Subject(s)
Hysterectomy, Vaginal/adverse effects , Pregnancy, Ectopic/etiology , Adult , Female , Humans , Infant, Newborn , PregnancyABSTRACT
The objective of this study was to determine if palpable uterine artery pulsation is a reliable clinical indicator of pregnancy at less than six weeks' gestation. A preliminary, nonblind study involved 299 women. Of 31 women who were at less than six weeks' gestation, 24 had definite uterine artery pulsations, and 7 did not. Of 268 nonpregnant women, 256 did not have pulsation, while 12 did (P < .001). Because other clinical parameters could bias the interpretation of uterine artery pulsation, a second, blind study was undertaken. During it, 155 patients underwent bimanual examination only, and no other clinical information was available to the examiner. Of 25 women at less than six weeks' gestation, 19 had definite uterine artery pulsation, while 6 did not. Of 130 nonpregnant patients, 121 did not have uterine artery pulsation, while 9 did (P < .001). Palpable uterine artery pulsation seems to be associated with early pregnancy, and physicians should add evaluation of pulsation to their clinical armamentarium.
Subject(s)
Palpation/methods , Pregnancy Tests/methods , Pulse , Uterus/blood supply , Arteries , Female , Humans , Predictive Value of Tests , Pregnancy , Pregnancy Trimester, First , Reproducibility of Results , Single-Blind MethodABSTRACT
In a study of 132 women having endometrial biopsy with either a Novak or Randall aspiration curet before hysterectomy, a tenaculum was not used initially if the curet could be passed easily through the cervix. One biopsy specimen was taken from the anterior endometrium and one from the posterior endometrium. Biopsy was successful in 80 women (61%) and unsuccessful in 52 (39%). Women who are premenopausal, who do not have cervical stenosis, and who have a uterus that sounds to 3.5 inches or less are significantly more likely to have a successful biopsy. Excluding six women in whom the curet could not be passed through the cervix, adequate tissue for histologic evaluation was obtained in 101 of 126 women (80%). Furthermore, endometrial biopsy accurately reflected histopathologic features of the surgical specimen in 98% (98/101) of the women who had sufficient tissue obtained for evaluation. Endometrial biopsy done with an aspiration curet but without placing a tenaculum on the cervix should be attempted in women who require evaluation. Endometrial biopsy would appear to rival dilation and curettage for obtaining endometrial tissue that accurately reflects endometrial histopathology.
