Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding.
OBJECTIVE
We compared endometrial sampling by pipelle endometrial curette with conventional dilatation and curettage (D&C) in patients with abnormal uterine bleeding.


METHODS
Endometrial sampling with pipelle curette was performed on 100 patients followed by formal D&C. Samples were labeled as A and B, respectively, and sent to a histopathologist who was blinded as to the method of sampling. The histopathology reports of both samples were compared, taking D&C as the gold standard.


RESULTS
An adequate sample was obtained in 98% of cases by pipelle and in 100% of cases by D&C. Pipelle had a sensitivity, specificity, positive predictive value and negative predictive value of 100% for diagnosing endometrial carcinoma, hyperplasia and secretory endometrium. Pipelle also had high diagnostic sensitivity, specificity and negative predictive value (100%, 98% and 100%, respectively) for hyperplasia with atypia, and low sensitivity (57%) and positive predictive value (57%), but high specificity (97%) and negative predictive value (97%) for endometritis. Similarly, for proliferative endometrium, the pipelle technique had values of 94% and 93% for sensitivity and specificity, respectively. Both samples labeled as inadequate for histology by pipelle were polyps on the D&C report. Difficult endotracheal intubation was encountered in two cases of D&C. No other complications of the procedure were observed.


CONCLUSIONS
The pipelle is a safe device for getting an adequate endometrial sample for histology, with a high sensitivity and specificity for detection of hyperplasia and malignancy.
Fakhar
Shazia
S
Department of Obstetrics and Gynecology, Shifa College of Medicine, Islamabad, Pakistan. drshaziaf@yahoo.com
Saeed
Gulshan
G
Khan
Amir Hussain
AH
Alam
Ali Yawar
AY
D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000295:instrumentation*; D014592:Uterine Hemorrhage / Q000209:etiology*