Clinicopathological correlation in postmenopausal women with endometrial hyperplasia diagnosed on ultrasonography- a hospital based study

Abstract

Abstract:
Background: Postmenopausal bleeding (PMB) is the most common reason for referral to
gynecological rapid access clinics. Towards an ageing, increasingly obese population, we
are likely to see a rise in estrogen dependent endometrial pathology, including endometrial
cancer, so clinicians need to be familiar with the evidence based and recommendations for
investigation and diagnosis. Objective of the present study was to study the symptoms and
signs associated with endometrial hyperplasia among postmenopausal women
Methods: The present observational descriptive institution-based study, cross sectional
was conducted in the Department of Obstetrics &Gynecology, Eden Hospital, Medical
College & Hospital, Kolkata, West Bengal, India between January 2020 and June 2021. All
postmenopausal women with endometrial hyperplasia with endometrial hyperplasia with
endometrial thickness more than or equal to 4.0 mm diagnosed by ultrasonography were
included in the study fulfilling the requisite criteria. Statistical data were analysed by using
Microsoft Excel and SPSS V.27 software.
Results: In our study, 16 (16.3%) patients were ≤50 years of age, 57 (58.2%) patients were
51-60 years of age. Prime para was 73 (74.5%) and multi para was 25 (25.5%). In study, 45
(45.9%) patients had heavy bleeding. In our study, 33 (33.7%) patients had spotting. In our
study, 13 (13.3%) patients had post coital bleeding. In our study, 32 (32.7%) patients were
asymptomatic. In our study, 30 (30.6%) patients had DM, 4 (4.1%) patients had DM &
HTN, 1 (1.0%) patients had DM, HTN & obesity, 16 (16.3%) patients had HTN, 23
(23.5%) patients had History of Chronic anovulation. Mean Age (mean±s.d.) of patients
was 57.1633± 5.7825. Mean Year since last child birth (mean±s.d.) of patients was
29.0000± 3.1492. Mean Age at menopause (mean±s.d.) of patients was 51.0204± 2.2198.
Mean Duration of menopause (mean±s.d.) of patients was 6.1429± 4.9948. Mean
Endometrial Thickness (mean±s.d.) of patients was 6.9398± 1.4398. In Endometrial Polyp
HPE, 4 (20.0%) patients were Asymptomatic. In Hyperplasia with Atypia HPE, 15 (39.5%)
patients were Asymptomatic. In Endometrial Polyp HPE, 6 (30.0%) patients had DM, 1
(5.0%) patients had DM & HTN, 4 (20.0%) patients had HTN.
Conclusion : Clinico-pathological correlation of ultrasound data in post-menopausal
patients with endometrial hyperplasia allows for a clear definition of the treatment policy,
avoidance of relapse, treatment optimization and early diagnosis and observation of such
patients.
Keywords:Endometrial hyperplasia, postmenopausal women, ultrasonography