Citation Information :
Jain U, Kalra R, Ghanghoria S, Jain D. Study of Usefulness of Endometrial Pipelle Biopsy Procedure in an Endometrial Sampling of Abnormal Uterine Bleeding. J South Asian Feder Menopause Soc 2018; 6 (2):83-87.
Introduction: Abnormal bleeding from uterus is a commonly encountered complaint in gynecological practice. As per the National Health Portal report of India (2017) prevalence of AUB is 17.9%. A Gynae Endocrine Society of India (GESI) initiative in collaboration with Endocrine Committee of Association of Obstetrics and Gynecologists of India recommended that endometrial aspiration is preferred procedure for taking endometrial sample for histopathology examination in place of Dilatation and curettage. D&C should not be the procedure of choice for endometrial assessment.
Methodology: A retrospective analysis was done of the abnormal uterine bleeding (AUB) cases who underwent endometrial biopsy using pipelle procedure. The duration of study was from January 2016 to December 2017 at the Private Hospital Clinic of Shivpuri, Madhya Pradesh. Those women who had complaints of AUB were included and as per the recommended protocol for AUB management by GESI required endometrial sampling. Case records of patients those who had undergone endometrial biopsy by pipelle procedure were analyzed. The procedure was “successful” if the cervical os was negotiated successfully and even if after three attempts failed to negotiate cervix it was a “failure.”
Result: Of the total 230 cases attempted for pipelle procedure, 227 cases (98.69%) were successful. The 98% cases the sample obtained was satisfactory. 41.40% of cases were in the age group of 30-40 years. Maximum cases (44.49%) were para 3. Rural cases were 78.41% of the total cases. The presenting symptoms majority were menometorrhagia (49.33%). Histopathology reports were negative for malignancy (60.79%). Hyperplasia without atypical (12.33%) positive suspicious for malignant tumor (0.44%) atrophic endometrium (4.40%) endometrits (9.69%).
Conclusion: Pipelle biopsy procedure is a simple, easy, patient friendly technique to obtain endometrial biopsy on the outpatient basis without need of patient admission and anesthesia
Fraser IS, Langham S, et al. Health-related quality of life and economic burden of abnormal uterine bleeding. Expert Rev Obstet Gynecol 2009;4:179-189.
Shapley M, Jordan K, et al. An epidemiological survey of symptoms of menstrual loss in the community. Br J Gen Pract 2004;54:359-363.
Rastogi A. Abnormal uterine bleeding. National Health Portal Jul 28 2017 https://www.nhp.gov.in/disease/gynaecology-and-obstetrics/abnormal-uterine-bleeding. (Date assessed 17/3/2018).
Munro MG, Critchley HO, et al. The FIGO Classification of causes of abnormal uterine bleeding in the reproductive years. Feritility Sterility 2011;95(7):2204-2208.
Kriplani A, Agarwal N. Management of abnormal uterine bleeding in reproductive period. Evidence based clinical practice Recommendations for Indian women A gynae endocrine society of India (GESI)initiative in collaboration with Endocrine committee of Association of Obstetrics and Gynecologists of India. www.fogsi.org/wp-content/uploads/2016/02/gcpr-on-aub.pdf.
Yanoh K, Norimatsu Y, et al. New diagnostic reporting format for endometrial cytology based on cytoarchitectural criteria. Cytopathology 2009;20(6):388-394.
Fakhar S, Saeed G, et al. Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding. Ann Saudi Med 2008;28(3).
Abdelazim IA, Aboelezz A, et al. Pipelle endometrial sampling versus conventional dilatation & curettage in patients with abnormal uterine bleeding. J Turkish-German Gynecol Assoc 2013; 14:1-5.
Rezk M, Sayyed T, et al. The effectiveness and acceptability of pipelle endometrial sampling versus classical dilatation and curettage: A Three-Year Observational Study. Gynecol Obstet Invest 2016;81:537-542.
Choudry A, Javaid M. Clinical usefulness of pipelle endometrial sampling. Pakistan Armed Forces Medical Journal 2005;55:122-125.
Alliratnam AS, Priya SS, et al. Diagnostic value of pipelle endometrial sampling in comparison with dilatation and curettage among patients with abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol 2016;5(3):864-867.
Hung GS, Gebb JS, et al. Accuracy of preoperative endometrail sampling for detection of high grade endometrial tumors. Am J Obstet Gynaecol 2007;196(3):243.1-5.
Machado F, Moreno J, et al. Accuracy of Endometrial Biopsy with the Cornier Pipelle for diagnosis of endometrial cancer and atypical hyperplasia. Eur J Gynaecol Oncol 2003;24:279-281.
Dijkhuizen FP, Mol BW, et al. The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer 2000;89(8):1765-1772.
