• Aiza Saadia
  • Azher Mubarik
  • Alia Zubair
  • Shahid Jamal
  • Ambreen Zafar


Background: Abnormal uterine bleeding is one of the most frequent problems in life of an adult female.Uterine curettage or biopsy remains a preferred sampling procedure for diagnosis of the endometrialpathology. The objective of this study was to compare the sensitivity, specificity, positive and negativepredictive value of endometrial curettage. Patients and Methods: This validation study was carried outat the Department of Histopathology, Army Medical College Rawalpindi in collaboration with MilitaryHospital, Rawalpindi from January to December 2010. The study included 50 curettage and subsequenthysterectomy specimen of the same patients. Non-probability sampling technique was used to dividepatients into two groups with 50 patients in each group. One group was of endometrial curettage havingendometrial pathology (group A). Second group was of subsequent hysterectomy specimen of the samepatients (group B). Results: Endometrial curettage was found most accurate in diagnosing endometrialcarcinoma. Sensitivity of endometrial curettage was found to be 33% whereas specificity and positivepredictive value was found to be 100% each. Negative predictive value was found to be 93.1%.Conclusion: Endometrial biopsy is a sensitive and a specific test in and is accurate in diagnosingendometrial pathology. It is found most accurate in diagnosing endometrial carcinoma.Keywords: Dilation and curettage, Hysterectomy, Hormone imbalance, endometrium, dysfunctionaluterine bleeding, DUB


Sarwar A, Haque A. Types and frequencies of pathologies in

endometrial curettings of abnormal uterine bleeding. Int J Pathol


Montgomery BE, Daum GS. Endometrial Hyperplasia: a review.

Obstet Gynecol Surv 2004;59:368–78.

Connell LO, Fries MH, Zeringue E. Triage of abnormal

postmenopausal bleeding: a comparison of endometrial biopsy and

transvaginal sonohysterography versus fractional curettage with

hysteroscopy. Am J Obstet Gynecol 1998;178(5):956–61.

Hendrickson MR, Longacre AT, Kempson L. The uterine corpus.

In: Stacy E Mills, (editor). Sternberg’s diagnostic surgical

pathology. Philadelphia USA. Lippincott Williams and

Wilkins;2004. p.2435.

Samson, S-L, Donna G. Who needs an endometrial biopsy?

Canadian Family Physician 2002;48:885.

Epstein E, Ramirez A, Skoog L. Dilatation and curettage fails to

detect most focal lesions in the uterine cavity in women with

postmenopausal bleeding. Acta Obstet Gynecol Scand.


Muzaffar M, Khanum KA, Yasmin S, Rahman M, Iqbal W, Khan

MA. Menstrual Irregularities with excessive blood loss: a ClinicoPathological Correlation. J Pak Med Assoc 2005;55(11):486–9.

Gazozai S, Bugti QA, Siddiqa A, and Ehsan N. Excessive Uterine

haemorrhage- A histopathological study. Gomal J Med Sci


Knudtson EJ, Shellhaas C, Stephens JA, Senokozlieff M, Ye H,

Iams JD. The association of chronic endometritis with preterm

birth. Am J Obstet Gynecol 2007;196 (4):337.

Lee WH, Tan KH, Lee WY. The etiology of postmenopausal

bleeding- A study of 163 consecutive cases in Singapore. Singapore

Med J 1995;36:164–8.

Mutter GL. Endometrial Precancers: The Benign Endometrial

Hyperplasia Sequence and EIN. Unpublished manuscript Mimeol,

Department of Pathology, Harvard Medical School 2008.

Moghal M. Diagnostic value of endometrial curettage in abnormal

uterine bleeding–a histopathological study. J Pak Med Assoc


Jones HW, Jones GS. Novak’s Textbook of Gynecology. 10th Ed,

Baltimore USA. Williams and Wilkins;1981. pp 377–80.

McCluggage WG. My approach to the interpretation of the

endometrial biopsies and curretings. J Clin Pathol 2006;59:801–12.

Shazia F, Ghazala M. Validity of hysteroscopy and histopathology

in patients with menstrual irregularity. J Ayub Med Coll

Abbottabad 2010;22(1):129–30.

Clark TJ, Mann CH, Shah N, Khan KS, Song F, Gupta JK.

Accuracy of outpatient endometrial biopsy in the diagnosis of

endometrial hyperplasia. Acta Obstet Gynecol Scand


Stovall TG, Ling FW, Morgan PL. A prospective, randomized

comparison of the Pipelle endometrial sampling device with the

Novak curette. Am J Obstet Gynecol 1991;165:1287–9.

Rodriquez GC, Yaqub N, King ME. A comparison of the Pipelle

device and the Vabra aspirator as measured by endometrial

denudation in hysterectomy specimens. Am J Obstet Gynecol


Dijkhuizen FP, Mol BW, Brolmann HA, Heintz AP. The accuracy

of endometrial sampling in the diagnosis of patients with

endometrial carcinoma and hyperplasia: a meta-analysis. Cancer


Ribeiro CT, Rosa-e-Silva JC, Silva-de-Sa MF, Rosa-e-Silva ACJ,

Neto OBP, Nogueira AA. Hysteroscopy as a standard procedure for

assessing endometrial lesions among postmenopausal women. Sao

Paulo Med J 2007;125(6):338–42.

Greiver M. Endometrial biopsy [Practice Tips]. Can Fam Physician


Clark TJ, Mann CH, Shah N, Khan KS, Song F, Gupta JK.

Accuracy of outpatient endometrial biopsy in the diagnosis of

endometrial cancer: a systematic quantitative review. Br J Obstet

Gynaecol 2002;109:313–21.