Relationship between the findings of vaginal sonography and pathology of endometrial curettage in women with abnormal uterine bleeding at perimenopause

Abstract

Introduction: Abnormal uterine bleeding (AUB) is one common problem in perimenopausal women that should be carefully evaluated. Evaluation in terms of endometrial cancer and premalignant lesions is very important. This study was performed with aim to investigate the relationship between the findings of transvaginal sonography and pathology of endometrial curettage in women with abnormal uterine bleeding at perimenopause. Methods: This descriptive-analytical study was conducted on 184 perimenopausal women aged 40-50 years with AUB in 2017. The patients underwent transvaginal sonography. D&C was done one week after sonography report if endometrial thickness was > 4 mm. Data collection tool was a self-made questionnaire. Demographic findings of the patients and the results of transvaginal sonography, and hystopathologic assessment of endometrium were recorded. Data were analyzed by SPSS software (version 20), and ANOVA and Kruskal-Wallis tests. PResults: The most common findings of transvaginal sonography was 37% normal, 30% increased thickness, and 20% endometrial polyp. About 47.3% of histopathologic findings were proliferative, then secretory and endometrial polyps and less than 5% of cases was malignant. There was only one case of adenocarcinoma with 6 mm endometrial thickness. In the estimation of the consistency of sonographic findings with D&C findings, there was significant agreement in abnormal and normal groups (P=0.004). Conclusion: Major and malignant pathologies namely carcinoma and metaplasia can also be detected in cut-off levels less than 8 mm, even around 5 mm. Therefore, use of D&C along with TVUS in low cut-off levels less than 8 mm seems to be necessary.

Keywords

• dilatation and curettage
• dysfunctional uterine bleedings
• perimenopause
• ultrasonography