Use of pelvic ultrasound to monitor ovarian and uterine maturity in childhood onset anorexia nervosa

Abstract

This study reports the use of pelvic ultrasound scanning in childhood onset anorexia nervosa. The aim was to determine the weight and weight for height ratio (wt/ht) that would correspond with ovarian and uterine maturity and therefore offer the optimal opportunity for the start or resumption of menstruation. On initial assessment, all children had mean weight, wt/ht, ovarian and uterine volumes significantly below expected. At follow up, half the children had started or resumed menstruation. When compared with those who had persisting amenorrhoea, the recovered children had a significantly higher mean weight (48.4 kg v 43.8 kg), mean wt/ht (96.5% v 87.5%), mean ovarian volume (6.2 ml v 4.9 ml), and mean uterine volume (14.6 ml v 10.8 ml). The study indicates that conventional target weight and wt/ht in anorexia nervosa may be too low to ensure ovarian and uterine maturity, and that pelvic ultrasound, which is well tolerated by this group of children, is a useful addition to their management.