Journal of Emergency Health Care
Formerly known as: International Journal of Medical Investigation
Volume 7, Issue 1 (3-2018)
J Emerg Health Care 2018, 7(1): 56-67 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Gelini Moghaddam T, Hedayatifar F, Nouri B. Comparing The Pipelle With Dilatation And Curettage (D&C) In Diagnostic Power Of Sampling For Evaluating The Patients With Abnormal Uterine Bleeding. J Emerg Health Care 2018; 7 (1) :56-67
URL: http://intjmi.com/article-1-303-en.html
URL: http://intjmi.com/article-1-303-en.html
Department of Obstetrics & Gynecology, Mazandaran University of Medical Science, Sari, Iran.
Abstract: (7919 Views)
Introduction: Abnormal uterine bleeding is a common and serious problem in the women of late reproductive age, and an indication for biopsy. Common diagnostic methods in Iran including the endometrial biopsy with dilatation and curettage (D&C) are the gold standard for diagnosis. The aim of this study is to compare the diagnostic power, complications, and duration of endometrial biopsy caused by two diagnostic methods of endometrial sampling of pipelle with dilatation and curettage (D&C) in patients with AUB. Methods: This single blinded- parallel randomized clinical trial was performed at the Iranian Center for Clinical Trials (IRCT). The research population is the patients referring to the specialized clinic of Mostafavian and Baghban 1 in Sari with complaints of AUB from October 2016 to September 2018. The patient selection was available for study. The patients were divided in simple random method into two groups of D&C and pipelle alternatively. The samples were sent to pathology after sampling, and when sampling is done, the patient was examined for complications such as uterine bleeding or vasovagal shock symptoms for the cervical stimulation, then, the results were compared with D&C, and also it was compared with the sample histopathologically. Findings: A number of 70 patients were included, while many of which were excluded, and finally 50 patients were completed the study. First, the biopsy with pipelle and then biopsy with D&C were performed on all the patients. The mean age of subjects was 47.5 years old. The highest number of patients (28%) was in the 40-45 group. The mean thickness of the endometrium in patients was 11.5 mm. In the pipelle group, 34% of the cases of insufficient samples were obtained, while using the biopsy, only 4% of the insufficient samples are obtained. A total of 23 samples from 50 patients undergoing pathologic diagnosis were obtained from two similar sampling methods. In the pipelle group, the insufficient sample with 34% proliferative, and then the secretion and proliferative samples were the second and third (prophylactic and secretion pathology are considered as normal tissues that was calculated 56% in this study) in the diagnosis, and accommodation of the pipelle and D&C samples in proliferative has allocated the highest percentage of 9%, and the lowest accommodation was in the in atrophy and polyps and hyperplasia. The average duration of the procedure in the pipelle group was significantly lower than D&C. The pain was significantly higher in pipelle group than D&C (P <0.05). Conclusion: Pipelle is a cheap, fast, outpatient method with low side effects without the use of anesthesia and operating room facilities for diagnosis of hyperplasia and cancer with lower susceptibility to D&C. In the D&C with acceptable susceptibility and specificity, the pain was lower, number of insufficient samples was lower, and diagnosis of polyps was higher.
References
1. 1.Antoni J, Folch E, Costa J, Foradada CM, Cayuela E, Combalia N, et al. Comparison of cytospat and pipelle endometrial biopsy instruments. European Journal of Obstetrics & Gynecology and Reproductive Biology. 1997;72(1):57-61.2.Esmaeilivand M, Mohammadi M, Khatony A, Najafi F. Comparison of DialysisAdequacy in Permanent Catheter, Fistula, and Graft Vascular Access Types. Journal of Babol University Of Medical Sciences. 2016;18(3):14-8.3.Rauf R, Shaheen A, Sadia S, Waqar F, Zafar S, Sultana S, et al. Outpatient endometrial biopsy with Pipelle vs diagnostic dilatation and curettage. J Ayub Med Coll Abbottabad. 2014;26(2):145-8.4.Rezk M, Sayyed T, Dawood R. The Effectiveness and Acceptability of Pipelle Endometrial Sampling versus Classical Dilatation and Curettage: A Three-Year Observational Study. Gynecol Obstet Invest. 2016.5.Z. Ghanbari, B.Hajibaratali, M.Fazaeli, P. Mehdizadeh, M. Dadyar. A comparison of endometrial biopsy, transvaginal ultrasonography and dilation and curettage in diagnosis of abnormal uterine bleeding. Tehran University Medical Journal. 2006;64(3):102-8.6.Kazandi M, Okmen F,Ergenoglu A, Yeniel A, Zeybek B, Zekioglu O, et al. Comparison of the success of histopathological diagnosis with dilatation-curettage and Pipelle endometrial sampling. Journal of Obstetrics and Gynaecology. 2012;32(8):790-4.7.Gungorduk K, Asicioglu O, Ertas I, Ozdemir I, Ulker M, Yildirim G, et al. Comparison of the histopathological diagnoses of preoperative dilatation and curettage and Pipelle biopsy. European journal of gynaecological oncology. 2013;35(5):539-43.8.Liu H, Wang F-L, Zhao Y-M, Yao Y-Q, Li Y-L. Comparison of Pipelle sampler with conventional dilatation and curettage (D&C) for Chinese endometrial biopsy. Journal of Obstetrics and Gynaecology. 2015;35(5):508-11.9.Ben-Baruch G, Seidman D, Schiff E, Moran O, Menczer J. Outpatient endometrial sampling with the Pipelle curette. Gynecologic and obstetric investigation. 1994;37(4):260-2.10.Gordon S, Westgate J. The incidence and management of failed Pipelle sampling in a general outpatient clinic. Australian and New Zealand journal of obstetrics and gynaecology. 1999;39(1):115-8.11.Rezk M, Sayyed T, Dawood R. Gynecologic and obstetric investigation. 2016.12.Rachamallu L, Bhavani V, Byna P. Histological correlation of pipelle endometrial sampling with dilatation and curettage in abnormal uterine bleeding. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2015;4(5):1324-9.13.Bourdel N, Chauvet P, Tognazza E, Pereira B, Botchorishvili R, Canis M. Sampling in Atypical Endometrial Hyperplasia: Which Method Results in the Lowest Underestimation of Endometrial Cancer? A Systematic Review and Meta-analysis. Journal of minimally invasive gynecology. 2016;23(5):692-701.14.Shavit YB, Rabinovici J, Carp HJ. Abnormal Uterine Bleeding. Progestogens in Obstetrics and Gynecology: Springer; 2015. p. 93-110.15.Novak E, Berek JS. Berek & Novak's gynecology: Lippincott Williams & Wilkins; 2007.16.Hillard P. Benign disease of the female reproductive tract In: Berek J (Editor), Novak’s Gynecology. Lippincott, Williams and Wilkins; 2002.17.O'connell LP, Fries MH, Zeringue E, Brehm W. Triage of abnormal postmenopausal bleeding: a comparison of endometrial biopsy and transvaginal sonohysterography versus fractional curettage with hysteroscopy. American journal of obstetrics and gynecology. 1998;178(5):956-61.18.Saygili H. Histopathologic correlation of dilatation and currettage and hysterectomy specimens in patients with postmenopausal bleeding. European journal of gynaecological oncology. 2005;27(2):182-4.19.Alliratnam A,Shankar R. Diagnostic value of pipelle endometrial sampling in comparison with dilatation and curettage among patients with abnormal uterine bleeding. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016;5(3):864-7.
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |