scholarly journals A Comparison of Pipelle Endometrial Biopsy with Dilatation and Curettage for Evaluation of Endometrial Pathology in Abnormal Uterine Bleeding

2020 ◽  
Vol 7 (21) ◽  
pp. 1024-1028
Author(s):  
Sunitha Mary Mathew
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Dilatation And Curettage ◽  
Endometrial Pathology

scholarly journals A prospective study on the efficacy of Pipelle biopsy to diagnose endometrial pathology in patients with abnormal uterine bleeding

2019 ◽  
Vol 8 (11) ◽  
pp. 4238
Author(s):  
Sunitha Mary Mathew ◽  
Pramod Thomas
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Atypical Hyperplasia ◽  
Focal Lesions ◽  
Endometrial Sampling ◽  
Endometrial Pathology

Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability.Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology.Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report.Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.

scholarly journals Study of endometrial histopathology in women with abnormal uterine bleeding

2017 ◽  
Vol 6 (3) ◽  
pp. 824
Author(s):  
Ushadevi Gopalan ◽  
Sathiyakala Rajendiran ◽  
Karnaboopathy Ranganathan
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Dilatation And Curettage ◽  
Proliferative Endometrium ◽  
A Prospective Study ◽  
Secretory Endometrium

Background: Abnormal uterine bleeding is a major gynaecological problem accounting for 33% of Gynaec outpatients. The cause of the bleeding is established in only 50-60% of the cases. The aim of this study was to evaluate the various histopathological patterns in the endometrial biopsy of patients presenting with abnormal uterine bleeding and to determine the specific pathology in the different age groups.Methods: This was a prospective study done in a tertiary care teaching hospital for a period of 2 years. Total of 905 patients with abnormal uterine bleeding were included in the study and they were subjected to a Dilatation and Curettage. Histopathological examination of the endometrial biopsy was done and the various histopathological patterns identified and classified.Results: The age of patients ranged from 24-74 years. 54.7% were in the age group 40-49 years followed by 23.4% in the age group 30-39 years. The most frequent findings were proliferative findings in 47.3% followed by secretory endometrium in 16.1 % patients. Proliferative endometrium was more common in the age group 40-49 years as also disordered proliferation, secretory endometrium, cystoglandular hyperplasia and endometrial hyperplasia.Conclusions: Endometrial curettings and biopsy is an important diagnostic procedure for assessing all cases of abnormal uterine bleeding and to plan for successful management.

scholarly journals Pipelle Endometrial Biopsy vs Dilatation and Curettage to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding

2017 ◽  
Vol 5 (2) ◽  
pp. 123-128
Author(s):  
Nikhitha Chandrashekar ◽  
Jyothi GS ◽  
Prasanna Shetty
Keyword(s):  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Histopathological Analysis ◽  
Care Hospital ◽  
Dilatation And Curettage ◽  
Risk Of Cancer

ABSTRACT Aim The objective of this study was to assess the adequacy of the sample aspirated in order to make a definite diagnosis of endometrial disease in abnormal uterine bleeding (AUB) and to draw comparisons between the histopathological findings of Pipelle endometrial aspiration biopsy and dilatation and curettage (D&C). Materials and methods Pipelle endometrial biopsy and D&C samples were collected from 100 patients with AUB in the Department of the Obstetrics and Gynecology and sent to the Department of Pathology of a tertiary care hospital for adequacy of the sample and for histopathological analysis. Results The Pipelle sample was adequate in 73% of the cases and inadequate in 27% compared with D&C, which showed 85% and 15%, respectively. About 53% of cases were comparable between D&C and Pipelle and 37% were discordant. For endometrial hyperplasia using Pipelle aspirator, the sensitivity was 58.8%, specificity was 91.6%, positive predictive value (PPV) was 58.8%, negative predictive value (NPV) was 91.6%, and concordance was 86%. For detection of endometrial carcinoma using Pipelle, the sensitivity was 50%, specificity was 99%, PPV was 50%, NPV was 99%, and concordance rate was 98%. Conclusion It is more convenient and cost-effective for patients to undergo pipelle biopsy to confirm normalcy and rule out endometrial hyperplasia rather than undergoing D&C initially. Out of the 27% of inadequate samples, 14.8% had fibroids and 11.1% had polyps, thus showing that tumors localized to a polyp or a small area of endometrium went undetected with Pipelle. Clinical significance Due to the high specificity and NPV and low sensitivity and PPV in diagnosing endometrial lesions and carcinomas, pipelle is suitable for women with a low risk of cancer. In cases where the diagnosis is hyperplasia on Pipelle, the patients are advised to undergo hysteroscopic-guided D&C following pipelle to confirm the diagnosis. This is also applicable for cases of polyps and fibroids. How to cite this article Chandrashekar N, Jyothi GS, Shetty P. Pipelle Endometrial Biopsy vs Dilatation and Curettage to Diagnose Endometrial Diseases in Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc 2017;5(2):123-128.

