What is often the first-line diagnostic test for abnormal uterine bleeding?

• A. Colonoscopy
• B. Endometrial biopsy
• C. Pelvic ultrasound
• D. CT scan

Answer: (C)

In the context of evaluating abnormal uterine bleeding, a pelvic ultrasound is typically considered the first-line diagnostic test. This imaging study is non-invasive and effective for assessing the structural causes of bleeding, such as uterine fibroids, polyps, or other abnormalities in the reproductive organs. It provides valuable information about the size and shape of the uterus and can help identify any masses or lesions that may be contributing to abnormal bleeding.

While an endometrial biopsy is also an important diagnostic tool, particularly for assessing the endometrial lining for hyperplasia or carcinoma, it is often not the first step in the diagnostic process. Instead, it is usually indicated when the ultrasound findings suggest the need for further evaluation, such as in cases of thickened endometrium or other concerning ultrasound findings.

Colonoscopy and CT scan are not standard approaches for investigating abnormal uterine bleeding. A colonoscopy is focused on evaluating colon-related issues, while a CT scan is typically reserved for specific situations that may require detailed imaging of the pelvis or abdomen but is not routinely used for primary assessment of uterine bleeding. Thus, the pelvic ultrasound’s ability to provide immediate and relevant visual information makes it the preferred initial diagnostic test in this scenario.