Improving Outpatient Endometrial Biopsy Results

NCT ID: NCT06694246

Last Updated: 2024-12-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

400 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-11-01

Study Completion Date

2025-04-30

Brief Summary

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Pipelle is the most commonly used outpatient endometrial biopsy device. Pipelle endometrial biopsy can diagnose 90% of endometrial cancer cases. Pipelle endometrial biopsy is one of the first-line diagnostic procedures for women presenting with abnormal peri- and post-menopausal vaginal bleeding.

Insufficient samples are obtained in 5-23% of cases. In Adan Hospital, a retrospective analysis of all outpatient endometrial samples sent to the histopathology department from April- to October 2024 study showed an insufficient sample percentage of 32% This may be attributed to factors such as patients, equipment, and physicians.

This project aims to improve the endometrial biopsy results by Identifying these factors in the Adan hospital setting, Implementing measures to modify these factors, and finally re-auditing the endometrial biopsy results after six months.

Detailed Description

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Conditions

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Histopathology Screening Tool Techniques

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Interventions

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Improving technique

A checklist was developed to ensure the important steps were followed, with tips for obtaining a more adequate sample. This checklist was put in the outpatient procedures room, and each physician performing a biopsy was asked to fill it out.

Also, a diagram containing illustrative images with the basic steps was put in the procedures room.

The topic was covered in the biweekly scientific meeting, and all factors attributed to the inadequate sample were discussed.

The department lead mentioned the topic in the OBGYN department's private messaging group.

It was finally mentioned in the morning meeting.

Intervention Type OTHER

Using hysteroscopy in candidate patients

Patients with focal lesions on ultrasound will undergo hysteroscopy and biopsy instead of blind endometrial sampling.

Patient with stenosed cervix or failed previous sampling might also undergo hysteroscopic guided biopsy.

Intervention Type OTHER

Analgesia

Analgesia in the form of paracetamol or NSAIDs might be given to some patients 30- 60 minutes before the procedure to reduce the procedure-associated pain and the resultant failure to complete it and obtain an adequate sample.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All patients undergoing outpatient endometrial biopsy in the specified time interval (11/2024- 4/2025) will be included.

Exclusion Criteria

* Could not obtain the sample due to patient physicals, anxiety (patient decline), cervical stenosis, or severe bleeding
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Al Adan Hospital Kuwait

INDUSTRY

Sponsor Role collaborator

Cairo University

OTHER

Sponsor Role lead

Responsible Party

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Islam Tarek Elkhateb

Dr

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Adan hospital

Kuwait, Al Ahmadi, Kuwait

Site Status RECRUITING

Countries

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Kuwait

Facility Contacts

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Tarek

Role: primary

+965-99780408

References

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Andrews B, Quick K, MacLeod E, Edwards K, Rone BK. Cervical bleeding with cervical stabilization during IUD placement: allis clamp versus single-tooth tenaculum, a randomized control trial. Arch Gynecol Obstet. 2023 Apr;307(4):1015-1019. doi: 10.1007/s00404-022-06784-x. Epub 2022 Dec 7.

Reference Type BACKGROUND
PMID: 36477274 (View on PubMed)

Sierecki AR, Gudipudi DK, Montemarano N, Del Priore G. Comparison of endometrial aspiration biopsy techniques: specimen adequacy. J Reprod Med. 2008 Oct;53(10):760-4.

Reference Type BACKGROUND
PMID: 19004401 (View on PubMed)

ACOG Committee Opinion No. 734: The Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Women With Postmenopausal Bleeding. Obstet Gynecol. 2018 May;131(5):e124-e129. doi: 10.1097/AOG.0000000000002631.

Reference Type BACKGROUND
PMID: 29683909 (View on PubMed)

ACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Obstet Gynecol. 2013 Apr;121(4):891-896. doi: 10.1097/01.AOG.0000428646.67925.9a.

Reference Type BACKGROUND
PMID: 23635706 (View on PubMed)

Terzic MM, Aimagambetova G, Terzic S, Norton M, Bapayeva G, Garzon S. Current role of Pipelle endometrial sampling in early diagnosis of endometrial cancer. Transl Cancer Res. 2020 Dec;9(12):7716-7724. doi: 10.21037/tcr.2020.04.20.

Reference Type BACKGROUND
PMID: 35117374 (View on PubMed)

Blumenthal PD, Berek JS. A Practical Guide to Office Gynecologic Procedures. Lippincott Williams & Wilkins; 2013 Apr 8. Chapter 8

Reference Type BACKGROUND

Gallos ID, Alazzam M, Clark TJ, Faraj R, Rosenthal AN, Smith PP, Gupta JK. Management of endometrial hyperplasia. Green-top guideline no. 67. RCOG/BSGE Joint Guideline. 2016.

Reference Type BACKGROUND

Williams PM, Gaddey HL. Endometrial Biopsy: Tips and Pitfalls. Am Fam Physician. 2020 May 1;101(9):551-556.

Reference Type BACKGROUND
PMID: 32352730 (View on PubMed)

Del Priore G. Office-based endometrial sampling procedures. In: UpToDate, Connor RF (Ed), Wolters Kluwer. (Accessed on November 28, 2024.)

Reference Type BACKGROUND

Provided Documents

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Document Type: Study Protocol

View Document

Study Documents

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Document Type: Study Protocol

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View Document

Other Identifiers

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QIP2

Identifier Type: -

Identifier Source: org_study_id