The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Relationship between the findings of vaginal sonography and pathology of endometrial curettage in women with abnormal uterine bleeding at perimenopause

Document Type : Original Article

Authors
Sara Mirzaeian 1
Mahsa Dehghani 2
Seyedeh Azam Pourhoseini 1
Ahmad Jafari Joshaghan 3
Malihe Dadgar Moghadam 4
Maryam Emadzadeh 5
1 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 M.Sc. of Midwifery, School of Nursing and Midwifery, Torbate Heydariyyeh University of Medical Sciences, Torbate Heydariyyeh, Iran.
3 MD, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Assistant Professor, Department of Social Sciences, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Assistant Professor, Department of Community Medicine, Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/ijogi.2019.13914
Abstract
Introduction: Abnormal uterine bleeding (AUB) is one common problem in perimenopausal women that should be carefully evaluated. Evaluation in terms of endometrial cancer and premalignant lesions is very important. This study was performed with aim to investigate the relationship between the findings of transvaginal sonography and pathology of endometrial curettage in women with abnormal uterine bleeding at perimenopause.
Methods: This descriptive-analytical study was conducted on 184 perimenopausal women aged 40-50 years with AUB in 2017. The patients underwent transvaginal sonography. D&C was done one week after sonography report if endometrial thickness was > 4 mm. Data collection tool was a self-made questionnaire. Demographic findings of the patients and the results of transvaginal sonography, and hystopathologic assessment of endometrium were recorded. Data were analyzed by SPSS software (version 20), and ANOVA and Kruskal-Wallis tests. PResults: The most common findings of transvaginal sonography was 37% normal, 30% increased thickness, and 20% endometrial polyp. About 47.3% of histopathologic findings were proliferative, then secretory and endometrial polyps and less than 5% of cases was malignant. There was only one case of adenocarcinoma with 6 mm endometrial thickness. In the estimation of the consistency of sonographic findings with D&C findings, there was significant agreement in abnormal and normal groups (P=0.004).
Conclusion: Major and malignant pathologies namely carcinoma and metaplasia can also be detected in cut-off levels less than 8 mm, even around 5 mm. Therefore, use of D&C along with TVUS in low cut-off levels less than 8 mm seems to be necessary.
Keywords
Dilatation and Curettage
Dysfunctional Uterine Bleedings
Perimenopause
Ultrasonography
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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 22, Issue 8
October 2019
Pages 1-9