Inaccuracy of Dilatation and Curettage in Detection of Uterine Disease for the Women with Abnormal Uterine Bleeding
MD Parvaneh Bozorgi1, MD Bahia Namavar Jahromi2, MD Mohammad Javad Ashraf31Department of OB-GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 2Infertility Research Center, Department of OB-GYN, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 3Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract: The purpose of this study was to evaluate the accuracy of dilatation and curettage (D and C) for the detection of uterine diseases in the patients with abnormal uterine bleeding (AUB). In this prospective study, histopathological results of D and Cs of 85 women with AUB were analyzed and compared to the results of their hysterectomy specimens. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) was calculated for D and C histopathologic results. The women’s mean age was 46.63± 8.53 years. Their mean hemoglobin levels and endometrial thicknesses were 12.63±2.56 g/dL and 6.34 ± 8.16mm, respectively. We found a reverse relationship between endometrial thickness and hemoglobin levels. For detection of endometrial polyps D and C had sensitivity of 80.0 %, specificity of 82.5 %, PPV of 22.2% and NPV of 98.5%. For detection of inactive endometrium, sensitivity, specificity, PPV and NPV of dilatation and curettage was 33.3%, 97.6%, 33.3% and 97.6% compared to hysterectomy results, respectively. Histopathologic examination of the hysterectomy specimens revealed myomas in 17 patients, intracavitary polyps in 5 patients and adenomyosis in 44 patients that were not reported in D and C results. The histopathologic results of D and C specimens matched only at 14.12% of the patients with the results of hysterectomy specimens. It appears that D and C may be appropriate for evaluation of endometrial pathologies however it seems to be an inadequate diagnostic tool for evaluation of the uterine diseases in the women with AUB.
Keywords: Abnormal uterine bleeding; hysterectomy; Dilatation; curettage; diagnosis; endometrial histology Back to TOC