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Endometrial sampling before or after saline contrast sonohysterography in women with postmenopausal bleeding (ESPRESSO Trial): A multicenter randomized controlled trial.

Abstract：

INTRODUCTION:The aim of this study is to evaluate the quality of the endometrial sample obtained by office endometrial aspiration when performed before or after saline contrast sonohysterography (SCSH) in women with postmenopausal bleeding and a thickened endometrium. To conduct a complete, minimally invasive and cost-effective diagnostic workup in women with postmenopausal bleeding and a thickened endometrium, ideally both the office endometrial sampling and SCSH are performed. However, it is not known whether both tests affect each other when performed one after another. MATERIAL AND METHODS:Women with postmenopausal bleeding and an endometrial thickness >4 mm were eligible. Women were randomized into two groups: one group received endometrial aspiration before SCSH, the other group received SCSH before endometrial aspiration. The primary outcome was the proportion of sufficient endometrial samples. Reliability of the SCSH images and pain during procedures were secondary outcomes. RESULTS:During the inclusion period, 513 eligible women with postmenopausal bleeding visited the participating hospitals, 293 of whom received information about the study. Of these women, 232 (79%) agreed to participate. In the SCSH-aspiration group, 65 women (59%) had a sufficient endometrial sample compared with 70 (67%) in the aspiration-SCSH group (odds ratio 1.46, 95% CI 0.83-2.54, P = .19). The proportion of reliable sonographic images was significantly higher in the SCSH-aspiration group (n = 88, 87%) compared with the aspiration-SCSH group (n = 71, 74%) (OR 2.38, 95% CI 1.38-4.99, P = .02) in the per protocol analysis. CONCLUSIONS:This study shows that the quality of an endometrial sample in women with postmenopausal bleeding is not affected by SCSH. Both procedures can be performed in one outpatient visit to perform an optimal diagnostic workup.

journal_name

Acta Obstet Gynecol Scand

journal_title

Acta obstetricia et gynecologica Scandinavica

authors

Vroom AJ,Aerts L,Bongers MY,Lim AC,Pielkenrood BJ,Geomini PMAJ,van Hanegem N

doi

10.1111/aogs.14086

subject

Has Abstract

pub_date

2021-01-17 00:00:00

eissn

0001-6349

issn

1600-0412

pub_type

杂志文章

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Endometrial sampling before or after saline contrast sonohysterography in women with postmenopausal bleeding (ESPRESSO Trial): A multicenter randomized controlled trial.