Endometrial thickness by ultrasonography and its correlation with histopathology in abnormal uterine bleeding among peri and post menopausal women

Abstract

Background: The endometrium constitutes a dynamic organ in female reproductive years, as it is subjected to hormonal variations in every cycle. Present study was conducted with the aim to correlate the endometrial thickness with the histopathology in the peri-menopausal females presenting with abnormal uterine bleeding (AUB) and to identify cut off value of endometrial thickness in order to reach at some consensus regarding when to intervene so that not a single endometrial pathology will be missed. Materials and Methods: This was an observational study conducted on 242 peri-menopausal and post-menopausal women ≥40 years of age presenting with abnormal uterine bleeding (AUB). Results: Based on the ROC curve, the cutoff point that delineates the abnormal histology and normal histology for endometrial thickness was 14.20 mm. Area under the curve (AUC) was 0.783 with 95% CI as 0.686-0.880 having sensitivity 71% and specificity 90% (p < 0.001). Conclusion: Heavy menstrual bleeding and frequent cycle were found to be commonly associated with gynecological pathology in these age groups. In all post and peri-menopausal AUB trans vaginal sonography for endometrial thickness is the initial best modality of investigation. Endometrial thickness cutoff in the range of ≥ 14 mm is of prime importance.