Comparison between Hysteroscopy, Pipelle and Dilatation and Curettage in Abnormal Uterine Bleeding

Background: Among cancer patients in their later reproductive years, abnormal uterine bleeding (AUB) is a prevalent and life-threatening complication. Endometrial illnesses are more common in women over the age of 40, and many medical professionals recommend doing a biopsy on any woman whose uterine bleeding is out of the ordinary if she is at least that old. Aim and objectives: In order to evaluate the efficacy, risks, and time required for endometrial biopsies in patients with AUB, we compared three different diagnostic endometrial sample techniques: office hysteroscopy, pipelle with dilatation, and curettage (D&C). Patients and methods: The obstetrics and gynaecology outpatient clinic at Al-Hussein University Hospital served as the site of this cross-sectional investigation. From July 2023 through July 2024, sixty women whose uterine haemorrhage was abnormal were studied. Three groups were randomly assigned to the patients: Twenty participants were randomly assigned to three groups: A, which underwent office hysteroscopy, B, which underwent Pipelle endometrial sample, and C, which underwent D&C biopsy. Results: The study showed that there was strong Kappa agreement between endometrial curettage and hysteroscopy in detection of endometritis, Kappa=1, sensitivity of hysteroscopy reached 100%, while specificity reached 100%. Conclusion: This study supports the use of office hysteroscopy and Pipelle biopsy as accurate and less invasive alternatives to D&C in the evaluation of women with AUB. These methods showed high concordance with D&C across various endometrial pathologies, suggesting they could be reliably used as first-line diagnostic tools in many cases, potentially reserving D&C for situations where these less invasive methods are inconclusive or additional intervention is required.