Comparison Between Pipelle Endometrial Sampling and Dilatation and Curettage Among Women with Abnormal Uterine Bleeding

Background and objectives: Abnormal uterine bleeding is one of the most widespread gynecological complaints that necessitate endometrial biopsy. Obtaining a sufficient specimen allowing a histopathological diagnosis is as important as patients' safety. The purpose of the study was to compare the efficiency of pipelle device to dilatation and curettage in obtaining high-quality endometrial tissue for histopathological analysis. Methods: A prospective cohort study of 57 patients presented with Abnormal uterine bleeding from June 1st, 2022 to June 1st, 2023. The endometrial sampling was accomplished using the pipelle gadget without first performing cervical dilatation. The same patient then underwent conventional Dilatation and Curettage to obtain a second sample. The Dilatation and curettage report was used as a reference when comparing the Pipelle sample's histopathology reports to those of the Dilatation and curettage sample. Results: The pipelle’s sensitivity was 81.3%, specificity was 100%, with a 100% positive predictive value which makes the accuracy 94.7% in diagnosing secretory endometrium. Furthermore, for proliferative endometrium, it showed a sensitivity, specificity, PPV, and NPV of 100%,98.1%, 75%, and 100% respectively making the accuracy 96.5%. while for hyperplasia without atypia and disordered endometrium, the accuracy was 98.2%. The analysis showed that the histopathology results of the pipelle were in concordance with the results obtained by Dilatation and Curettage, with a p-value of less than 0.001. Conclusion: The results obtained by pipelle are almost as accurate as Dilatation and curettage, so it can be used in the first-line diagnosis of endometrial biopsy.