The role of transvaginal color doppler indices to predict malignancy in abnormal uterine bleeding according to PALM-COEIN classification

Abstract

Introduction: The objective of this study is to analyze the differences in transvaginal color Doppler parameters in premenopasual women with abnormal uterine bleeding (AUB) among PALM-COEIN groups.

Materials and method: This cross-sectional study was performed in a training and educational hospital, included 147 premenopausal women with AUB. Patients were divided into four groups according to PALM-COEIN. All subjects were evaluated by transvaginal Doppler sonography and uterine artery (UA) pulsatility and resistive indexes (PI, RI) were calculated then compared.

Results: Four groups named AUB-P, AUB-E, AUB-M and AUB-O included 39, 30, 32 and 46 patients, respectively. The mean age of patients was 44.82 (35-55 years), EC rate was 3.4 %. UA-PI was lower in the AUB-M group compared with AUB-P and AUB-O (p < 0.001). UA-RI was different among gruops (p < 0.001). UA-RI was lowest in the AUB-M, and highest in the AUB-O (0.60 ± 0.15; 0.85 ± 0.05 respectively). The cut-off values of ET, UA-PI and UA-RI for detecting AUB-M were 13.5, 1.55 and 0.71 respectively.

Conclusion: Transvaginal color Doppler sonography may be beneficial in detecting the etiology of AUB in premenopausal women.

Keywords: Abnormal uterine bleeding; Doppler ultrasonography; Perimenopause.