PREDICTIVE VALUE OF TRANSVAGINAL ULTRASOUND ENDOMETRIAL THICKNESS MEASUREMENT IN EVALUATION OF POSTMENOPAUSAL BLEEDING IN KANO

*Sunday Enemona Achanya, Ibrahim Adamu Yakasai, Usman Aliyu Umar, Anas Ismail, Muhammed Ibrahim Imam, Olayinka Taiwo Hassan, Abdullahi Abba Habib, Usman Abba and Ifesinachi Joy Omeje

ABSTRACT

Background: Postmenopausal bleeding is one of the common presentations of endometrial pathology. Transvaginal endometrial thickness, a less invasive test, can be the initial screening test for evaluating endometrial pathology in these women, in order to determine those that will require endometrial biopsy. Aim: The aim of this study was to determine the predictive value (validity) of transvaginal endometrial thickness measurement in the evaluation of endometrial pathology among women presenting with postmenopausal bleeding in Kano. Methods: It was a cross-sectional multicenter study of women with postmenopausal bleeding (PMB) that had endometrial thickness measurement using a 6.5MHZ transvaginal transducer and endometrial sample by suction curettage and subjected to histopathologic diagnosis. Results: Forty-five women were evaluated. The mean age of the patients was 58.2 ± 6.0 years, mean parity was 4.4 ±1.9, mean age at menopause was 51.3 ± 1.4 years and mean duration from menopause to symp tom was 6.9 ± 4.9 years. Nighteen (42.2%) of patients had endometrial hyperplasia with 10 (52.6%) being simple hyperplasia and 9 (47.4%) atypical hyperplasia. Endometrial cancer was found in 12 (26.7%) while 14 (31.1%) had normal histology. Transvaginal endometrial thickness of 5mm cut-off was found to have a sensitivity of 87.1%, specificity 50%, positive predictive value 79.4%, negative predictive value of 63.6% and diagnostic accuracy of 75.6%. Conclusion: Transvaginal endometrial thickness at a cut-off value of 5mm correlated well with histopathologic diagnosis of endometrial pathology. Therefore, it should be the first line test in the evaluation of women with postmenopausal bleeding in Kano.

Keywords: Transvaginal, endometrial thickness, biopsy, Postmenopausal bleeding.