Aspirate from the uterine cavity. Endometrial aspiration biopsy: how and why is endometrial aspiration performed

The collected aspirate from the uterine cavity allows you to quickly determine the presence of gynecological ailments that have just begun to develop. In what cases is aspirate from the uterine cavity necessary procedure? Are there any contraindications to it?

When pathological intrauterine processes are detected in a patient, the gynecologist may prescribe an aspirate from the uterine cavity. Cytological examination is a method for obtaining important data on the pathological processes of the uterine endometrium, cellular atypia, or even the presence of cancer cells.

Held cytological examination aspirate from the uterine cavity, usually on an outpatient basis. The material is collected as follows:

When the uterine position and its dimensions are determined, mirrors are inserted and the cervix is treated with alcohol. Then the catheter is lightly inserted, an aspirate is taken with a syringe, the catheter is removed, and the resulting material is applied to a special fat-free and marked glass in order to study the smear.
Another method is carried out using a syringe, in which there are already a couple of milliliters of sterile saline and 10% sodium nitrate for the purpose of prophylaxis in the material blood clots. First, the liquid is injected into the uterine cavity using a catheter, and then immediately aspirated into a syringe. Then the catheter is removed from the uterus, and the liquid is placed in a special tube for 10 minutes for further centrifugation. The sediment is left for cytological examination, and the liquid is washed off.
The best way is the simultaneous introduction and removal of fluid from the uterine cavity using 2 catheters. Prepare 2 syringes, 1 of which contains a solution of sodium nitrate, and the second is applicable for collecting material (aspiration). The fluid flushes the uterine cavity, but does not enter the fallopian tubes or into the peritoneum. Next, the liquid is placed in a centrifuge tube, the precipitate obtained from the liquid is examined and the results of the manipulation are recorded, in which the presence or absence of diseases is noted.

What is the purpose of such tests? The main purpose of the this study- determination of the state of the endometrium of the uterus. The results obtained allow us to determine how the endometrium complies with the norms in a particular phase. menstrual cycle. Along with this, this analysis allows you to quickly determine the presence of benign or malignant neoplasms.

Indications and contraindications for this procedure

The collection of aspirate from the uterine cavity is currently considered the most gentle and informative way to study the endometrium. It does not injure the uterine mucosa in the same way as with curettage.

Inflammation and other complications are extremely rare. After just a couple of days after the manipulation, a woman can already pick up the results. If cells of an atypical type are detected, a woman needs a biopsy and a histological examination to determine the features of the pathology and further treatment tactics.

Other indications for the study include: disturbed menstrual cycle, infertility, diagnosis of endometriosis or hyperplasia, the presence of malignant neoplasms, negative ultrasound results, the presence of atypical vaginal discharge in the patient, monitoring the condition of the uterine mucosa during treatment hormonal drugs, prolonged wearing of the spiral and the use of contraceptives.

The spiral can not be worn longer than the prescribed period, otherwise the uterine mucosa may become thinner. As a result, the reproductive organs become inflamed.

The aspiration procedure is contraindicated in the following cases:

exacerbated or chronic gynecological or urological ailments;
inflammation of the cervix or vagina;
colpitis and cervicitis;
pregnancy.

What complications can occur after aspirate sampling?

Rarely, but still sometimes the uterus is injured. In this case, the patient experiences severe pain in the abdomen. Sometimes there is an irradiation of pain up, almost reaching the area of the collarbone.

Injury to the blood vessels can provoke the development of internal bleeding.

In this case, the patient develops nausea, she feels dizzy, arterial pressure, there are pains in the abdomen, in some cases, spotting may appear.

In rare cases, inflammatory processes may begin to develop in the uterus. This position causes a woman to have general weakness, abdominal pain and sometimes an increase in body temperature. Signs of this inflammation may occur a few days later or immediately after the aspirate is taken.

According to numerous patient reviews, most often aspiration is absolutely harmless. Special preparation for the procedure is not required, it is enough to carry out hygienic actions.

