Uterine artery Doppler indices may predict significant causes of perimenopausal bleeding

Mohammad Salah, Ayman Shabana, Mohamed Rezk, Dalia Ibrahim, Shaimaa Abd-Elhamid
In: Menoufia Medical Journal · 2019 · vol. 32(4) , pp. 1388 · doi:10.4103/mmj.mmj_335_18 · W2997860744
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Abstract

ObjectiveThe aim was to assess whether uterine artery Doppler indices can predict significant causes of uterine bleeding in patients with perimenopausal bleeding or not.BackgroundTreatment of abnormal uterine bleeding needs easy diagnostic procedure, for determining the etiological factor of disease. The abnormal uterine bleeding is more common in the perimenopausal than in the postmenopausal women, and it is a sign of endometrial proliferative or hyperplastic changes.Patients and methodsThis prospective observational study was conducted on 106 women with perimenopausal bleeding [who were subdivided into two groups, one with nonsignificant causes (52 patients) and the other with significant causes (54 patients)] and 50 healthy controls, with transvaginal ultrasonic color Doppler study performed before endometrial sampling with pipelle in those with perimenopausal bleeding. Test characteristics of uterine artery pulsatility index and resistance index for prediction of significant causes of bleeding were the main outcome measures.ResultsUterine artery pulsatility index at cutoff value of 1.82 with area under the curve of 0.834, sensitivity of 70.8%, specificity of 92%, positive predictive value of 94.9%, negative predictive value of 69.9%, and accuracy of 78%, whereas uterine artery resistance index at cutoff value of 0.575 with area under the curve of. 998, sensitivity of 96.2%, specificity of 100%, positive predictive value of 100%, negative predictive value of 92.6%, and accuracy of 97% were predictive of significant causes of perimenopausal bleeding.ConclusionUterine artery Doppler is a simple, readily available and noninvasive tool that could be beneficial in conjunction with endometrial sampling to detect significant causes of perimenopausal bleeding.

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