Assessment of the Predictability of Pipelle Biopsy in Detecting Endometrial Pathology

Abstract

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.