Vacuum aspiration of the uterine cavity is the easiest and most reliable way to extract the contents of the uterus for examination. Unlike diagnostic curettage, this method is much more gentle with respect to the delicate mucous membrane of the uterine cavity, does not injure it, and leads to complications, such as inflammation, much less frequently. Aspiration from the uterine cavity is indicated in the following cases:

at ;
with infertility;
with endometriosis;
at ;
with tumors of the ovaries;
with suspicion of malignant tumors in the endometrium;
when monitoring the effectiveness of hormone therapy.

A cytological examination of the aspirate helps to track whether the endometrium corresponds to the phase of the cycle, whether it develops malignant formations, and detect uterine cancer at the earliest, preclinical stage.

How is an aspirate taken from the uterine cavity?

A woman who is to aspirate the contents of the uterine cavity is usually interested in how painful such a manipulation is, on what day of the cycle it can be performed and how to properly prepare for it.

Until recently, Brown syringes were used to take aspirate from the uterine cavity - plastic containers 300 mm long and 3 mm in outer diameter, while a woman could experience unpleasant, even acutely painful sensations. Now more advanced tools are used for these purposes: American-made vacuum syringes and cannulas made in Italy. In order to minimize discomfort, an anesthetic should be taken 30-60 minutes before the manipulation. The study is usually prescribed for 20-25 days of the menstrual cycle.

During the procedure for taking an aspirate from the uterine cavity, the doctor performs the following manipulations:

Examines the patient.
Disinfects the external genitalia with iodonate.
Exposes the cervix with mirrors.
Grabs the cervix with bullet forceps.
Probes the uterus to determine the size of its cavity.
Take aspirate with a vacuum syringe.
Removes instruments and re-treats the external genitalia with iodonate.

Vacuum aspiration of the contents of the uterine cavity is performed within the walls of a regular district antenatal clinic and takes only a few minutes. This procedure does not require any specific preparation, so a woman needs to perform only the usual hygiene procedures, as before an ordinary visit to the gynecologist.

Contraindications for vacuum aspiration of the uterine cavity

Taking an aspirate from the uterine cavity should not be performed in acute and exacerbations chronic diseases urogenital area, presence inflammatory processes in the cervix and vagina.

Complications after taking aspirate from the uterine cavity

In a small percentage of cases, in the process of taking an aspirate from the uterine cavity, the mucous membrane of the walls of the uterus can be injured, which is manifested by pain in the abdomen, which is given up to the collarbone. If blood vessels are injured during the procedure, internal bleeding may occur. As a result of blood loss, blood pressure drops, there is a feeling of nausea and dizziness, bloody discharge from the genitals.

Another possible complication after aspiration of the uterine cavity may be the development of an inflammatory process in the uterus. In this case, the woman has weakness, pain in the lower abdomen, the body temperature rises. Symptoms of inflammation can appear both a few hours after taking the aspirate, and after a few days.

Many patients of gynecologists hear about such manipulation as aspirate from the uterine cavity. Let's talk about what this procedure is, why it is carried out for women in different ages what are its advantages and disadvantages.

The term "aspiration" in literal translation means "suck out". In medicine, aspiration biopsy is widely used - that is, obtaining tissue fragments using “sucking”, as a rule, based on a pressure difference. The procedure is carried out with a syringe, special probes, vacuum electric aspirators, and so on.

Such an aspirate can be taken from the lungs, bronchi, stomach, sinuses, volumetric liquid formations. In gynecology, aspiration biopsy from the uterine cavity is very common.

There are three main types of this procedure:

Aspiration biopsy endometrium with a vacuum aspirator;
Aspiration biopsy with a syringe or manual (manual) vacuum aspiration;
Paypel endometrial biopsy or aspirate using a special uterine probe.

Recently, these manipulations have become widespread for various indications:

Approximate and initial diagnosis for suspected various diseases of the body of the uterus. Such manipulation can be carried out to diagnose conditions such as cancer of the uterine body, endometrial hyperplasia, chronic endometritis, various options for abnormal conditions of the uterine cavity - hematometer, serometer.
Scheduled examination before various gynecological manipulations and operations. Endometrial biopsy is performed before IVF, insemination, stimulation of ovulation in women with infertility.

