Publication:

Prospective study of role of transvaginal sonography in postmenopausal bleeding and its histopathological correlation: a prospective study from a tertiary care hospital of Rajasthan

Postmenopausal bleeding is vaginal bleeding that occurring after one years of menopause. When periods have stopped for more than one years in women who are generally over than 45 years old and it is common condition in postmenopausal women, it can be the presenting symptom of endometrial cancer. Aim of study is to assess endometrial thickness by vaginal sonography and correlate it with the cytological pattern evaluated by endometrial sampling and histopathological typing of the endometrium.

Methods This is a prospective observational study conducted in department of obstetrics and gynaecology at R.N.T. Medical college Udaipur from January 2022 to October 2024.  Total 100 women with postmenopausal bleeding who attended the Gynaecology outpatient department were screened for this study. Transvaginal ultrasound examination was carried out to calculate endometrial thickness.

Results This study depicts atrophic and thickened endometria were considered normal findings which was 73 of 100 (73%). The following were considered abnormal seen in 27% (27/100).Endometrial hyperplasia was seen in 15 of 100 women (15%), endometrial carcinoma in 7 women (7%) and endometrial polyp in 5 women (5%). 3/4th (71%) patients had endometrium findings are non-malignant e.g., atrophic endometrium (46%), proliferative endometrium (19%), secretory endometrium (09%). While29% cases in endometrium findings e.g. hyperplasia (17%), polyp (6%), carcinoma (6%).

Conclusions Transvaginal sonography is safe, simple, non-invasive and cost effective in the diagnosis of endometrial disease. Evaluation of PMB at the earliest is essential for diagnosing endometrial status for early intervention. Role of endometrial thickness cannot be undermined for detecting patients at high risk especially with co-morbid conditions. endometrial thickness of less than 5 mm, most of the reports were benign on HPR and those with endometrial thickness of 10mm or more had mostly malignant findings. So we conclude that with increasing endometrial thickness, the risk of malignancy increases.