.26]. Area under curve values of EMT for predicting LB in fresh, frozen-thawed and all ET were 0.56, 0.47 and 0.52, respectively. EMT and LB rate were not linearly correlated in fresh or frozen-thawed ET cycles. Limitations, reasons for caution Although our study is retrospective, no women was denied ET due to EMT in our center. Only patients undergoing ET were included in the analysis, which may introduce bias due to the selection of couples who were competent enough to produce at least one blastocyst fit for transfer. Wider implications of the findings: Since women with thin endometrium had reasonable chance for LB even in the absence of a cut-off for EMT in this unique dataset, delaying or denying ET for any given EMT value alone does not seem justified. Further studies in which ET is carried out regardless of EMT are needed. Trial registration number Not applicable

Endometrial Thickness Measurement for Detecting Endometrial Cancer in Women With Postmenopausal Bleeding

2010 ◽  
Vol 116 (1) ◽  
pp. 160-167 ◽  
Author(s):  
Anne Timmermans ◽  
Brent C. Opmeer ◽  
Khalid S. Khan ◽  
Lucas M. Bachmann ◽  
Elisabeth Epstein ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Thickness ◽  
Thickness Measurement ◽  
Postmenopausal Bleeding

scholarly journals Transvaginal ultrasound and lactate dehydrogenase isoenzyme activity profile in uterine aspirate for diagnosis of endometrial carcinoma in women with postmenopausal bleeding

2007 ◽  
Vol 17 (6) ◽  
pp. 1322-1326 ◽  
Author(s):  
O. Niklasson ◽  
G. Skude ◽  
G. Lingman ◽  
B. Casslén ◽  
K. Maršál
Keyword(s):  
Lactate Dehydrogenase ◽  
Endometrial Carcinoma ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
High Sensitivity ◽  
Postmenopausal Bleeding ◽  
Activity Profile ◽  
Sampling Device ◽  
Uterine Fluid ◽  
The Cost

Postmenopausal patients with vaginal bleeding (n= 72) were evaluated with the combination of transvaginal ultrasonography (TVS) and analysis of the lactate dehydrogenase (LD) isoenzyme activity profile in uterine fluid aspirates. TVS evaluation of the endometrium was classified as <5 mm, ≥5 mm, or poorly defined. The LD isoenzyme activity profile was characterized as abnormal or normal. Pathologic findings were further evaluated with diagnostic curettage. TVS found the endometrium to be ≥5 mm or poorly defined in 44 patients (61%). Endometrial carcinoma was found in 6 of 72 patients (8%). They appeared in the TVS groups endometrium >5 mm (n= 2) and endometrium poorly defined (n= 4) but not in the endometrium <5 mm. The LD isoenzyme activity profile was abnormal in the six malignant cases and in ten benign cases. Thus, the need for further evaluation with hysteroscopy and curettage was reduced to 16 cases. Since TVS had 100% sensitivity but only 42% specificity, it is suitable for first-level examination in patients with postmenopausal bleeding. The second-level method should have similarly high sensitivity but much higher specificity. The LD isoenzyme activity profile in uterine fluid aspirates had 100% sensitivity and 85% specificity. Another important feature is that the method is not sensitive to endometrial thickness, amount of sample, sampling device, or dilution. Thus, it is more reliable than aspiration histology. For every hysteroscopy or curettage that can be replaced by LD analysis, the cost is reduced by approximately EUR 720 or 540, respectively.

scholarly journals False Endometrial Thickening in Postmenopausal Patients Using Anticoagulants or Antiplatelets Agents

2021 ◽  
Vol 3 (2) ◽  
pp. 25-28
Author(s):  
Nahit Ata ◽  
Nur Gözde Kulhan
Keyword(s):  
Postmenopausal Women ◽  
Endometrial Thickness ◽  
Antiplatelet Agents ◽  
Control Group ◽  
Drug Status ◽  
Postmenopausal Bleeding ◽  
Endometrial Sampling ◽  
Endometrial Thickening ◽  
First Results ◽  
The Mean

Objective There is no report that anticoagulant or antiplatelet use may lead to abnormal endometrial sonographic findings. This retrospective study reports our first results associated with endometrial sampling in asymptomatic postmenopausal women using anticoagulants or antiplatelet. Materials methods A total of 268 postmenopausal patients who applied to our gynecology outpatient clinic for any reasons except postmenopausal bleeding were included in the study. Patients were divided into three groups according to using drug status: first healty control group [HCG], second anticoagulants agents group [ACG], and third antiplatelet agents group [APG]. The effects of anticoagulant and antiplatelet agents on endometrial thickness were compared with histopathological findings. Results The mean endometrial thickness was significantly greater in group ACG [5.2 mm] and APG [4.1 m]  than in group HCG [3.3 mm]. No significant differences were found in the mean endometrial thickness between groups HCG and APG. However, it is noteworthy that the average endomeric thickness in the ACG group is more than the other two groups and this is statistically significant [p < 0.05].   Conclusion If the thickness of the endometrium was > 4 mm. endometrial sampling may be recommended in in asymptomatic postmenopausal women using anticoagulants or antiplatelet agents.  

Sign in / Sign up

Export Citation Format

Share Document