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Transvaginal Sonography and Endometrium

Galal Lotfi. MD, MRCOG Professor Obstetrics & Gynecology Suez Canal University Egypt

Aim Of Work To stydy the efficacy of TVS in dignosing abnormal Endometrial pattern in postmenopausal women .

specificity and sensitivity  Endometrial cytology  Office Biopsy.Introduction  Screening Methods Include:  Pap Smear. Clinical and technical difficulties  D&C add anestetic hazards and limitations .

Clinical and technical difficulties D&C: Invasive. Costly.Drawbacks Smear: lack of specificity and sensitivity Endometrial cytology: Clinical and technical difficulties Office Biopsy. Anesthesial .

without or with postmenopausal bleeding .Design Antrospective study for Postmenopausal women.

Material and Methods Postmenopausal women with no bleeding . . n=132. n=187 Postmenopausal women with bleeding.

.Material and Methods. cont. All women were subjected to TVS for pelvic assessment and endometrial thickness measurement Pap smea D&C biopsy .

Mareial and Methods cont  Postmenopausal women without bleeding n=187 group Ia: high risk group n=36 group Iib: low risk group n=131  Postmenopausal woen without bleeding n=187 group Ia: high risk group n=72 .

Risk Factors: Diabetes Hypertension Obesity Previous PCO Family abnormal smea History .

RESULTS Table (1): TV results of group I.005 Endometrial thickness >12 6 56 131 Total . (n=187) en Endometrial thickness High Risk Group Low Risk Group X2 P 31 117 25.005 Endometrial thickness >8<12mm 1 8.3 <0.3 <0. postm S enopausal wom without bleeding.4 NS Endometrial thickness >4<8mm 12 5 12.7 <0.005 Endometrial thickness =<4mm 7 8 1.

4 NS >4<8m m Endom etrial thickness 12 5 12.005 >8<12m m Endom etrial thickness >12 6 1 8.7 <0.3 <0. (n=187) en Endom etrial thickness High Risk Group Low Risk Group X2 P Endom etrial thickness 31 117 25.3 <0. postm S enopausal wom without bleeding.Results Table (1): TV results of group I.005 =<4m m Endom etrial thickness 7 8 1.005 Total 56 131 .

005 >8<12m m Endom etrial thickness >12 13 4 3. postm S enopausal wom with bleeding.05 Total 72 60 .05 0. (n=132) en Endom etrial thickness High Risk Group Low Risk Group X2 P Endom etrial thickness 28 37 6. Table (2): TV results of group II.7 0.Results cont….005 =<4m m Endom etrial thickness 11 10 0.8 >4<8m m Endom etrial thickness 20 9 11.8 <0.1 <0.

(n=131) en Endom etrial thickness Abnorm sam al ple Abnorm sm al ear Endom etrial thickness =<4m m 0/117 0/117 Endom etrial thickness >4<8m m 0/8 1/8 Endom etrial thickness >8<12m m 2/5 2/5 Endom etrial thickness >12 1/1 1/1 Total 3/131 3/131 . postm en enopausal wom without bleeding. Table (3): TV results of endom S etrial thickness. cytology and endom etrial sam pling in low risk wom in groupI..Results cont..

(n=60) en Endom etrial thickness Abnorm sam al ple Abnorm sm al ear Endom etrial thickness =<4m m 0/37 6/37 Endom etrial thickness >4<8m m 3/10 4/10 Endom etrial thickness >8<12m m 4/9 4/9 Endom etrial thickness >12 3/4 4/4 Total 10/60 18/60 . Table (5): TV results of endom S etrial thickness.Results cont. cytology and endom etrial sam pling in low risk wom in groupII.. postm en enopausal wom with bleeding.

postm en enopausal wom with bleeding. (n=72) en Endom etrial thickness Abnorm sam al ple Abnorm sm al ear Endom etrial thickness =<4m m 6/28 5/28 Endom etrial thickness >4<8m m 7/11 4/11 Endom etrial thickness >8<12m m 13/20 17/20 Endom etrial thickness >12 9/13 7/13 Total 35/72 33/72 . Table (6): TV results of endom S etrial thickness. cytology and endom etrial sam pling in low risk wom in groupII.Results cont..

Table (4): TV results of endom S etrial thickness..Results Cont. (n=56) en Endometrial thickness Abnormal sample Abnormal smear 0/31 0/31 Endometrial thickness =<4mm 0/7 1/7 Endometrial thickness >4<8mm 5/12 Endometrial thickness >8<12mm 2/12 6/6 6/6 Endometrial thickness >12 8/56 12/56 Total . cytology and endom etrial sam pling in high risk wom in groupI. postm en enopausal wom without bleeding.

RESULTS .

TVS:     Delineate the endometrium Measures the endometrila thickness Detects associated endometrial pathology Detects other pathology in the pelvis .

.Other pathology detected      Endometrila polyps Samall fibroid Adenomyosis Hydrosaplix with PID Ovarian cysts.

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