In gynecological patients, this manipulation is carried out as the primary stage before elective operations, for example, before the removal of uterine fibroids, pelvic floor plastics. Previously, separate diagnostic curettage of the uterine cavity was used for these purposes, but last years in most cases, there is no need for such a traumatic study.

Diagnosis of the causes of infertility in women. In this case, endometrial tissue can be obtained for histological examination. This is important for assessing the usefulness of the endometrium, its compliance with the phase of the menstrual cycle, the presence or absence of an inflammatory response.
Monitoring and evaluating the effectiveness of the treatment of a particular condition. An aspirate from the uterine cavity can give an answer whether the prescribed medications help, for example, from endometrial hyperplasia, whether chronic endometritis is treated with antibiotics.

Now consider each type of aspiration biopsy separately.

Vacuum biopsy

This is an older method, which, in addition to diagnosing the condition of the endometrium, has been used and continues to be used to terminate a pregnancy at a short time and also to clean the uterine cavity from blood clots, hematometers, serometers, remnants of the fetal egg after abortion, postpartum lochia with their delay.

Source: www.vashamatka.ru

The essence of the method is to use the principle of a vacuum cleaner. A vacuum aspirator is an electrical device consisting of a compressor, a thin aspiration probe or catheter inserted into the uterine cavity, and a container for the resulting aspirate.

It is this aspirator that is also used to terminate early pregnancy.

The aspiration procedure is as follows:

The patient lies on the gynecological chair in a standard position.
The cervix is displayed in the mirrors, fixed with forceps, using a button probe, the doctor passes the cervical canal and inserts the catheter into the uterine cavity.
The catheter is fixed, the doctor turns on the pedal of the device, the “vacuum cleaner” creates negative pressure and the tissues of the uterine cavity are sucked into the container.
The doctor removes the instruments, treats the vagina and cervix with antiseptics. The procedure is over.

The resulting tissues are fixed depending on their number. With a good, abundant aspirate, a formalin biopsy can be placed and sent for histological examination. With scanty aspirate, histology is usually uninformative. It is better to place such a biopsy on a cytological glass and send it for a cytological examination of the cellular composition.

Manipulation is usually carried out without general anesthesia under local anesthesia - the cervix at certain points is cut off with a solution of novocaine or lidocaine. In young women who have given birth naturally, the procedure is sometimes performed calmly without anesthesia at all, causing the patient a moment of minor discomfort.
Manual aspiration

The meaning of the procedure is actually similar, but instead of the power of electricity, manual force is used to “suck out”. A manual aspirator is a kind of large syringe with a tight piston and a container for collecting the resulting tissues.

Paypel biopsy

This is the most modern, technologically advanced and minimally invasive method for obtaining endometrial tissues. For this variant of the aspirate, special aspiration probes are used.

The technique of the operation is similar, but does not require the expansion of the cervix, as well as the use of "brute" force - manual or electric. Pipell probes are very thin, flexible, easily enter the cervical canal, very convenient to use.

Advantages and disadvantages

Let's start with the positives:

Low invasiveness and practically complete absence traumatization of the mucous membrane of the uterine cavity, in contrast to separate curettage of the uterine cavity and hysteroscopy. This is very important and relevant for young nulliparous women, patients planning a pregnancy, because the mucous membrane of the uterine cavity is one of the fundamental factors for the successful onset and course of pregnancy.
No need for general anesthesia, and, consequently, the absence of risks of anesthesia, its possible complications.
Simplicity and speed. Unlike hysteroscopy, these methods are widely available, available in almost every institution, and not expensive.
No need for hospitalization and stay in the hospital.

In the United States, this kind of manipulation is called "office" or "office", because it is not carried out in a hospital, but on a purely outpatient basis - on a regular gynecological chair in a regular gynecologist's examination room, they do not require special preparation, anesthesia and sick leave.

That is, a woman goes through this procedure and can return to work, to the “office”.
Few complications. Given the minimally invasive nature of the procedure, there is practically no serious complications, in contrast to the WFD or hysteroscopy.

