Overview

Endometrial Biopsy is a diagnostic procedure used to obtain tissue samples from the uterine lining for histological examination. It is essential for evaluating abnormal uterine bleeding.

Endometrial biopsy is crucial for diagnosing endometrial hyperplasia, endometrial cancer, and other uterine pathologies. It provides definitive histological diagnosis.

Learn more in our comprehensive RxDx OBG Course

Indications

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Abnormal Uterine Bleeding

Heavy or irregular bleeding

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Postmenopausal Bleeding

Bleeding after menopause

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Infertility Evaluation

Assessment of endometrial function

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Endometrial Cancer Screening

High-risk patients

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Hormone Therapy Monitoring

HRT follow-up

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Pregnancy
✗ Active cervicitis

Relative Contraindications

✗ Heavy bleeding
✗ Coagulopathy
✗ Cervical stenosis

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient consent, proper positioning, equipment setup, and understanding contraindications.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, obtain consent, position patient.

⚠️ Common Mistakes to Avoid:

  • Inadequate consent
  • Poor positioning

💡 Pro Tip:

Position patient in lithotomy position.

Step 2: Speculum Insertion

Insert speculum to visualize cervix.

⚠️ Common Mistakes to Avoid:

  • Poor visualization
  • Patient discomfort

💡 Pro Tip:

Use appropriate speculum size.

Step 3: Cervical Stabilization

Apply tenaculum if needed.

⚠️ Common Mistakes to Avoid:

  • Cervical trauma
  • Poor stabilization

💡 Pro Tip:

Apply tenaculum gently.

Step 4: Catheter Insertion

Insert pipelle catheter into uterus.

⚠️ Common Mistakes to Avoid:

  • Wrong direction
  • Uterine perforation

💡 Pro Tip:

Insert gently and carefully.

Step 5: Tissue Sampling

Obtain endometrial tissue sample.

⚠️ Common Mistakes to Avoid:

  • Inadequate sample
  • Wrong technique

💡 Pro Tip:

Use proper sampling technique.

Step 6: Specimen Handling

Preserve specimen in formalin.

⚠️ Common Mistakes to Avoid:

  • Poor preservation
  • Lost specimen

💡 Pro Tip:

Handle specimen carefully.

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Post-procedure Care

Post-procedure care involves monitoring for complications, patient education, and scheduling follow-up appointments.

Complications & Management

Complication Incidence Signs Management Prevention
Uterine perforation 1-2% Abdominal pain, bleeding Observation, laparoscopy Gentle technique
Cervical trauma 2-5% Cervical bleeding Pressure, suturing Gentle technique
Vasovagal reaction 5-10% Dizziness, syncope Trendelenburg position Gentle technique
Infection 1-3% Fever, foul discharge Antibiotics Sterile technique

Clinical Pearls

💡

Perform in proliferative phase when possible.

🎯

Use gentle technique throughout.

⚡

Ensure adequate sample size.

🔍

Document all findings carefully.

📊

Handle specimen properly.

🎨

Provide clear post-procedure instructions.

⚠️

Monitor for complications.