Diagnostic accuracy of office based endometrial biopsy when compared with subsequent findings of dilatation and curettage in patients with abnormal uterine bleeding in age group of 25 to 45 years

Background: Endometrial sampling is considered the gold standard method for assessing Abnormal uterine bleeding (AUB). The primary objective of this study was to assess the diagnostic accuracy of office based endometrial biopsy using Pipelle method when compared with subsequent findings of Dilatation and Curettage (D&C) which is an inpatient procedure and to make a comparative analysis between these two approaches. Methods: This was a prospective study carried out in the Department of Obstetrics and Gynaecology of Dr. Babasaheb Ambedkar Memorial Hospital, Central Railway, Mumbai over a period of one year on 100 gynaecological patients with one or more than one episode of abnormal uterine bleeding. Pipelle endometrial biopsy was taken on OPD basis and patients were subjected to D&C subsequently. Endometrial samples obtained using both methods then sent to the Department of Pathology for adequacy of sample and for histopathological analysis. Results: In my study, I got adequate sample in 100% of cases of D&C whereas with pipelle, one sample was inadequate. Sensitivity, specificity, positive and negative predictive value of pipelle for diagnosing atrophic endometrium, secretory phase endometrium, simple endometrial hyperplasia was 100% and for proliferative phase endometrium it was 99% when compared with that of D&C. Conclusions: Endometrial sampling by suction curette device is an inexpensive, safe OPD procedure that appears to be a feasible alternative to more invasive procedure like D&C for evaluation of patients with abnormal uterine bleeding in reproductive and premenopausal patients.