The disadvantages of manipulation are:

The absence of "eye control", that is, the procedure is in principle carried out blindly, in contrast to hysteroscopy, in which a biopsy can be taken under visual control, from the most suspicious area.
Orientation of diagnosis. As a rule, in serious cases, for example, when cancer cells are detected in the aspirate from the uterine cavity, a clarifying diagnosis is indicated - hysteroscopy.
The absence of a significant therapeutic effect - that is, with an aspiration biopsy, it is impossible to stop the bleeding, remove the polyp. Maximum with vacuum aspiration, you can empty the cavity from liquid, blood, exudate. When
Paypel biopsy healing effect generally impossible due to the thinnest diameter of the probe.

Training

Although the procedure is called "office", a minimum examination before it is still required:

Ultrasound of the pelvic organs, so that the doctor understands the picture and indications for the procedure, as well as in case of some structural features of the genital organs in this patient - for example, a bicornuate uterus or a septum in the uterus.
General blood and urine tests to exclude an acute inflammatory process in the body.
Gynecological smear on the flora to exclude the inflammatory process in the vagina.
A smear from the cervix for atypical cells - oncocytology.

Complications

Complications with this type of procedure are extremely rare, but it is important to know the possible ones:

Perforation of the walls of the uterus with instruments or a probe is an almost casuistic situation, since in this version of the manipulation there are no sharp, hard instruments, as in hysteroscopy or RFE.
Secondary infection - acute or chronic endometritis, which can occur with poor smears in the patient and violation of asepsis rules.

In conclusion, I would like to say that aspirate from the uterine cavity is an excellent alternative surgical methods diagnostics, a real salvation for patients with contraindications to anesthesia and invasive procedures.

Content

Histological examination of the endometrium is one of the most informative methods for detecting gynecological pathologies on early stages. To assess the condition of the reproductive organ, tissue samples are required that are located in its cavity, in order to obtain them, gynecologists use aspiration methods.

The concept of the method

Vacuum aspiration is a modern type of analysis and a type of biopsy. During the procedure, endometrial tissue is taken from the cavity of the reproductive organ. This method is considered less painful and traumatic than curettage. Various tools are used to obtain the necessary biomaterial.

Research types.

Manual method - aspirate is taken from the uterine cavity using a Brown syringe, which is equipped with a flexible probe. It is introduced into the cavity of the organ through the cervical canal to the bottom.
Electric aspiration method- endometrial aspirate is obtained using a small compressor, after inserting the probe into the cavity of the genital organ, the doctor turns on the device, and small tissue samples enter the catheter.
Pipeline biopsy - an aspirate from the uterine cavity is taken using a thin flexible catheter, which is equipped with a piston, soft tip.

To get a clearer picture, a small amount of saline is injected into the uterine cavity. The whole procedure lasts no more than a quarter of an hour, and the actual sampling of the material lasts a few seconds.

Features of the procedure

Since vacuum methods for examining the reproductive organs are often used, many women are interested not only in what the analysis of aspirate from the uterine cavity is, but also how painless the procedure is.

In the process of taking aspirate manually and electrically, the cervix is grasped with forceps, which causes significant discomfort. With a pipel biopsy, the neck is fixed only with the help of mirrors, no discomfort does not occur.

Therefore, the answer to the question whether it hurts or not to take an aspirate sample from the uterine cavity depends on the research method. But doctors recommend, in any case, an hour before the procedure, take No-shpu or another antispasmodic to relax the muscles.

Complications after aspiration are rare, sometimes internal bleeding occurs, which manifests itself in the form of increased heart rate, decrease in arterial indicators, nausea, attacks of dizziness, intense thirst, bloody vaginal discharge.

Another problem that may arise after the procedure is inflammation of the genital organ, the woman feels hot, the temperature rises, cutting, cramping pains appear in the lower abdomen, and weakness.

