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Rebleeding and endometrial growth in women with postmenopausal bleeding and endometrial thickness <5 mm managed by dilatation and curettage or ultrasound follow-up: a randomized controlled study

Epstein, Elisabeth LU and Valentin, Lil LU (2001) In Ultrasound in Obstetrics & Gynecology 18(5). p.499-504
Abstract
OBJECTIVE: To compare the frequency of rebleeding and endometrial growth during a 12-month follow-up period between women with postmenopausal bleeding and an endometrial thickness < 5 mm managed by dilatation and curettage, and those managed by ultrasound follow-up. DESIGN: Consecutive women with postmenopausal bleeding and an endometrial thickness < 5 mm were randomized to ultrasound follow-up after 3, 6, and 12 months (n = 48) or to primary dilatation and curettage with ultrasound follow-up at 12 months (n = 49). At all follow-up examinations, the endometrial thickness was measured and the women were asked about rebleeding. The endometrium was sampled at the 12-month examination, if sampling had not been performed previously... (More)
OBJECTIVE: To compare the frequency of rebleeding and endometrial growth during a 12-month follow-up period between women with postmenopausal bleeding and an endometrial thickness < 5 mm managed by dilatation and curettage, and those managed by ultrasound follow-up. DESIGN: Consecutive women with postmenopausal bleeding and an endometrial thickness < 5 mm were randomized to ultrasound follow-up after 3, 6, and 12 months (n = 48) or to primary dilatation and curettage with ultrasound follow-up at 12 months (n = 49). At all follow-up examinations, the endometrial thickness was measured and the women were asked about rebleeding. The endometrium was sampled at the 12-month examination, if sampling had not been performed previously because of rebleeding or endometrial growth. RESULTS: Rebleeding was reported by 33% (16/48) of the women in the ultrasound group and by 21% (10/48) of those in the dilatation and curettage group (P = 0.17). Endometrial growth to >or= 5 mm was found in 21% (10/48) of the women in the ultrasound group and in 10% (5/48) of those in the dilatation and curettage group (P = 0.16). No endometrial pathology was found in women with isolated rebleeding. Endometrial pathology during follow-up was found more often in women with endometrial growth than in those without (33% vs. 4%; P = 0.008). CONCLUSION: Rebleeding and endometrial growth are common during a follow-up period of 12 months in women with postmenopausal bleeding and an endometrial thickness < 5 mm, irrespective of whether or not dilatation and curettage is primarily carried out. If these women are managed by ultrasound follow-up, endometrial sampling should be performed if the endometrium grows, but not necessarily in the case of rebleeding without endometrial growth. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Endometrial biopsy, Endometrial cancer, Expectant management, Postmenopausal bleeding, Ultrasound
in
Ultrasound in Obstetrics & Gynecology
volume
18
issue
5
pages
499 - 504
publisher
John Wiley & Sons
external identifiers
  • pmid:11844172
  • scopus:0035170610
ISSN
1469-0705
DOI
10.1046/j.0960-7692.2001.00548.x
language
English
LU publication?
yes
id
9867b18e-a3cb-4afe-aede-a6dd3d2feb79 (old id 1120558)
date added to LUP
2008-06-27 08:50:31
date last changed
2018-05-29 11:59:33
@article{9867b18e-a3cb-4afe-aede-a6dd3d2feb79,
  abstract     = {OBJECTIVE: To compare the frequency of rebleeding and endometrial growth during a 12-month follow-up period between women with postmenopausal bleeding and an endometrial thickness &lt; 5 mm managed by dilatation and curettage, and those managed by ultrasound follow-up. DESIGN: Consecutive women with postmenopausal bleeding and an endometrial thickness &lt; 5 mm were randomized to ultrasound follow-up after 3, 6, and 12 months (n = 48) or to primary dilatation and curettage with ultrasound follow-up at 12 months (n = 49). At all follow-up examinations, the endometrial thickness was measured and the women were asked about rebleeding. The endometrium was sampled at the 12-month examination, if sampling had not been performed previously because of rebleeding or endometrial growth. RESULTS: Rebleeding was reported by 33% (16/48) of the women in the ultrasound group and by 21% (10/48) of those in the dilatation and curettage group (P = 0.17). Endometrial growth to &gt;or= 5 mm was found in 21% (10/48) of the women in the ultrasound group and in 10% (5/48) of those in the dilatation and curettage group (P = 0.16). No endometrial pathology was found in women with isolated rebleeding. Endometrial pathology during follow-up was found more often in women with endometrial growth than in those without (33% vs. 4%; P = 0.008). CONCLUSION: Rebleeding and endometrial growth are common during a follow-up period of 12 months in women with postmenopausal bleeding and an endometrial thickness &lt; 5 mm, irrespective of whether or not dilatation and curettage is primarily carried out. If these women are managed by ultrasound follow-up, endometrial sampling should be performed if the endometrium grows, but not necessarily in the case of rebleeding without endometrial growth.},
  author       = {Epstein, Elisabeth and Valentin, Lil},
  issn         = {1469-0705},
  keyword      = {Endometrial biopsy,Endometrial cancer,Expectant management,Postmenopausal bleeding,Ultrasound},
  language     = {eng},
  number       = {5},
  pages        = {499--504},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Rebleeding and endometrial growth in women with postmenopausal bleeding and endometrial thickness <5 mm managed by dilatation and curettage or ultrasound follow-up: a randomized controlled study},
  url          = {http://dx.doi.org/10.1046/j.0960-7692.2001.00548.x},
  volume       = {18},
  year         = {2001},
}