title: Patient and provider factors associated with endometrial Pipelle sampling failure.
abstract: OBJECTIVE
  To explore risk factors associated with sampling failure in women who underwent Pipelle biopsy.
  
  
  METHODS
  A consecutive sample of 201 patient records was selected from women who underwent Pipelle biopsy procedures for suspected uterine pathology in a large healthcare system over a 6-month period (January 2013 through June 2013). Personal and medical data including age, BMI, gravidity and parity, and previous history of Pipelle biopsy were abstracted from medical records for each patient. Logistic regression analyses were used to determine factors associated with biopsy sampling failure.
  
  
  RESULTS
  Pipelle biopsy sampling failed in 46 out 201 women (22.89%), where 8 (17.39%) were due to inability to access the endometrium, 37 (80.43%) were inadequate samples, and 1 (2.18%) was due to unknown reasons. Personal and medical factors found to be related to sampling failure included: postmenopausal bleeding as biopsy indication (OR 7.41, 95% CI 2.27-24.14); history of prior biopsy failure (OR 23.87, 95% CI 3.76-151.61); and provider type (physician vs. midlevel provider) (OR 9.152, 95% CI 2.49-33.69).
  
  
  CONCLUSIONS
  We identified several risk factors for biopsy failure that suggest the need for particular care with Pipelle sampling procedures among women with certain characteristics, including postmenopausal bleeding and a history of prior failed Pipelle biopsy. Our finding of a significantly higher risk of sampling failure based on personal and clinical data suggests that providers must take into account additional considerations to improve sampling success.
authors.affiliation: University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Graduate School of Public Health, 130 De Soto St, Pittsburgh, PA 15261, United States. Electronic address: SHA70@pitt.edu.
authors.forename: Shalkar
authors.initials: S
authors.lastname: Adambekov
authors.affiliation: University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, 3380 Boulevard of the Allies, 300 Halket Street, Pittsburgh, PA 15213, United States.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Goughnour
authors.affiliation: University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, 3380 Boulevard of the Allies, 300 Halket Street, Pittsburgh, PA 15213, United States.
authors.forename: Suketu
authors.initials: S
authors.lastname: Mansuria
authors.affiliation: University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, 3380 Boulevard of the Allies, 300 Halket Street, Pittsburgh, PA 15213, United States.
authors.forename: Nicole
authors.initials: N
authors.lastname: Donnellan
authors.affiliation: University of Pittsburgh School of Medicine, Department of Pathology, 300 Halket Street, Pittsburgh, PA 15213, United States.
authors.forename: Esther
authors.initials: E
authors.lastname: Elishaev
authors.affiliation: University of Pittsburgh School of Medicine, M240 Scaife Hall, 3550 Terrace St, Pittsburgh, PA 15261, United States.
authors.forename: Hugo J
authors.initials: HJ
authors.lastname: Villanueva
authors.affiliation: University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, 3380 Boulevard of the Allies, 300 Halket Street, Pittsburgh, PA 15213, United States; University of Pittsburgh Cancer Institute, 5150 Centre Ave, Pittsburgh, PA 15232, United States.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Edwards
authors.affiliation: University of Pittsburgh Cancer Institute, 5150 Centre Ave, Pittsburgh, PA 15232, United States; University of Pittsburgh School of Medicine, Department of Psychiatry, 3811 O'Hara St, Pittsburgh, PA 15213, United States.
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
authors.affiliation: University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, Graduate School of Public Health, 130 De Soto St, Pittsburgh, PA 15261, United States; University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, 3380 Boulevard of the Allies, 300 Halket Street, Pittsburgh, PA 15213, United States; University of Pittsburgh Cancer Institute, 5150 Centre Ave, Pittsburgh, PA 15232, United States.
authors.forename: Faina
authors.initials: F
authors.lastname: Linkov
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D012307:Risk Factors; D013048:Specimen Handling / Q000009:adverse effects*
keywords: Endometrial cancer; Pipelle failure