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Title: |
Endometrial Biopsy in DUB | |||||||||||||||||||
| Authors: | Stephanie J. Ash, B.Sc., M.D., Scott A. Farrell, M.D., F.R.C.S.C., and Gordon Flowerdew, D.Sc. | |||||||||||||||||||
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OBJECTIVE: To determine the incidence of abnormal endometrial histology in women with dysfunctional uterine bleeding and to evaluate the predictive value of risk factors for endometrial cancer in women with dysfunctional uterine bleeding (DUB).
STUDY DESIGN: We conducted a retrospective review of 310 women with DUB who underwent endometrial biopsy. The risk factors for abnormal endometrial histology included menstrual cycle irregularity, diabetes, nulliparity, hypertension, weight _100 kg and age _40 years. The incidence of endometrial abnormalities was determined, and the predictive value of combinations of risk factors was assessed using stepwise logistic regression. RESULTS: Twenty-one patients (6.7%) had abnormal endometrial biopsies. Menstrual cycle irregularity (P=.0001), age _40 years (P=.022) and hypertension (P=.058) were independently significant risk factors for abnormal endometrial histology. The probability of abnormal endometrial histology in a premenopausal woman with DUB whose cycle was regular was <1%. The presence of menstrual cycle irregularity increased the probability of abnormal endometrial histology to 14.3%. CONCLUSION: The patient who presents with DUB and a history of menstrual cycle irregularity warrants an endometrial biopsy, regardless of age. The current clinical emphasis on age (especially _40 years) as justification for endometrial biopsy is unwarranted in patients with DUB. More careful selection of patients for endometrial biopsy will mean that fewer women are unnecessarily exposed to the discomfort and risk of complications associated with endometrial biopsy. (J Reprod Med 1996;41:892-896) |
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| Keywords: | endometrial neoplasms; biopsy; menstruation disorders; dysfunctional uterine bleeding | |||||||||||||||||||
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