Diagnostic Accuracy of Transvaginal Ultrasound in Perimenopausal and Postmenopausal Bleeding

1 Associate Professor, Department of obstetrics and gynecology, Kannur Medical College, Anjarakandy 2 Professor, Department of obstetrics and gynecology, Kannur Medical College, Anjarakandy ABSTRACT Aim: To study the endometrial pathology in patients with perimenopausal and postmenopausal bleeding by using transvaginal ultrasound, hysteroscopy and histopathology To compare the sonographically measured endometrial thickness and morphology and hysteroscopic finding with histopathologic diagnosis in women with perimenopausal and postmenopausal bleeding Materials and methods: Sample size is 50 and study was conducted between January 2008 and December 2014. Inclusion criteria—perimenopausal women beyond 40 years and postmenopausal women, Exclusion criteria—any use of hormone replacement therapy or progesterone therapy and patients with fibroids and adnexal mass. All patients underwent transvaginal ultrasound (TVS), hysteroscopy and endometrial biopsy in that order. Histopathological report was compared with TVS and hysteroscopic findings Observations: Endometrial thickness measured by transvaginal ultrasound. Thickness above 4 mm is taken as abnormal. Endometrium studied by hysteroscopy and findings compared with transvaginal ultrasound and histopathological findings Conclusions: TVS was complementary to hysteroscopy in the diagnosis of endometrial pathology. A 5 mm cutoff for endometrial thickness in postmenopausal women could reliably be ruled out endometrial pathology. Hysteroscopy was superior to TVS in the detection of focal pathology like polyps. Both TVS and hysteroscopy are complementary diagnostic methods to histopathology and could be accurately used to discriminate between normal and pathologic endometrial conditions in women with postmenopausal and perimenopausal bleeding.