Comparison of Diagnostic Efficacy of Pipelle Endometrial Biopsy with Dilatation and Curettage in Patients with Abnormal Uterine Bleeding

2020 ◽  
Vol 7 (34) ◽  
pp. 1789-1793
Author(s):  
Alka Murlidhar Patankar ◽  
Sushma Suresh Nitnaware
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Diagnostic Efficacy ◽  
Dilatation And Curettage

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 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 Histopathological pattern of endometrial samples in abnormal uterine bleeding

1970 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
R Baral ◽  
S Pudasaini
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Physiological Changes ◽  
Biopsy Material ◽  
Histological Pattern ◽  
Biopsy Specimens ◽  
Histological Characteristics

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16

Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

2004 ◽  
Vol 128 (9) ◽  
pp. 1000-1003 ◽  
Author(s):  
Ilene B. Bayer-Garner ◽  
Jennifer A. Nickell ◽  
Soheila Korourian
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Chronic Endometritis ◽  
Underlying Malignancy ◽  
Proliferative Endometrium ◽  
Exogenous Progesterone ◽  
Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

scholarly journals Hysteroscopic evaluation in infertility and abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 612
Author(s):  
Navneet Kaur ◽  
Ruby Bhatia ◽  
Paramjit Kaur ◽  
Surinder K. Bhopal
Keyword(s):  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Therapeutic Modality ◽  
Secondary Infertility ◽  
Endometrial Polyps ◽  
Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

scholarly journals Histo-Pathological Study of Endometrial Biopsies in Patients With Abnormal Uterine Bleeding

2017 ◽  
Vol 15 (2) ◽  
pp. 26-31
Author(s):  
Sharmila Parajuli ◽  
Binita Thapa
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
The Elderly ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Common Cause ◽  
Histopathological Findings ◽  
Common Sign ◽  
Work Up

Introduction: Abnormal uterine bleeding is a common sign of a number of different uterine disorders ranging from dysfunctional (non organic) abnormalities or complications of pregnancy to organic lesions such as polyps, hyperplasia or carcinoma. Methods: This is a retrospective study conducted at Hospital of 2nd author during a period of 5 years (Jan 2008-Dec 2013).  Histopathology records were retrieved and searched for cases of abnormal uterine bleeding. Relevant histopathological findings and clinical data were recorded and analyzed. The aim of the study was to determine the causes for abnormal uterine bleeding in women presenting to the hospital and to compare the histopathological findings at various age groups.Results: The age of patients ranged from 17 to 71 years with an average of 43 years. The most common cause of uterine bleeding was found to be proliferative phase endometrium; that were 649 cases (56.43%). Out of the pathological causes, the most common cause was found to be endometrial hyperplasia- 44 cases (3.82%). Endometrial carcinoma was found to be more common in the elderly postmenopausal women. A total of 6 cases (0.5%) of endometrial carcinoma were present.Conclusion: Endometrial hyperplasias and malignancies are common in increasing age group, especially in perimenopausal and postmenopausal women. So, a thorough work-up and diagnostic endometrial biopsy is therefore mandatory without delay in these patients to rule out malignancies. 

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