Usefulness of pipelle endometrial biopsy in the diagnosis of women at risk for ectopic pregnancy.
OBJECTIVE
The purpose of this study was to determine the accuracy of endometrial Pipelle (Unimar) biopsy to detect chorionic villi in suspected ectopic pregnancy.


METHODS
This was a blinded prospective trial that involved 32 women who were in stable condition with suspected ectopic pregnancy. Endometrial pipelle sampling was performed before uterine dilation and curettage. Pipelle and frozen section results were compared with final disease.


RESULTS
Ten of 32 patients (31%) had chorionic villi that was consistent with a miscarriage; 22 of 32 patients (69%) had none detected. Pipelle biopsy had a sensitivity of 30% (95% CI, 6.7-65.2), a specificity of 100% (95% CI, 84.5-100), a positive predictive value of 100% (95% CI, 29.2-100), and a negative predictive value of 76% (95% CI, 56.5-87). Frozen section had a sensitivity of 87.5% (95% CI, 47.3-99.7), a specificity of 100% (95% CI, 83.1-100), a positive predictive value of 100% (95% CI, 59-100), and a negative predictive value of 95.3% (95% CI, 76.1-99.8).


CONCLUSIONS
In patients with suspected ectopic pregnancy, Pipelle sampling is not a substitute for curettage because the sensitivity and predictive values are unacceptable.
Barnhart
Kurt T
KT
Center for Reproductive Medicine and Surgery, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Gracia
Clarisa R
CR
Reindl
Beth
B
Wheeler
James E
JE
D000022:Abortion, Spontaneous / Q000473:pathology; D001706:Biopsy / Q000379:methods; D002824:Chorionic Villi / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016037:Single-Blind Method