TRANSVAGINAL DOPPLER SONOGRAPHY OF THE ENDOMETRIUM IN WOMEN WITH POSTMENOPAUSAL BLEEDING FOR PREDICTION OF MALIGNANCY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 9
Abstract
BACKGROUND The climacteric marks the phase in ageing process that signals transition from reproductive to nonreproductive. One of the common complaints in this period is vaginal bleeding, which in 10% of people can be due to underlying endometrial malignancy. Invasive office biopsy of the endometrium is the first choice for the diagnosis of these endometrial pathologies. Since, only 10% of women with postmenopausal bleeding have endometrial carcinoma, a simpler less expensive safe and noninvasive diagnostic method was searched for. Hence, transvaginal sonography with Doppler study of the endometrium was looked into as a replacement for the invasive office biopsy. The aim of the study is to study the efficacy of transvaginal sonography with Doppler for predicting endometrial carcinoma in women with postmenopausal bleeding. MATERIALS AND METHODS It was a study carried out in 30 women who presented with postmenopausal bleeding after one year of amenorrhea. Endometrial biopsy was taken in all patients. Transvaginal sonography with colour Doppler was performed just prior to the endometrial biopsy in these patients. RESULTS Total number of patients evaluated with transvaginal sonography and Doppler were 30. Histologically proven malignant cases were 18 and benign were 12. Majority of the women were parous and had achieved menopause after age of 50. Endometrial thickness measured by transvaginal sonography was significantly higher in malignancy as compared to benign. Resistance index measured by Doppler in the uterine arteries and endometrial vessels were studied and though resistance index was lower in patients with neoplastic pathology, it was not of statistical significance. CONCLUSION Endometrial thickness and colour Doppler measurements in the detection of endometrial pathologies are a useful adjuvant to endometrial biopsy in the detection of malignancy, but not a substitute for biopsy.
Authors and Affiliations
Elizabeth Joseph, Pushpalatha Neelakandan
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