Endometrial Volume as a Predictor of Endometrial Pathology in Perimenopausal Uterine Bleeding | ||||
| The Egyptian Journal of Fertility and Sterility | ||||
| Article 3, Volume 25, Issue 1 - Serial Number 11106352, January 2021, Page 20-29 PDF (2.24 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2021.143081 | ||||
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| Author | ||||
| Hanan Nabil, Mouatafa Elzayat, Mohammed Moustafa, Mahmoud Mohamed Abdelrazik | ||||
| Department of Obstetrics and Gynecology, Faculty of Medicine, Mansura University, Egypt. | ||||
| Abstract | ||||
| Background: Transvaginal ultrasonography (TVS) imaging is a routine, non-invasive procedure in initial evaluation of patients with abnormal uterine bleeding in perimenopausal age. However, there is no yet a cutoff value to discriminate benign form malignant cases. Aim of the Work: Is to assess the potential value of endometrial volume measurements by 2D TVS compared with that of endometrial thickness in prediction of different endometrial pathologies in women with perimenopausal uterine bleeding. Patients and Methods: Ninety-two perimenopausal women presented with uterine bleeding were enrolled to the study after exclusion of general and local caused of bleeding as polyps and fibroids. TVS (2D) was done to measure endometrial thickness and volume using a specific formula. Endometrial biopsy was taken and the pathological results was correlated with the endometrial thickness and volume. Results: There was a statistically noticeable difference between benign endometrial pathology compared to endometrial hyperplasia with atypia or endometrial carcinoma as regard age as well as body mass index. There was a high statistically significant difference between patients with benign endometrium pathology and malignant endometrial pathology regarding endometrial thickness and volume. That endometrial volume had a high predictive value as proved by an area under the ROC curve (AUC) of 0.826. The best cut-off value was an endometrial volume >11.675 cm3. While (ROC) curve analysis for differentiation of patients using endometrial volume and endometrial thickness into women with benign endometrial pathology or hyperplasia and those with endometrial carcinoma; Endometrial volume also had a higher predictive value than endometrial thickness as proved by an area under the ROC curve (AUC) of 0.871. The cut-off value was an endometrial volume >13.105 cm3. While using endometrial thickness cut-off value was an endometrial thickness > 14.5mm. Conclusion: endometrial volume measured with inexpensive 2D TVS has a higher predictive value than measuring endometrial thickness in correspondence to the pathological results in patients with perimenopausal bleeding. | ||||
| Keywords | ||||
| Perimenopausal bleeding; endometrial volume; 2D transvaginal ultrasound | ||||
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