Endometrial Cut Off Thickness as Predictor of Endometrial Pathology in Perimenopausal Women with Abnormal Uterine Bleeding: A Cross-Sectional Study

Abstract

Purpose. We aim to determine the predictive value of endometrial thickness by transvaginal ultrasonography (TVS) in diagnosing endometrial pathology and to evaluate whether Doppler complements its diagnostic efficacy in perimenopausal women with abnormal uterine bleeding. Methods. This cross-sectional observational study was conducted among 70 perimenopausal women with AUB who underwent TVS measurement of endometrial thickness (ET) and Doppler flow indices followed by endometrial sampling and histopathological examination (HPE). Results. In HPE, 51 (73%) women had normal diagnosis while 19 (27%) women had neoplastic histology either benign or malignant. They were categorised into group I and group II, respectively. There was a significant difference in age ( P = 0.001 ) and incidence of obesity ( P = 0.01 ) between the two groups. The ETs measured in group I and group II were 7.89 ± 2.62 mm and 14.07 ± 3.96 mm, respectively, with significant difference ( P < 0.001 ). A TVS-ET of 10.5 mm had the highest sensitivity and specificity of 89.5% and 86.3%, respectively, PPV of 70.68%, NPV of 95.68%, LR+ of 6.52, and LR− of 0.12. Doppler flow velocimetric study of endometrial and uterine vessels did not demonstrate a significant difference. Conclusions. Women in perimenopause with AUB should be offered to undergo endometrial sampling for histopathological examination if TVS ET ≥10.5 mm. The coexisting risk factors especially higher age (>45 years) and obesity (BMI>30) significantly escalate the chances of developing endometrial pathology.

Endometrial Thickness Measurement as Predictor of Endometrial Hyperplasia and Cancer in Perimenopausal Uterine Bleeding: Cross-Sectional Study

“…In the present study, EH/EC was reported at 9.7 (22/254) percent. From previous literatures, prevalence of EH/EC were reported ranging from 4 to 15.7 percent (Sattanakho et al, 2020;Jha et al, 2021;Dhakwa et al, 2021;Soja et al, 2020;Kumari et al, 2022). Our prevalence of EH/EC was within the range of previous works above.…”

Endometrial thickness and uterine artery Doppler parameters as soft markers for prediction of endometrial cancer in postmenopausal bleeding women: a cross-sectional study at tertiary referral hospitals from Vietnam

“…Moreover, this tool may help in differentiating between low-grade and high-grade tumors as well as evaluating the preoperative tumor invasion before surgery [ 11 ]. However, this combination remains controversial among studies [ 12 ]. In Vietnam, this controversy is not of great concern; thus, our study aimed to elucidate the optimal value of ultrasonographic findings and Doppler indices in predicting EC.…”

Development and Validation of a Nomogram Prediction Model for Endometrial Malignancy in Patients with Abnormal Uterine Bleeding

“…Previous studies showed that an ET >10–11 mm was one of the predictors associated with endometrial malignancy among symptomatic women. 5 9 10 Bivariate cut-off for an ET at 10 mm was chosen in our study, as this value was close to the optimal mathematical value according to logistic regression.…”

“…Previous studies showed no consent regarding the endometrial thickness (ET) cut-off value to be used for the indication of invasive diagnosis in premenopausal symptomatic women. 4 5 Several predictive models based on clinical variables and sonographic predictors have been developed to estimate the individual risk of EC or atypical endometrial hyperplasia (AEH). 6 Nevertheless, most of them focused on perimenopausal and postmenopausal women, and few have been validated.…”