Endometrial thickness screening in premenopausal women with abnormal uterine bleeding

Aim: To assess the role of measuring endometrial thickness by transvaginal ultrasonography (TVS) as a screening tool for abnormal uterine bleeding triage in premenopausal women. Methods: Between November 2002 and October 2004, endometrial thickness was measured by TVS in 111 premenopausal women with non-cyclic abnormal uterine bleeding before dilatation and curettage. Results: Of the 111 women, 31 (27.9%) had an abnormal endometrium (hyperplasia 13.5%, polyps 5.4%, submucous myoma 5.4%, and adenocarcinoma 3.6%). An endometrial thickness of 8 mm showed optimal sensitivity and specificity (83.9% and 58.8%, respectively) and 90.4% negative predictive value (NPV) for an abnormal endometrium. When submucous myoma was excluded, the sensitivity, specificity, and NPV were 80%, 53.8%, and 89.6%, respectively. Conclusion: Endometrial thickness of 8 mm or less is less likely to be associated with malignant pathologies in premenopausal uterine bleeding.