Obstetrics & Gynecology Science (Nov 2021)

Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy

  • Sangam Jha,
  • Akanksha Singh,
  • Hemali Heidi Sinha,
  • Poonam Bhadani,
  • Monika Anant,
  • Mukta Agarwal

DOI
https://doi.org/10.5468/ogs.21150
Journal volume & issue
Vol. 64, no. 6
pp. 517 – 523

Abstract

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Objective To determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausal women with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model that includes clinical variables for predicting EH/EC in these women. Methods This retrospective study was conducted between January 2015 and March 2020. All premenopausal women aged 25 kg/m2 (odds ratio [OR], 4.4705), age >40 years (OR, 1.14), endometrial thickness (ET) >13 mm (OR, 2.59), and hypothyroidism (OR, 1.35) were significantly associated with EH/ EC. Considering the pretest probability for an EH/EC of 4.7%, this prediction model with a likelihood ratio of 14.2% demonstrated a post-test probability of 41% in the presence of the above-mentioned variables. Conclusion The risk of EH/EC was lower in low-risk premenopausal women with AUB. However, premenopausal women with IMB aged >40 years, hypothyroidism, BMI >25 kg/m2, and thickened endometrium (ET >13 mm) are at high risk of EH/EC; therefore, endometrial biopsy should be considered early in their management plan.

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