Diagnostic Accuracy of Endometrial Thickness in Diagnosing Endometrial Hyperplasia by Taking Endometrial Sampling as the Gold Standard in Patients with Post-Menopausal Bleeding

Abstract

Background: Endometrial hyperplasia is most common with post-menopausal bleeding (PMB). The clinical tests to evaluate the endometrium include transvaginal ultrasound scanning (TVS) to measure endometrial thickness (ET) and endometrial sampling (ES) with hysteroscopy as gold standard. Objective: To determine diagnostic accuracy of endometrial thickness in diagnosing endometrial hyperplasia by taking endometrial sampling as the gold standard in patients with post-menopausal bleeding. Study Design: Cross-sectional study. Settings: Department of Obstetrics & Gynecology, Allied & DHQ Hospitals affiliated with Faisalabad Medical University, Faisalabad Pakistan. Duration: January 01, 2022 till March 31, 2022. Methods: A total of 150 patients fulfilling the inclusion criteria were recruited. Endometrial sampling was obtained by using a pipelle sampler. Patient’s characteristics taken into account were age, parity, body mass index, hypertension and diabetes. Histological findings were compared to measure the diagnostic accuracy of endometrial hyperplasia. Results: The mean age of patients was 55.29 ± 2.91 years with minimum and maximum age as 50 and 60 years. Endometrial hyperplasia was diagnosed in 67(44.7%) females on sampling and in 71(47.3%) females on endometrial thickness by USG. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of endometrial thickness was 82.09%, 80.72%, 77.46%, 84.81% and 81.33%. Conclusion: It is concluded that endometrial thickness is useful for diagnosis of endometrial hyperplasia in females with post-menopausal bleeding and used even in low source settings as ultrasonography requires basic ultrasound knowledge.