To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding
Objective: Abnormal uterine bleeding (AUB) can be associated with underlying endometrial pathology. The current existing guidelines discuss the role of endometrial biopsy in women 40 years old and above, however, there are no clear recommendations for younger women. This study aims to identify the f...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590161325000043 |
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| author | Sandra Lynn Jaya-Bodestyne Marlene Samantha Goh Madeline Chan Hiu Gwan Sonali Prashant Chonkar Khurshid Merchant Manisha Mathur |
| author_facet | Sandra Lynn Jaya-Bodestyne Marlene Samantha Goh Madeline Chan Hiu Gwan Sonali Prashant Chonkar Khurshid Merchant Manisha Mathur |
| author_sort | Sandra Lynn Jaya-Bodestyne |
| collection | DOAJ |
| description | Objective: Abnormal uterine bleeding (AUB) can be associated with underlying endometrial pathology. The current existing guidelines discuss the role of endometrial biopsy in women 40 years old and above, however, there are no clear recommendations for younger women. This study aims to identify the factors that increase the risk of endometrial pathology in women below 40 years of age presenting with AUB for consideration of endometrial biopsy. Methods: We conducted a retrospective observational study reviewing the records of 464 women aged under 40 years old who underwent endometrial biopsy for AUB. The data analysis included demographics, investigations undertaken, ultrasound findings, biopsy results, and treatment. Multivariable analysis was performed using modified Poisson regression models to compare women with endometrial hyperplasia (EH) (with or without atypia) and endometrial cancer (EC), to those with benign pathology, to identify risk factors for endometrial pathology. Results: In our study, 71.3 % of women had a benign histology, 22.8 % had EH with and without atypia and 2.2 % of women had a diagnosis of EC. A BMI ≥ 30 (RR 1.76, p = 0.002), nulliparity (RR 1.84, p = 0.001), ultrasound findings of thickened endometrium ≥ 15 mm (RR 1.39, p = 0.048) and cystic spaces in the endometrium (RR 1.83, p < 0.001) were identified as significant risk factors after a multivariate analysis. A combination of at least 3 of these risk factors had a cumulative increased risk of EH/EC (RR 3.80, p < 0.001). Conclusion: Endometrial biopsy in younger women with AUB should be carefully considered on a case-by-case basis and reserved for those with risk factors for a serious endometrial pathology. |
| format | Article |
| id | doaj-art-b13f075678964dd09839d0228094d242 |
| institution | Kabale University |
| issn | 2590-1613 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| spelling | doaj-art-b13f075678964dd09839d0228094d2422025-02-03T04:16:55ZengElsevierEuropean Journal of Obstetrics & Gynecology and Reproductive Biology: X2590-16132025-03-0125100368To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleedingSandra Lynn Jaya-Bodestyne0Marlene Samantha Goh1Madeline Chan Hiu Gwan2Sonali Prashant Chonkar3Khurshid Merchant4Manisha Mathur5Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, SingaporeDepartment of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore; Correspondence to: 100 Bukit Timah Road, Singapore 229899, Singapore.Obstetrics and Gynaecology Academic Clinical Programme, SingHealth Services, Singapore, SingaporeDepartment of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, SingaporeDepartment of Pathology and Laboratory Medicine, KK Women’s and Children’s Hospital, Singapore, SingaporeDepartment of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, SingaporeObjective: Abnormal uterine bleeding (AUB) can be associated with underlying endometrial pathology. The current existing guidelines discuss the role of endometrial biopsy in women 40 years old and above, however, there are no clear recommendations for younger women. This study aims to identify the factors that increase the risk of endometrial pathology in women below 40 years of age presenting with AUB for consideration of endometrial biopsy. Methods: We conducted a retrospective observational study reviewing the records of 464 women aged under 40 years old who underwent endometrial biopsy for AUB. The data analysis included demographics, investigations undertaken, ultrasound findings, biopsy results, and treatment. Multivariable analysis was performed using modified Poisson regression models to compare women with endometrial hyperplasia (EH) (with or without atypia) and endometrial cancer (EC), to those with benign pathology, to identify risk factors for endometrial pathology. Results: In our study, 71.3 % of women had a benign histology, 22.8 % had EH with and without atypia and 2.2 % of women had a diagnosis of EC. A BMI ≥ 30 (RR 1.76, p = 0.002), nulliparity (RR 1.84, p = 0.001), ultrasound findings of thickened endometrium ≥ 15 mm (RR 1.39, p = 0.048) and cystic spaces in the endometrium (RR 1.83, p < 0.001) were identified as significant risk factors after a multivariate analysis. A combination of at least 3 of these risk factors had a cumulative increased risk of EH/EC (RR 3.80, p < 0.001). Conclusion: Endometrial biopsy in younger women with AUB should be carefully considered on a case-by-case basis and reserved for those with risk factors for a serious endometrial pathology.http://www.sciencedirect.com/science/article/pii/S2590161325000043Endometrial hyperplasiaEndometrial cancerBiopsyPremenopausal |
| spellingShingle | Sandra Lynn Jaya-Bodestyne Marlene Samantha Goh Madeline Chan Hiu Gwan Sonali Prashant Chonkar Khurshid Merchant Manisha Mathur To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding European Journal of Obstetrics & Gynecology and Reproductive Biology: X Endometrial hyperplasia Endometrial cancer Biopsy Premenopausal |
| title | To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding |
| title_full | To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding |
| title_fullStr | To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding |
| title_full_unstemmed | To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding |
| title_short | To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding |
| title_sort | to do or not to do endometrial biopsy in younger women with abnormal uterine bleeding |
| topic | Endometrial hyperplasia Endometrial cancer Biopsy Premenopausal |
| url | http://www.sciencedirect.com/science/article/pii/S2590161325000043 |
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