scholarly journals Retrospective study of histopathological pattern of endometrium in abnormal uterine bleeding

2020 ◽  
Vol 9 (4) ◽  
pp. 1346
Author(s):  
A. Shantha ◽  
Nazia Hussain
Keyword(s):  
Retrospective Study ◽  
Social Life ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Dilatation And Curettage ◽  
Proliferative Endometrium ◽  
Considerable Morbidity

Background: Abnormal uterine bleeding (AUB) is a common gynaecological complaint associated with considerable morbidity. It significantly affects the patient’s family personal and social life. The aim of this study was to analyse the histopathological patterns of endometrium in patients presenting with AUB.Methods: This is a retrospective study conducted in the teaching hospital in the department of obstetrics and gynecology along with the pathology department. All patients with AUB were included in the study. This study of 138 samples both from hysterectomy specimens and endometrial biopsy were included.Results: The specimen obtained for examination of the endometrial samples 86 comprised from dilatation and curettage and rest 52 samples were obtained from hysterectomy specimens. Most common histopathological pattern was found to be proliferative endometrium, followed by disordered proliferative endometrium and atropic endometrium.Conclusions: Study of the histopathological pattern of the endometrial biopsies can be included in the initial evaluation of women with AUB when the cause of bleeding is not known along with ultrasound examination, then using it as the last modality for diagnostic and therapeutic purposes, irrespective of age group.

scholarly journals A comparative study to evaluate endometrial aspiration using Karman’s cannula versus dilatation and curettage in cases of abnormal uterine bleeding

2020 ◽  
Vol 9 (3) ◽  
pp. 1218
Author(s):  
Neetu Sangwan Tomar ◽  
Seerat Sandhu ◽  
Supriya Mahipal ◽  
Abhimanyu Chaudhary
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Aspiration Biopsy ◽  
Age Group ◽  
Vacuum Aspiration ◽  
Dilatation And Curettage ◽  
Normal Menstrual Cycle ◽  
Endometrial Pathology

Background: Abnormal uterine bleeding (AUB) is defined as any variation from the normal menstrual cycle such as changes in regularity, frequency, duration of flow or amount of flow. Objective of this study was to compare the adequacy and diagnostic accuracy of endometrial aspiration using Karman’s cannula versus dilatation and curettage in women with abnormal uterine bleeding.Methods: This prospective study was conducted on 250 women with AUB in age group of more than 40 years. In all patients, endometrial aspiration was done with manual vacuum aspiration (MVA) syringe attached to 4 mm Karman's cannula without anesthesia. The sample was collected in a bottle containing formalin and was labelled as sample A. After that, intracervical local anesthesia (1% Xylocaine) was given and cervix was dilated and scrapping of endometrial lining with sharp curette was done. The sample was also collected in a bottle containing formalin and was labelled as sample B. Both the samples A and B were sent for histopathology. The histopathology report of aspiration was compared with that of dilatation and curettage sample.Results: Endometrial aspiration biopsy had sensitivity of 92.3%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.56% for diagnosis of endometrial pathology while considering D and C gold standard. The sample adequacy of endometrial aspiration was 98.8% as compared to dilatation and curettage (98%).Conclusions: Present study showed that endometrial aspiration biopsy is an alternate to traditional dilatation and curettage in diagnosing endometrial pathologies in women with abnormal uterine bleeding.

