The accuracy of endometrial Pipelle sampling with and without sonographic measurement of endometrial thickness

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 82; no. 5; p. 727
• Main Authors: Goldchmit, R, Katz, Z, Blickstein, I, Caspi, B, Dgani, R
• Format: Journal Article
• Language: English
• Published: United States 01.11.1993
• Subjects: Adult; Aged; Biopsy - instrumentation; Endometrial Hyperplasia - diagnostic imaging; Endometrial Hyperplasia - pathology; Endometrium - diagnostic imaging; Endometrium - pathology; Female; Humans; Menopause; Middle Aged; Predictive Value of Tests; Prospective Studies; Sensitivity and Specificity; Ultrasonography
• ISSN: 0029-7844

To evaluate the accuracy of Pipelle endometrial sampling with and without sonographic measurement of endometrial thickness. We studied prospectively 176 consecutive patients (23% after and 77% before menopause) scheduled for D&C. Sonographic measurement of the endometrium and endometrial biopsy with the Pipelle were performed before the curettage. In 159 cases (90%), the endometrial histologic results of curettage agreed with those of the Pipelle biopsy. All three cases of endometrial cancer were identified by Pipelle aspiration. In seven cases (4%), the Pipelle aspiration failed to detect hyperplasia. Sonographic endometrial thickness of more than 5 mm slightly increased the sensitivity and slightly decreased the specificity of Pipelle aspiration from 82 to 92% and from 99 to 96%, respectively. In postmenopausal patients admitted for bleeding, the sensitivity and specificity reached 100%. Our data suggest that normal Pipelle aspirates in premenopausal patients with abnormal uterine bleeding are highly accurate. In postmenopausal patients with sonographic endometrial thickness of 5 mm or less, the accuracy reached 100%.