DIAGNOSTIC ADEQUACY AND HISTOLOGICAL OUTCOME OF PIPELLE ENDOMETRIAL BIOPSIES

Abstract

Objective: To assess diagnostic adequacy and histological outcome in pipelle endometrial biopsies of the patients presenting with abnormal uterine bleeding.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Histopathology department, Army Medical College Rawalpindi, from Jan to Dec 2018.

Methodology: A total of 220 cases, which presented with abnormal uterine bleeding and underwent endometrial pipelle biopsy were included in the study. The biopsies were evaluated in terms of material adequacy and histopathological outcome. Cases with bleeding due to complications of pregnancy, cervical pathologies and lower genital tract infections were excluded. Statistical analysis was done using SPSS version 22.

Results: Out of 220 pipelle biopsies, 65 (29.54%) were inadequate for assessment while 155 (70.45%) were adequate to make a definitive diagnosis on histological examination. Among the diagnostic samples, chronic endometritis was the most common pattern observed, seen in 70 cases (45.16%). Other histological patterns included proliferative endometrium (29.03%), secretory endometrium (9.03%), exogenous hormone effect (7.10%), endometrial hyperplasia (3.87%), atrophic endometrium (4.51%) and endometrial carcinoma (1.29%).

Conclusion: Pipelle biopsy is not as successful in our setup as it is in the developed countries. This technique can be used as an initial procedure in patients with abnormal uterine bleeding, however, in patients with high risk of malignancy where pipelle biopsy is inadequate, dilation and curettage is recommended instead of repeating pipelle biopsy to get adequate material for a definite diagnosis.