Objectives: The purpose of this study was to identify clinical indications in which endometrial sampling was performed under transabdominal ultrasound (US) guidance and to evaluate the outcomes of this approach in an academic practice.
Methods: We retrieved data from the electronic medical record for all patients referred to the gynecologic US unit for transabdominal US-guided endometrial sampling from January 2011 to June 2017. Data retrieved included age, parity, previous cesarean delivery or pelvic surgery, indication for endometrial biopsy, US abnormalities, clinical reasoning for US-guided sampling, and pathologic reports.
Results: A total of 113 patients were referred for US-guided sampling between January 2011 and June 2017. We identified the following reasons for US-guided biopsy referral: failed blind biopsy attempt, fibroids, uterine position or anomaly, need for targeted sampling, cervical stenosis, and other indications. Ninety-five of the 113 patients (84%) underwent successful US-guided endometrial sampling. Forty of the 113 patients were referred after a failed blind biopsy, with 83% subsequently undergoing successful US-guided endometrial sampling. Of the 30 patients referred for fibroids, 29 (97%) underwent successful US-guided sampling. High success rates were also noted for transabdominal US guidance referrals for the uterine position or anomaly (86%) and the need for targeted sampling (83%).
Conclusions: Our results suggest that endometrial sampling performed under US guidance could be considered for patients with a failed blind approach, fibroids, uterine anomalies, and interest in targeted sampling. In such cases, US-guided sampling could be considered before surgical options.
Keywords: endometrial biopsy; fibroid uterus; gynecology; sampling failure; ultrasound guidance.
© 2018 by the American Institute of Ultrasound in Medicine.