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

Obstet Gynecol. 1993 Nov;82(5):727-30.

Abstract

Objective: To evaluate the accuracy of Pipelle endometrial sampling with and without sonographic measurement of endometrial thickness.

Methods: 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.

Results: 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%.

Conclusions: 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%.

Publication types

  • Comparative Study

MeSH terms

  • 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