To reduce the likelihood of unpleasant consequences, you should refrain from sexual intercourse for three days after aspiration, do not visit pools, saunas, exclude swimming in open water, and avoid hypothermia. It is necessary to take a shower in the morning and evening, avoid taking a bath. It is recommended to use cleansers with a minimum amount of fragrances, an optimal pH level.

Aspiration does not apply to high-precision methods for diagnosing diseases of the uterine cavity, the study allows you to quickly identify changes in the endometrium, make a preliminary diagnosis, prescribe additional tests. The final result and diagnosis allows to put forward a biopsy by curettage of the uterine cavity.

Indications and contraindications

The study of the aspirate of the uterine cavity allows you to study the structure of the endometrium, determine how much its condition corresponds to the phase of the menstrual cycle, and identify malignant tumors. An aspirate must be taken if an ultrasound scan of the pelvic organs showed the presence of gynecological pathologies.

When to analyze a uterine cavity aspirate:

irregular periods;
infertility of an unexplained nature, the presence of a missed pregnancy in the past;
bleeding in the middle of the cycle, with menopause, after childbirth or abortion, discharge of an atypical nature;
to control the condition of the endometrium and the uterine cavity while taking hormonal drugs or contraceptives, prolonged use of the intrauterine device;
with the appearance of signs of endometrial hyperplasia, endometriosis, hormone-dependent pathological processes, cervical or ovarian formations;
a pipel biopsy is recommended at the stage of pregnancy planning to reduce the risk of miscarriage, polyhydramnios, hypoxia, placental insufficiency, pathologies nervous system fetus.

Aspiration is not carried out in the presence of inflammatory processes in the organs reproductive system- a biopsy can provoke a recurrence or exacerbation of the disease. The analysis is contraindicated during pregnancy, women who often or constantly take anticoagulants have a history of anemia.

Result

The results of the study of the state of the endometrium can be found in a few days. At the initial stage, an assessment appearance aspirate, note changes in color and structure.

What the analysis reveals:

morphological study allows you to assess the state of the endometrium, identify all cells, compare their characteristics with normal indicators;
in many diseases, there is a decrease or increase in the activity of the endometrium - signs of atrophy, hyperplasia will be noticeable in the aspirate;
if cells of an atypical nature are found in the aspirate, the woman needs to additionally undergo curettage of the uterine cavity and cervical canal in order to identify the nature and severity of the gynecological pathology.

The results of the analysis may be incorrect if the aspirate was taken during menstruation, exacerbation of chronic infectious disease. Vaginal can distort values antibacterial drugs if a woman used them the day before the procedure, the gel that remained after the ultrasound of the genital organs.

Aspiration is carried out on days 6–9, 20–25 of the menstrual cycle.

Preparation consists in the exclusion of sexual intercourse 3-4 days before the study, douching.

Uterine aspirate analysis is one of the modern species primary diagnosis, with its help assess the state of the functional layer of the endometrium. The procedure does not last long, does not require prior special preparation, the risk of negative consequences minimum.

Previously, in some gynecological diseases, only traumatic methods of biopsy of the uterine mucosa were used to collect endometrial samples, which involved its curettage (i.e., a procedure similar to a classic surgical abortion). However, thanks to the advent of aspiration biopsy (or Pipel biopsy), such a study has become more painless and safer.

This minimally invasive surgical technique for collecting endometrial tissue is carried out using a special plastic tube called a pipel. The thickness of this device is 3 mm, and the principle of its operation is similar to the syringe mechanism. There is a piston inside the tube, and at one end there is a side hole for admission by aspiration of the endometrium into the tip of the pipel.

In this article, we will acquaint you with the indications, contraindications, how to prepare the patient for the procedure, the benefits and methods of performing endometrial aspiration biopsy. This information will help you understand the essence of this diagnostic technique, and you can ask your doctor if you have any questions.

Unlike the classical surgical technique sampling of endometrial tissue, with aspiration biopsy, expansion of the cervical canal is not required. The tip of a disposable tube is inserted into the uterine cavity without the use of additional devices. The doctor pulls back on the plunger, creating negative pressure to aspirate a small area of the endometrium as needed. At the same time, extensive wound surfaces are not formed on the inner layer of the uterus, the cervix does not suffer from mechanical stress, and the patient does not experience pronounced discomfort.

