Clinical Investigations

Ultrasound scan: transvaginal ultrasound scan is often performed in patients with abnormal uterine bleeding and other symptomatology related to the uterus. This may show focal lesions or diffuse thickening of the endometrium or myometrium. The endometrial thickness can be measured and related to the menopausal status of the patient.

Endometrial sampling: usually sampling of the endometrium to provide material for histology is necessary for a definitive pathological diagnosis, especially in cases of abnormal uterine bleeding such as postmenopausal bleeding. In some centres, endometrial brushings with cytological examination is carried out but this is rare. Previously, the most common means of sampling the endometrium was by dilatation and curettage (D & C). This requires a general anaesthetic and is performed as an inpatient procedure. However, pipelle endometrial biopsies can now be performed as an outpatient procedure without the need for a general anaesthetic. Histological sampling of the endometrium may also be performed in women who are being treated with tamoxifen or those who are infertile.

Hysteroscopy: in many cases, hysteroscopy with direct visualisation of the endometrium is performed and biopsies are taken at this procedure.

MRI scanning: in cases where endometrial sampling confirms a malignancy, radiological staging procedures are carried out and this usually comprises MRI scanning.

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100 Pregnancy Tips

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