Incidence and Factors Associated with Inadequate Endometrial Tissue for Pathological Evaluation from Uterine Curettage in Abnormal Uterine Bleeding at Udon Thani Hospital

Abstract

Objective: To study the incidence and factors associated with inadequate endometrial tissue for pathological evaluation from uterine curettage in patients with abnormal uterine bleeding (AUB) at Udon Thani Hospital. Materials and Methods: The electronic medical records of women aged 35 years and older with AUB that underwent endometrial curettage in a regional hospital between October 2018 and November 2019 were retrospectively reviewed. The incidence of inadequate endometrial tissue for pathological evaluation was studied. Multiple logistic regression analysis was performed to determine the factors associated with inadequate curettage. Results: Three hundred fifty-two patients with AUB that underwent endometrial tissue curettage and had complete medical records were included in the present study. The mean age was 48.09±8.01 years. The incidence of inadequate endometrial tissue for pathological evaluation was 23.30% (95% CI 18.98 to 28.07). Postmenopausal status (adjusted OR 3.80, 95% CI 1.93 to 7.50), the low experience of the clinician (adjusted OR 2.20, 95% CI 1.15 to 3.87), and the uterine cavity length measured by uterine sound (adjusted OR 0.66 for each 1 cm increment, 95% CI 0.54 to 0.80) were significant factors associated with inadequate tissue for pathological evaluation. Conclusion: The incidence of inadequate endometrial tissue for pathological evaluation from endometrial curettage was one-quarter of all cases. The associated factors of inadequate endometrial tissue included postmenopausal status, inexperience operators, and shorter uterine length. Keywords: Endometrial tissue curettage; Insufficient endometrial tissue; Sampling adequacy; Endometrial carcinoma; Abnormal uterine bleeding