Perimenopausal women presenting with abnormal uterine bleeding: Endometrial thickness

Relaxin is released by granulocytes. This causes dissolution of stromal fibres. The stratum functionalis is broken down to be discharged as menstruating endometrium. The stratum basalis is not shed from which regeneration begins. The presence of spiral arterioles, are the characteristic features of the endometrium. The key event in the menstruation as postulated by Markee is the intense vasoconstriction of spiral arterioles about 24 hours prior to menstruation, results in ischaemic necrosis of the endometrial segment supplied by them. This necrotic endometrium gets separated with accumulation of blood underneath. Thus, the endometrial shedding begins at various places with the bleeding lasting over 2-7 days period. Written informed consent taken from all patients enrolled in the study. They were evaluated by history, clinical examination and relevant investigations. Transvaginal ultrasound and endometrial biopsy done for all subjects. The endometrial biopsy specimen report obtained and compared and correlated with endometrial thickness by TVS. In perimenopausal women, when endometrial thickness of 14mm on transvaginal ultrasound was taken as cut off, the modality had sensitivity of 97.71% and specificity of 84.21 %. P value with chi square test was found to be < 0.05.