Significance of endometrial thickness on transvaginal ultrasonography in abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is characterized by excessive flow at the time of an expected menses or by bleeding at abnormal or unexpected times. Aims: The study aimed to evaluate the endometrial thickness (ET) on ultrasound and histopathological examination and their correlation in patients with AUB. Materials and Methods: The present prospective study was conducted on 100 female patients of all age groups attending the Department of Obstetrics and Gynaecology at S. P. Medical College and A. G. H. Bikaner, Rajasthan, India, from June 2018 to May 2019, with a clinical diagnosis of AUB. These women underwent clinical examination, investigations, and ultrasound examination, followed by endometrial biopsy. Results: The mean age of the patients was 43.14 ± 10.44 years. Menometrorrhagia (28%) was the chief complaint. The mean ET in the premenopausal group (7.568 ± 2.774 mm) was more than the postmenopausal group (7.388 ± 4.138 mm) (P = 0.795). Proliferative endometrium (66%) was the most common endometrial pattern, followed by secretory endometrium (16%), endometrial hyperplasia (7%), adenocarcinoma (3%), atrophic endometrium (2%), and pseudodecidual reaction (1%). Out of the total cases, in 5 (5%) cases, no histopathological pattern was observed because of inadequate sample. After applying analysis of variance, the association between histopathological findings and mean ET was found to be statistically significant (P = 0.00). When ET was >12 mm, endometrial hyperplasia and adenocarcinoma were observed in six and one cases, respectively. Conclusion: ET can be used as a marker of endometrial hyperplasia and malignancy; however, it cannot replace comprehensive tissue diagnosis.