THE ACCURACY OF ENDOMETRIAL PIPELLE SAMPLING WITH AND WITHOUT SONOGRAPHIC MEASUREMENT OF ENDOMETRIAL THICKNESS

Objective: To evaluate the accuracy of Pipelle endometrial sampling wi th and without sonographic measurement of endometrial thickness. Metho ds: We studied prospectively 176 consecutive patients (23% after and 7 7% before menopause) scheduled for D&C. Sonographic measurement of the endometrium and endometrial biopsy with the Pipelle were performed be fore the curettage.Results: In 159 cases (90%), the endometrial histol ogic results of curettage agreed with those of the Pipelle biopsy. All three cases of endometrial cancer were identified by Pipelle aspirati on. In seven cases (4%), the Pipelle aspiration failed to detect hyper plasia. Sonographic endometrial thickness of more than 5 mm slightly i ncreased the sensitivity and slightly decreased the specificity of Pip elle aspiration from 82 to 92% and from 99 to 96%, respectively. In po stmenopausal patients admitted for bleeding, the sensitivity and speci ficity reached 100%. Conclusions: Our data suggest that normal Pipelle aspirates in premenopausal patients with abnormal uterine bleeding ar e highly accurate. In postmenopausal patients with sonographic endomet rial thickness of 5 mm or less, the accuracy reached 100%.