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Endometrial thickness for invasive investigations in women with postmenopausal bleeding.

Raouf, S A and Gupta, P and Papaioannou, S and Pradhan, P (2011) Endometrial thickness for invasive investigations in women with postmenopausal bleeding. Climacteric : the journal of the International Menopause Society, 14 (1). pp. 117-20. ISSN 1473-0804. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids

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Official URL: http://informahealthcare.com/doi/abs/10.3109/13697...

Abstract

OBJECTIVE

To determine the prevalence of endometrial hyperplasia and endometrial cancer in postmenopausal women with endometrial thickness of 4.1-8 mm on transvaginal ultrasound scan.

DESIGN

Prospective observational study carried out in the Heart of England NHS Trust Teaching Hospital in the West Midlands, UK, in a population of 58 women with postmenopausal bleeding.

METHOD

Prospective analysis of all women referred to the Rapid Access Clinic in the Heart of England Hospital with a history of postmenopausal bleeding over a 12-month period (April 2007-April 2008). Endometrial histology was taken as the final diagnosis. The main outcome measure was endometrial histology in women with postmenopausal bleeding with endometrial thickness of 4.1-8 mm.

RESULTS

All women (n = 58) diagnosed with endometrial thickness of 4.1-8 mm on transvaginal sonography were included in the analysis. Pipelle endometrial biopsy could only be performed in 22 women (37.9%). Hysteroscopy was performed in 45 women (77.5%). Out of these, a histological diagnosis was available in 28 women (62.2%). In the remaining 17 women, the endometrium was observed as atrophic on hysteroscopy. In these 17 cases, either no or insufficient endometrial sample was obtained. In total, two (3.4%) women were diagnosed with complex endometrial hyperplasia and two (3.4%) women were diagnosed with endometrial carcinoma.

CONCLUSION

There was a significant prevalence of endometrial hyperplasia and endometrial cancer in postmenopausal women with a history of postmenopausal bleeding and who had endometrial thickness of 4.1-8 mm. Therefore, the current recommendation of histological assessment on all women with endometrial thickness >4 mm should remain unchanged.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids
Subjects: WP Gynaecology. Women’s health
WQ Obstetrics. Midwifery
Divisions: Womens and Childrens > Gynaecology
Womens and Childrens > Obstetrics
Depositing User: Mr Philip O'Reilly
Date Deposited: 04 Jul 2014 12:34
Last Modified: 04 Jul 2014 12:34
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/503

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