Diagnostic value of pipelle endometrial sampling in comparison with dilatation and curettage among patients with abnormal uterine bleeding
A S Alliratnam, S Senthil Priya,R Shankar
Background : Dilatation and curettage (D and C) is the gold standard for endometrial sampling, but 60 percent of cases less than half of the uterine cavity is curetted, with the added risk of general anesthesia, infection and perforation, whereas pipelle does not require a syringe or pump nor require general anesthesia or cervical dilatation and permits almost painless endometrial sampling. Aims and Objectives: 1. Determine the reliability of pipelle device in acquiring an adequate and representative endometrial sample comparing to D and C 2. Comparing the result of histopathological diagnosis of pipelle sampling with D and C. Methodology: A cross-sectional study was done at Vinayaka Missions Medical College Salem between September 2014 - August 2015. Hundred (100) cases of abnormal uterine bleeding (AUB) attending the outpatient clinic in the department of obstetrics and gynecology were included in the study. Endometrial sampling with pipelle device was performed in 100 patients followed by formal D and C. Results: For obtaining the endometrial sample the sensitivity of pipelle sampling was 97 percent and the specificity was 100 percent when compared with D and C sampling. The diagnosis made by the histopathological examination (HPE) report by the sample obtained from pipelle sample had shown a very high sensitivity, specificity, positive predictive value and negative predictive value, except for the diagnosis of endometrial polyp which the pipelle sample was not able to detect. Conclusion: The pipelle is a safe technique of endometrial biopsy for getting an adequate endometrial sample for histopathology, with high sensitivity and specificity for endometrial pathologies and endometrial carcinoma.