title: Pipelle endometrial sampling in the evaluation of abnormal first trimester pregnancies.
abstract: OBJECTIVE
  To evaluate the utility of pipelle endometrial sampling as a diagnostic tool in the evaluation of abnormal first trimester gestations.
  
  
  METHODS
  Thirty-one women with abnormal first trimester pregnancies defined as gestations with abnormally rising or falling quantitative human chorionic gonadotropin (β-hCG) levels and ultrasound findings consistent with a nonviable or ectopic pregnancy were prospectively evaluated. Endometrial pipelle sampling was performed on each patient in a standardized fashion immediately before curettage and evaluated as a fixed, permanent specimen to assess for the presence of either chorionic villi, trophoblastic or fetal tissue.
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value, and negative predictive value for endometrial biopsy were 70.1%, 100%, 100%, and 33.3%, respectively. For curettage, the sensitivity, specificity, positive predictive value, and negative predictive value were 88.9%, 100%, 100%, and 57.1%, respectively.
  
  
  CONCLUSIONS
  Curettage's overall sensitivity is superior to endometrial biopsy in detecting the presence of intrauterine products of conception in early abnormal pregnancies. However, in some clinical situations where the diagnosis of ectopic pregnancy is in question, particularly if the β-hCG is ≤ 2,000 mIU/mL, endometrial pipelle biopsy could be a useful tool in the evaluation algorithm.
authors.affiliation: Madigan Army Medical Center, 9040 Fitzsimmons Drive, ATTN: MCHJ-CLG, Tacoma, WA 98431.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Batig
authors.affiliation: Madigan Army Medical Center, 9040 Fitzsimmons Drive, ATTN: MCHJ-CLG, Tacoma, WA 98431.
authors.forename: Dawn
authors.initials: D
authors.lastname: Elliott
authors.affiliation: Madigan Army Medical Center, 9040 Fitzsimmons Drive, ATTN: MCHJ-CLG, Tacoma, WA 98431.
authors.forename: Harlan
authors.initials: H
authors.lastname: Rumjahn
authors.affiliation: Madigan Army Medical Center, 9040 Fitzsimmons Drive, ATTN: MCHJ-CLG, Tacoma, WA 98431.
authors.forename: Joren
authors.initials: J
authors.lastname: Keylock
authors.affiliation: Madigan Army Medical Center, 9040 Fitzsimmons Drive, ATTN: MCHJ-CLG, Tacoma, WA 98431.
authors.forename: Michael
authors.initials: M
authors.lastname: Chinn
authors.affiliation: Madigan Army Medical Center, 9040 Fitzsimmons Drive, ATTN: MCHJ-CLG, Tacoma, WA 98431.
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Chow
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy / Q000379:methods; D006063:Chorionic Gonadotropin / Q000097:blood*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000175:diagnosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin