The role of vaginal scan in measurement of endometrial thickness in postmenopausal women

Article Abstract:

Bleeding after menopause, when the menstrual periods stop, can be an early sign of endometrial carcinoma, or cancer of the lining of the uterus (endometrium). The five-year survival rate for this type of cancer is 65 percent, and improvements have not been made in this statistic over the past two decades. Ultrasonography, the use of high-frequency sound waves to visualize internal organs and structures, is utilized to screen for signs of endometrial carcinoma or precancerous abnormalities. Two types of ultrasonography are available for visualizing the uterine lining: transabdominal, in which the sound waves are directed through the abdomen; and transvaginal, in which the instrument transmitting the sound is inserted into the vagina. This study was conducted to evaluate the usefulness of transvaginal ultrasonography for visualizing endometrial abnormalities, particularly precancerous changes, in postmenopausal women. There were 111 women, 103 of whom had postmenopausal bleeding and eight of whom were having a hysterectomy (removal of the uterus). For 94 patients, it was possible to correlate the results of ultrasonography with laboratory analysis of the characteristics of the endometrial tissue. An important aspect of the ultrasonographic findings is the thickness of the endometrium; a thickness over 5 millimeters was found in 31 percent of the women, and they all had abnormalities of the endometrial tissue. Thus the results confirmed findings from previous studies, that women with an endometrial thickness of over 5 millimeters should be further evaluated for endometrial cancer. Transvaginal ultrasonography was found to be very useful; it was simple to perform, was well accepted by the patients, and is a non-invasive technique. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Endometrial cancer, Postmenopausal women

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Transvaginal ultrasound. A reliable basis for clinical management? Case reports

Article Abstract:

Vaginal bleeding after menopause, when the menstrual periods cease, needs to be evaluated since it can be a sign of cancer or other diseases. Standard techniques for diagnosing the cause of postmenopausal bleeding include dilatation and curettage ('D and C'), in which the cervix is dilated and the lining of the uterus is scraped to obtain tissue samples. However, this technique cannot be used in a small percentage of women, such as those with abnormal anatomy of these organs or a history of complications during previous D and C procedures. The cases of four women who could not be evaluated by D and C are described. Instead they had transvaginal ultrasonography, in which an instrument that transmits high-frequency sound waves is inserted into the vagina to visualize the uterine lining. The transvaginal technique is new, and may be superior to the traditional transabdominal ultrasonography technique, in which the sound waves are directed through the abdomen. The four patients described were evaluated for abnormalities of the uterine lining (endometrium) based solely on the results of transvaginal ultrasonography, since they could not have the D and C, and this approach was found to be accurate. Each patient was diagnosed successfully using transvaginal ultrasonography: two patients had endometrial polyps, one had an infection of the endometrium, and one had no abnormalities other than the bleeding. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Ultrasound imaging, Causes of, Uterine bleeding, Uterine hemorrhage

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Changes in circulating alphafetoprotein following administration of mifepristone in first trimester pregnancy

Article Abstract:

Alphafetoprotein (AFP) is a protein made by the fetus, and maternal blood levels of AFP may be elevated following certain diagnostic procedures such as amniocentesis. Mifepristone (RU 486) is a drug which blocks the effects of progesterone and therefore prevents progression of early pregnancy; it is being used in France to induce abortion. Its effects in preventing pregnancy development are enhanced by administration of gemeprost, a type of prostaglandin, a locally-acting hormone. The effects of mifepristone treatment with gemeprost on maternal AFP levels were studied in 30 women given the drugs to terminate pregnancy in the first trimester. All women bled shortly after treatment with gemeprost, which was given two days after mifepristone, and the abortions were complete. AFP levels were unchanged within the four hours after mifepristone treatment, but had increased significantly two days later (before gemeprost administration) in 21 women. Administration of gemeprost did not appear to enhance this rise in AFP level. The results support earlier findings that fetal blood or blood products may mingle with the maternal circulation during termination of early pregnancy, whether the abortion is induced by mechanical or pharmacological means. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abortion, Mifepristone, Alpha fetoproteins

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