Indications

Indications for this study are pathological processes localized in the endometrium - the inner layer of the uterus.

An aspiration biopsy is prescribed in cases where, after a gynecological examination and ultrasound, the doctor suspects that the patient has pathological changes in the state of the inner layer of the uterus - the endometrium. The resulting tissue samples allow for a histological analysis of the mucous layer of the uterus and make a correct diagnosis.

Endometrial aspiration biopsy is prescribed in the following clinical cases:

endometrial hyperplasia;
disorders (acyclic scanty spotting, menometrorrhagia, scanty menstruation, of unknown origin);
chronic endometritis;
suspicion of infertility;
heavy bleeding in women in the period;
suspicion of the presence of a benign or malignant tumor (, endometrial cancer).

A pipel biopsy can be performed not only to diagnose endometrial pathologies, but also to evaluate the effectiveness of hormone therapy.

Contraindications

Endometrial aspiration biopsy cannot be performed in the following cases:

in the acute phase;
pregnancy.

Possible limitations for performing a Pipel biopsy include the following clinical cases:

disorders of the blood coagulation system;
severe forms;
constant reception and (Clexane, Warfarin, Trental, etc.);
individual intolerance to the applied.

If such conditions are identified, an aspiration biopsy can be performed after special preparation of the patient or replaced by another study.

How to properly prepare for the procedure

Aspiration biopsy of the endometrium, although it is a minimally invasive procedure, but during its implementation, instruments are inserted into the uterine cavity and, albeit insignificant, damage to the integrity of the inner layer of this organ occurs. That is why, in order to exclude possible complications such a study, the patient needs to properly prepare for the collection of material.

For exclusion possible contraindications To perform an aspiration biopsy of the endometrium, it is necessary to carry out the following diagnostic studies:

gynecological examination;
smear on microflora;
cytological smear from the cervix (PAP test);
Ultrasound of the pelvic organs;
blood test for hCG;
blood test for hepatitis B and C, syphilis and HIV;
(preferably).

When prescribing a Paypel biopsy, the doctor must obtain from the patient all the information about the medications she is taking. medicines. Special attention given to the reception of blood-thinning agents (Clopidogrel, Aspirin, Warfarin, etc.). If necessary, the doctor can change the order of taking them a few days before the procedure.

When prescribing an endometrial aspiration biopsy, special attention is paid to the choice of the date of the study. If a woman has not yet entered the menopause period, then the duration of the procedure depends on the day of the menstrual cycle. If the patient is no longer menstruating, then tissue sampling is performed depending on the onset of pathological uterine bleeding.

Typically, an endometrial aspiration biopsy is performed on these days:

18-24 days - to establish the phase of the cycle;
on the first day with pathological bleeding - to identify the cause of bleeding;
on the 5th-10th day of the cycle - with excessively heavy periods (polymenorrhea);
on the first day of the cycle or the day before menstruation - if infertility is suspected;
once a week - if pregnancy does not occur and menstruation is absent;
on days 17-25 - to monitor the effectiveness of hormone therapy;
any day of the cycle - if a malignant neoplasm is suspected.

Direct preparation for the Pipel biopsy is carried out 3 days before the study. These days, a woman needs to follow the following doctor's recommendations:

Refuse sexual intercourse.
Do not douche, do not insert suppositories, ointments and creams into the vagina.
Exclude from the menu products that contribute to increased gas formation.
In the evening before the study, conduct a cleansing enema.

The endometrial aspiration biopsy procedure can be performed in a specially equipped room in a polyclinic. As a rule, it does not require the use of local anesthesia, but sometimes this method of pain relief is performed for particularly sensitive patients. In such cases, before conducting the study, the doctor must make sure that there are no allergic reaction on the drug used (according to anamnesis or performed test).

How is the procedure carried out

During the procedure, the patient is on the gynecological chair.

