title: Usefulness of pipelle endometrial biopsy in the diagnosis of women at risk for ectopic pregnancy.
abstract: 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.
authors.affiliation: Center for Reproductive Medicine and Surgery, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Barnhart
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
authors.forename: Beth
authors.initials: B
authors.lastname: Reindl
authors.forename: James E
authors.initials: JE
authors.lastname: Wheeler
mesh_terms: 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