Obstetrics & Gynecology Track the topics, authors and articles important to you
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 2008;111:137-143
© 2008 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Supplement: Appendix
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Timmermans, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Timmermans, A.
Related Collections
Right arrow General gynecology
Right arrow Ultrasound/doppler

ORIGINAL RESEARCH

Follow-up of Women After a First Episode of Postmenopausal Bleeding and Endometrial Thickness Greater Than 4 Millimeters

Anne Timmermans, MD1,2, Lena C. van Doorn, MD, PhD3, Brent C. Opmeer, PhD4, Maurice V. A. M. Kroeks, MD, PhD5, M. Jitze Duk, MD, PhD1,6, Annette M. Bouwmeester, MD7, Roy F. M. P. Kruitwagen, MD, PhD8, F. Paul H. L. J. Dijkhuizen, MD, PhD9, Ben W. J. Mol, MD, PhD2 for the Dutch Study in Postmenopausal Bleeding (DUPOMEB)*

From the Departments of 1Perinatology and Gynecology, University Medical Centre, Utrecht; 2Obstetrics and Gynecology, Academic Medical Centre, Amsterdam; 3Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam; 4Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam; 5Obstetrics and Gynecology, Diakonessenhuis, Utrecht; 6Meander Medical Center, Amersfoort; 7Obstetrics and Gynecology, Mesos Medical Center, Utrecht; 8Obstetrics and Gynecology, TweeSteden Hospital, Tilburg; and 9Obstetrics and Gynecology, Rijnstate Hospital, Arnhem, the Netherlands.

OBJECTIVE: To estimate the incidence of recurrent postmenopausal bleeding among women who were diagnosed with an endometrial thickness greater than 4 mm.

METHODS: We designed a prospective cohort study and included consecutive women not using hormone replacement therapy, presenting with a first episode of postmenopausal bleeding. We evaluated patients who had an endometrial thickness greater than 4 mm at transvaginal ultrasonography and benign endometrial sampling; presence of carcinoma was ruled out by office endometrial sampling, hysteroscopy, and/or dilation and curettage. Time until recurrent bleeding was measured, and diagnosis at recurrent bleeding was recorded.

RESULTS: Among 318 patients who had an endometrial thickness greater than 4 mm, 222 patients had benign histology results and were available for follow-up. During follow-up, 47 (21%, 95% confidence interval 16–27%) patients had recurrent bleeding, with a median time to recurrent bleeding of 49 weeks (interquartile range 18 to 86 weeks). There was no difference with respect to recurrence rate between patients with polyp removal, patients with a normal hysteroscopy, and patients with office endometrial sampling alone at the initial workup. Two patients were diagnosed with atypical endometrial hyperplasia upon recurrent bleeding.

CONCLUSION: The recurrence rate of postmenopausal bleeding in women with endometrial thickness greater than 4 mm is 20%. This recurrence rate is not related to incorporation of hysteroscopy or polyp removal at the initial workup.

LEVEL OF EVIDENCE: II






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the American College of Obstetricians and Gynecologists.