Correlation Between Endometrial Histopathology and Transvaginal Ultrasound Findings in Women with Abnormal Uterine Bleeding: A Retrospective Chart Review

Abstract

Background: Abnormal uterine bleeding (AUB) is a common problem in gynecologic practice, accounting for more than 70% of gynecological consultations in the pre- and postmenopausal age bracket.

Aim and Objective: Correlate endometrial histopathology with transvaginal ultrasound among women experiencing abnormal uterine bleeding at a tertiary care hospital.

Methodology: We conducted this retrospective study in the Obstetrics and Gynecology Department of the Indus Hospital and Health Network, Sheikh Saeed Campus in Korangi, Karachi, from 1st Jan 2016 to 31st Dec 2019. We have taken data from the digital information system of the hospital and utilised data from the radiology and histopathology departments for correlation. 

Results: A total of 620 female patients were primarily identified from the hospital management information system. Following review of the available records, 202 patients were excluded because of discrepancies between the dates of transvaginal ultrasonography and endometrial biopsy. A further 75 patients were excluded because of incomplete or missing clinical information. Therefore, 343 women met the eligibility criteria and were included in the final study population. Demographic and relevant clinical characteristics were documented for all participants. The median age of the study population was 45.0 years (IQR: 38.3–55.1). According to BMI classification, approximately half of the participants (50.1%) were categorized as obese, whereas 2.3% were classified as underweight. The median parity was 4.0 (IQR: 2.0–5.0). The mean age at menarche was 12.4 ± 1.4 years, while the mean age at menopause was 50.0 ± 3.9 years.

Conclusion: Abnormal uterine bleeding (AUB) signifies a common and medically significant gynecological complaint. In the current study, transvaginal ultrasonography (TVS) demonstrated a diagnostic accuracy of 32.9% for identifying abnormal endometrial findings among postmenopausal women and 56.1% among premenopausal women. While the diagnostic correctness observed in this study was limited, TVS remains a safe, non-invasive, well-tolerated, and readily accessible imaging modality. Its extensive accessibility in secondary and tertiary healthcare settings makes it a meaningful preliminary inquiry in the valuation of women presenting with AUB.