Objective To estimate the accuracy of transvaginal ultrasound (TVS) measurement of endometrial thickness (ET) in diagnosing endometrial cancer in postmenopausal women with vaginal bleeding (PMB).Design Retrospective cohort study.Setting One-stop PMB clinic in a Hong Kong teaching hospital. Main outcome measures Accuracy data for TVS ET presented as sensitivity, specificity, and area under the receiver operator characteristic (ROC) curve.Results Endometrial cancer was diagnosed in 3.8% of women. The median ET in those with endometrial cancer was significantly higher than those with benign conditions (15.7 versus 3.2 mm, P < 0.001). The area under the ROC curve was 0.92 (95% CI 0.89-0.94). The sensitivity for the detection of endometrial cancer at 3-, 4-, and 5-mm cut-offs were 97.0% (95% CI 94.5-99.6%), 94.1% (95% CI 90.5-97.6%), and 93.5% (95% CI 89.7-97.2%), respectively. The corresponding estimates of specificity at these thresholds were 45.3% (95% CI 43.8-46.8%), 66.8% (65.4-68.2%), and 74.0% (72.7-75.4%).Conclusions Transvaginal ultrasound using a 3-mm cut-off has high sensitivity for detecting endometrial cancer and can identify women with PMB who are highly unlikely to have endometrial cancer, thereby avoiding more invasive endometrial biopsy.

Objective To assess the impact of adopting the st biometry standards in a Chinese population.Design Retrospective cohort study.Setting A teaching hospital in Hong Kong.Population A total of 10 527 Chinese women with a singleton pregnancy having a second-or third-trimester fetal anomaly or growth scan between January 2009 and June 2014.Methods Z-scores were derived for fetal abdominal circumference (AC), head circumference (HC), and femur length (FL) using the INTERGROWTH-21 st and Chinese biometry standards.Pregnancies with aneuploidy, structural or skeletal abnormalities, or that developed pre-eclampsia were excluded. Z-scores were stratified as <2.5th, <5th, <10th, >90th, >95th, or >97.5th percentile. Birthweight centile, adjusted for gestation and gender, was categorised as ≤3rd, 3rd to ≤5th, 5th to ≤10th, and >10th. Pairwise comparison and the McNemar test were performed to assess biometry Z-score differences and concordance between the INTERGROWTH-21 st and Chinese standards.Main outcome measures The sensitivity of both the local and INTERGROWTH-21 st AC standards to identify pregnancies that were small-for-gestational-age (SGA) was assessed.Results INTERGROWTH-21 st AC, HC, and FL Z-scores were significantly lower than those obtained using our local reference for AC, HC, and FL (P < 0.0001 for all). The proportion of fetuses with biometry in the <2.5th, <5th, <10th, >90th, >95th, or >97.5th percentiles was statistically significant (P < 0.01 for all

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Plasma total thyroxine (TT4) and free thyroxine (FT4) were measured in 23 women with hyperemesis gravidarum at presentation, on average at about 10 wecks, in the second trimester, and before dclivcry. The l i n t TT4 was raised abnormally in eight women and the FT4 in ninc. but by the second trimester the TT4 was a b n o r m a l y high in only three although in eight the FT4 remained high. By the third trimester all measurements, except one slightly raised FT4, were normal. Birthweight was not related to the thyroxine levels but there was a weak significant negative correlation between FT4 in the second trimester and gestational age at delivery.