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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 orcid (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)
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author
and
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 Inc.
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
2016-04-01 16:16:34
date last changed
2022-01-28 18:33:59
@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}},
  keywords     = {{Endometrial biopsy; Endometrial cancer; Expectant management; Postmenopausal bleeding; Ultrasound}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{499--504}},
  publisher    = {{John Wiley & Sons Inc.}},
  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}},
  doi          = {{10.1046/j.0960-7692.2001.00548.x}},
  volume       = {{18}},
  year         = {{2001}},
}