Comparison of the Diagnostic Accuracy of Pipelle Endometrial Sampling with Dilatation and Curettage in Cases of Abnormal Uterine Bleeding in Perimenopausal and Post Menopausal Women

BACKGROUND: Endometrial sampling for histopathology is important in the assessment of abnormal uterine bleeding. Aim of the study is mainly to compare the diagnostic accuracy of the pipelle device in acquiring an adequate and representative sample from the endometrium in perimenopausal and postmenopausal women. METHOD: An observational clinical correlation diagnostic study of 100 patients in perimenopausal and postmenopausal age group women with abnormal uterine bleeding carried out in the Department of Obstetrics and Gynecology,. Endometrial sampling with Pipelle curette was performed in 100 patients before giving anaesthesia followed by Dilatation and curettage. The histopathology reports of both samples were compared. RESULTS: 96 %of the samples obtained by conventional DandC, while 93 % of the samples obtained by the pipelle device were adequate for histopathological examination. In this study the pipelle device had 100 % sensitivity, 100 % specificity and 100 % accuracy for diagnosing endometrial hyperplasia and endometrial carcinoma. Both pipelle and DandC failed to detect polyps. The adequacy and diagnostic accuracy of Pipelle in comparison with DandC is with sensitivity of 96.88 %, specificity of 100 %, PPV of 100 % and NPV of 57.14 %. CONCLUSION: The Pipelle sampling can be considered as a first line investigation for getting an adequate endometrial sample and high sensitivity and specificity for the detection of hyperplasia and malignancy. Thus Pipelle has an added advantage of no anesthesia or other procedural complications compared to DandC.