Role of pipelle versus dilatation and curettage in tissue diagnosis abnormal uterine bleeding

Background: Menstrual irregularities and abnormal heavy menstruation account for up to 26-35% of women attending Gynecological outpatient Department. Abnormal Uterine Bleeding (AUB), it is more common at extremes of age endometrial hyperplasia occurs in 5-10% of patients with post-menopausal bleeding out of which atypical hyperplasia has 26-32 % risk of having malignancy in future. Therefore, endometrial sampling for histopathology is important in the assessment of abnormal uterine bleeding is mandatory. Our study was conductive to know the effectiveness of pipelle type devices, versus Dilatation and curettage in obtaining quality endometrial tissue for histopathological examination.Methods: The study was undertaken in Department of obstetrics and gynaecology along with department of Pathology at Rajarshi Chhatrapati Shahu Maharaj, government medical college, Kolhapur after getting approval from the Hospital Committee on Clinical Research and Ethical Committee of the institution, during the period from October 2016 to March 2017 (six months). Total number of subjects included in study is Hundred after taking into consideration of inclusion and exclusion criteria.Results: The ease of doing procedure was much easier as compared to D&C and the Tissue sample obtained for histopathological examination were as par D&C. It was concluded that histopathology report was available in 92 of the 100 pipelle samples and 93 of 100 D&C samples. It was also, observed that increased endometrial thickness was not always associated with adequate tissue diagnosis.Conclusions: Pipelle is simple, affordable, patient friendly can be easily performed with minimal training, which can be performed in Outpatient Gynaecological Department. The diagnostic value and positive predictive value of Pipelle is at par with conventional D&C. So, pipelle can be recommended for all perimenopausal patients with AUB to rule out various, premalignant and malignant conditions of the endometrium.

Influence of umbilical vein oxytocin on blood loss and length of third stage of labour.

In this study the effect of intraumbilical vein oxytocin on duration and amount of blood loss in third stage of labour was studied. Pregnant women were randomized into two groups of fifty each. Study group was managed with 10 units of oxytocin diluted with 10 ml of normal saline given through umbilical vein while control group was managed with 10 units of oxytocin in 500 ml of normal saline through intravenous infusion after delivery of the baby. The mean blood loss in the third stage of labour was 143.30 ml for the control group and 151.43 ml for the study group while the duration of the third stage of labour was 6.02 and 5.42 minutes for each group. There was no significant difference in the duration and amount of blood loss between the two groups.