Evaluation Of Endometrial Thickness With Transvaginal Sonography In Perimenopausal Women Presenting With Abnormal Uterine Bleeding And Correlation With Its Histopathological Findings

Abstract

Introduction: Abnormal uterine bleeding (AUB) is one of the most common gynecological complaints among perimenopausal women, often arising from anovulatory cycles and hormonal fluctuations. Transvaginal sonography (TVS) has emerged as a non-invasive, cost-effective modality for assessing endometrial thickness and detecting underlying pathology. This study aimed to evaluate the diagnostic accuracy of endometrial thickness measured by TVS in perimenopausal women with AUB and correlate the findings with histopathology, the gold standard.

Materials and Methods: A cross-sectional study was conducted among 100 perimenopausal women aged 40–55 years presenting with AUB at Adichunchanagiri Institute of Medical Sciences, Adichunchanagiri University. Detailed demographic, clinical, and menstrual histories were obtained, followed by laboratory investigations, TVS, and endometrial sampling via dilatation and curettage. Endometrial thickness was recorded and categorized, and histopathological findings were correlated. Statistical analysis included chi-square tests and diagnostic performance calculations for TVS with histopathology as the reference.

Results: Heavy menstrual bleeding was the most common complaint (63%), followed by polymenorrhoea (21%). Endometrial thickness of 10–14.9 mm was observed in 47% of participants, while 11% demonstrated thickness ≥15 mm. TVS revealed normal findings in 58% of cases, with fibroids (12%) and adenomyosis (9%) being the most frequent abnormalities. Histopathology predominantly showed secretory (44%) and proliferative (40%) endometrium, while premalignant and malignant changes were identified in 11% of cases. An endometrial thickness ≥14 mm was strongly associated with abnormal histopathology (p < 0.0001). TVS demonstrated sensitivity of 91.67%, specificity of 94.32%, and overall accuracy of 94%.

Conclusion: TVS measurement of endometrial thickness is a reliable, non-invasive screening tool for evaluating AUB in perimenopausal women, with high diagnostic accuracy. It should be employed as the first-line investigation, while histopathology remains essential for definitive diagnosis.