Clinical indicators of advanced endometrial pathology in postmenopausal bleeding - abstract

ABSTRACT

One hundred and nine patients with postmenopausal bleeding who underwent a fractional dilation and curettage were studied over a 52-year period. Malignancies were found in 20.2 percent of the study group; 11.9 percent were endometrial carcinoma and 7.3 percent squamous carcinoma of the cervix. Forty-five per cent of the patients were discovered to have some form of organic pathology. Compared with the 30 patients who had an atrophic endometrium, those with endometrial carcinoma had an increased mean age of menopause (64 vs 49 yrs), a lower parity (4.2 vs 7.5), a lower haemoglobin level (11.5 vs 13.2g/dl) and a larger uterine size (85 percent vs 10 percent>6wk size). Bleeding was for more than 1 month in 85 percent compared with 15 percent in the atrophic group and it was more frequently heavy, resembling menses (77 percent vs 37 percent). This study points to a low haemoglobin level, heavy menses like bleeding and bleeding for more than one month as clinical features indicative of the presence of advanced endometrial pathology (AU)