scholarly journals ABNORMAL UTERINE BLEEDING

2011 ◽  
Vol 18 (04) ◽  
pp. 587-591
Author(s):  
SARWAT ARA ◽  
MAHNAZ ROOHI
Keyword(s):  
Significant Role ◽  
Pregnancy Complications ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Dysfunctional Uterine Bleeding ◽  
Bleeding Pattern ◽  
Dilatation And Curettage ◽  
Organic Lesions

Background: Abnormal uterine bleeding is one of the most frequent conditions in gynecology. Hysteroscope & plastic devices for outdoor endometrial biopsy are gaining popularity but in our setup traditional dilatation and curettage play significant role in diagnosis of abnormal uterine bleeding. Objective: To detect different histopathological findings in abnormal uterine bleeding by conventional dilatation and curettage. Design: Descriptive Period: From December 2002 to March 2005.Setting: Department of obstetric & gynecology Unit-I Allied Hospital, Faisalabad, under the guidance of Professor Mahnaz Roohi. Results: 161 patients with abnormal uterine bleeding divided into adolescent, reproductive and peri-menopausal age groups. Maximum 59.02% patients with abnormal uterine bleeding were perimenopausal. Menorrhagia 49.06% was commonest bleeding pattern. Histopathological reports revealed 62.11% dysfunctional uterine bleeding, 21.73% organic lesions and 16.16% pregnancy complications. Complications occurred only in 0.62%.Conclusion: Dilatation and curettage is a safe & successful procedure for detecting intrauterine pathologies in abnormal uterine bleeding. 

scholarly journals Correlation of Clinical Presentations with Endometrial Pathologies in Women Presenting with Abnormal Uterine Bleeding. A Prospective Descriptive Study

2018 ◽  
Vol 3 (1) ◽  
pp. 354-356
Author(s):  
Pritha Basnet ◽  
Achala Thakur ◽  
Ajay Agrawal ◽  
Sangeeta Bhandari ◽  
Sarita Sitaula ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Descriptive Study ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Sampling ◽  
Presenting Symptoms ◽  
Clinical Presentations ◽  
Proliferative Endometrium ◽  
Diagnostic Step ◽  
Endometrial Pathology

Introduction: Abnormal uterine bleeding (AUB) is one of the common presenting symptoms in women attending gynaecology outpatient department and has remained one of the most frequent indications for hysterectomy in developing countries. Endometrial sampling is used as the first diagnostic step in AUB.Objectives: To correlate the clinical presentations with endometrial pathologies in women presenting with abnormal uterine bleeding.Methodology: This was a hospital based descriptive study carried out on one hundred and nineteen women who presented with AUB and planned for endometrial biopsy. Clinical profile of the patient was recorded and the histopathology of the sampled endometrial tissue was retrieved. Correlation of abnormal uterine bleeding with histopathology report was done using appropriate statistical test.Results: The mean age of presentation of women with abnormal uterine bleeding was 46.56 yrs ± 9.525. Irregular menstrual cycle was the commonest reason seeking treatment for AUB. The commonest histopathology among women who underwent endometrial biopsy was secretory endometrium (39.5%). Other causes identified were proliferative endometrium (21.8%), mucus flakes with hemorrhage (16%), disordered proliferative endometrium (10%), pill endometrium (5%) ,endometritis (5.9%), endometrial carcinoma (1.7%),endometrial hyperplasia without atypia (1.7%).Conclusion: The nature of endometrial pathology is varied across the entire spectrum of women presenting with abnormal uterine bleeding. Knowledge of endometrial pathology helps in directing specific management and can provide better care to women presenting with abnormal uterine bleeding. BJHS 2018;3(1)5 : 354-356

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