Abstract:
Background: Post-menopausal bleeding is a common gynecologic problem accounting for a significant number
of yearly visits to our outpatient gynecologic clinic. Ultrasound in comparison with histopathology aids in the
early diagnosis of possible causes. Objective: To ascertain the diagnostic accuracy of pelvic ultrasonography in
patients with postmenopausal bleeding in our hospital. Methods: This was a descriptive cross-sectional study
done between July 2017 and June 2018 at Moi Teaching and Referral Hospital. Consecutive sampling on
consenting patients presenting with a clinical diagnosis of post-menopausal bleeding was done. A total of 67
participants were included. A structured questionnaire was administered to the participants. Categorical data was
summarized as well as continuous variables. Data analysis and statistical computing was done. Results: The
mean age was at 54.6 years. The years post menopause ranged from 1-15 years with a mean age of 4.6 years.
There were 31 (46.2%) participants with endometrial thickness greater than 5mm. Uterine fibroids in 2
participants while endometrial fluid was seen in 2 participamts. On histopathological diagnosis, atrophic
endometritis accounted for 48% of the cases. Endometrial hyperplasia was at 22%, endometrial carcinoma at
13%, chronic endometritis 8%, endometrial polyp 6% and unremarkable (normal) diagnosis at 3%. A level of
agreement for malignancy calculated was found to be 57%. Conclusion: Increase in endometrial thickness is
associated with an increased risk in malignancy. The level of agreement between ultrasound and histopathology
is low at 53 %.
