Assessment of the Predictability of Pipelle Biopsy in Detecting Endometrial Pathology
Keywords:Biopsy, endometrial hyperplasia, endometritis, hysterectomy.
Objective: To assess the predictability of pipelle biopsy in detecting endometrial pathology in patients with heavy menstrual bleeding and its verification by uterine histopathology at hysterectomy.
Methods: A validation study inclusive of 50 patients, aged 35-55 years, sampled through convenience sampling technique, diagnosed with abnormal uterine bleeding and belonging to the peri-meno- pausal age group was carried out in obstetrics and gynaecology department Karachi, from January 2015 to June 2015. The patients included in the research investigation, were scheduled for hysterec- tomy, and got their endometrial sampling done through pipelle technique. The data collected were then sent for histopathology analysis. The final findings of histopathology were then verified by means of histopathology report. Patients having previous experience of D&C within the last four weeks or with uterus size greater than sixteen weeks were excluded. Inferential analysis was performed using Wilcoxon signed sum rank test. Kappa analysis was also done to measure the degree of agreement between pipelle and histopathological outcomes.
Result: The results of the study showed the mean age of sample as 45.94 ± 7.92 years. Medical his- tory for the sample has been shown and revealed that 14% of the sample had menopause. KAPPA analysis was conducted to compare the degrees of acknowledgement for histopathology and pipelle outcomes. The analysis showed that there was a 76.6% positive agreement observed in between the two techniques, with p-value results significant (<0.01). The study reported 14% cases of proliferative endometrium, while 4% cases of endometrial hyperplasia and 4% cases of endometritis and en- dometrial polyps have been diagnosed in the given sample.
Conclusion: The results of the study has shown that pipelle biopsy is a significant methodology used to assess the endometrial pathology among the patients with heavy menstrual bleeding, as verified by histopathology reports after assessment through hysterectomy.