The Comparative Efficacy of Endometrial Biopsy using Pipelle and Diagnostic Dilatation & Curettage in Mariano Marcos Memorial Hospital and Medical Center
DOI:
https://doi.org/10.37275/bsm.v7i10.871Keywords:
Curettage, Diagnostic dilatation, Endometrial biopsy, PipelleAbstract
Background: The use of Pipelle sampling for endometrial histology and pathology is of some controversy - and vast importance. Pipelle procedures are performed commonly in medical offices when women show abnormal vaginal bleeding. While the method has several advantages over dilatation and curettage (D&C), clinical questions exist on the precision and accuracy of the procedure. This study aimed to assess the effectiveness of Pipelle biopsy sampling versus Dilatation & Curettage (D&C) in adequacy of sampling specimen in terms of cost effectiveness, diagnosis success rate, sensitivity, specificity, positive predictive value, and negative predictive value.
Methods: A retrospective study was conducted among all enrolled women with abnormal uterine bleeding counselling outpatient and inpatient in MMMHMC Batac from 2016 to 2017. Sample was divided in two groups - those that underwent Pipelle biopsy and those who underwent D&C. Key statistics were computed using SPSS 16.
Results: Cost effectiveness analysis showed that Pipelle biopsy offers a more cost effective alternative with an estimate of one correct diagnosis every P16 spent versus P61 spent for a correct diagnosis using D&C. Both procedures resulted in a 100% likelihood ratio of having the condition with a positive test result, with D&C resulting in a higher diagnosis success rate of 98% (versus 92% for Pipelle) and higher proportion of those who have the disorder, given the procedure tested positive.
Conclusion: Pipelle biopsy offers a more cost effective alternative to D&C. Both procedures resulted in equal probability of having the condition with a positive test result, with D&C resulting in a higher success rate of diagnosis and sensitivity rate, albeit not statistically significant.
Authors
- Melody Nethania Sutedja1*
- Ruth Judith Gay V. Cristobal1
- Maria Constancia Celina C. Ferraris1
- Czarina Juliana L. Alcaraz1
- Gisele V. Gonzales-Acantilado1
- 1Department of Obstetrics and Gynecology, Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines
Corresponding author Melody Nethania Sutedja — melodynethaniasutedja@gmail.com
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