On the appointed day, the patient with a referral comes to the room for an aspiration biopsy. The procedure for sampling endometrial tissue is as follows:

The woman lies down on a gynecological chair, and the doctor inserts a speculum into the vagina. Conducted if necessary local anesthesia the cervix by irrigating it with a local anesthetic solution.
The tip of the pipel is inserted into the uterine cavity through the cervical canal.
The gynecologist pulls back the plunger and negative pressure is created in the tube. As a result of this effect, part of the endometrium enters the pipel cavity. The doctor takes material from different areas.
Once sufficient material has been obtained, tissue samples are sent to a laboratory for processing. histological analysis.
The pipel is removed from the uterine cavity. The duration of the procedure is 1-3 minutes.

The results of histological analysis of endometrial tissues are obtained 7-14 days after the biopsy. After their assessment, the gynecologist makes a diagnosis and draws up a plan for further examination and treatment.

After the procedure

After performing an aspiration biopsy of the endometrium, the patient feels satisfactory and can go home. Her performance is not disturbed in any way, and the need for hospitalization does not arise.

In the next 1-2 days, the patient may feel slight painful sensations of a pulling nature in the lower abdomen. To eliminate spasmodic pains that cause significant inconvenience, a woman can take antispasmodics (No-shpa, Papaverine, Spasmalgon). As a rule, such discomfort does not last more than 1 day.

In the first few days after the aspiration biopsy procedure, women have mild bloody discharge from the genital tract. Most experts recommend that their patients refrain from sexual intercourse these days. After the termination spotting a woman can resume sexual life and use barrier contraceptives to prevent pregnancy.

After the study, menstruation may occur on time or with some delay (up to 10 days). In such cases, the woman is advised to take a pregnancy test and visit a doctor.

After an aspiration biopsy, pregnancy may occur already in the current or subsequent cycle. This method of sampling the endometrium does not affect the functioning of the ovaries and the remaining area of the uterine mucosa is sufficient for implantation of the fetal egg.

Possible Complications

The endometrial aspiration biopsy procedure is minimally invasive and, in rare cases, leads to complications. After the examination, the gynecologist necessarily acquaints the patient with symptoms, in the event of which she should immediately consult a doctor:

increase in body temperature;
bleeding from the vagina (thick, bright red discharge);
persistent pain in the lower abdomen;
dizziness or fainting;
convulsions.

Benefits of endometrial aspiration biopsy

Pipel biopsy has a number of significant advantages:

low risk of injury to the walls of the uterus;
there is no need to expand the cervical canal for the introduction of instruments;
the possibility of obtaining endometrial tissue from inaccessible areas of the uterine cavity;
minimal risk of infection;
minimal risk of complications;
no pain during the procedure;
rapid recovery of the patient after the biopsy;
the possibility of performing the study on an outpatient basis and the absence of the need for hospitalization of the patient;
high information content;
no negative impact on the body of a woman preparing for pregnancy (for example, before IVF);
simple preparation for the procedure;
low research cost.

What will the result of histological analysis after aspiration biopsy show?

In the absence of pathological abnormalities in the structure of the mucous layer of the uterus, the analysis will indicate that the endometrium corresponds to the age norm and the phase of the menstrual cycle, and there were no signs of atypia.

If abnormalities in the structure of the mucous layer of the uterus are detected, the following pathological changes can be indicated in the results of the analysis:

adenomatosis (or complex endometrial hyperplasia);
simple diffuse (or glandular, glandular-cystic) endometrial hyperplasia;
local endometrial hyperplasia with or without atypia (or polyposis, single polyps);
simple or complex atypical endometrial hyperplasia;
hypoplasia or atrophy of the endometrium;
endometritis;
discrepancy between the thickness of the endometrium and the phase of the menstrual cycle;
malignant transformation of the endometrium.

Endometrial aspiration biopsy is often used as a screening method for examining patients with questionable ultrasound results. However, this method of sampling the tissues of the inner layer of the uterus does not always make it possible to obtain a sufficient amount of material to completely exclude the presence of malignant tumors. That is why, if a cancerous process is suspected, the examination of the patient is supplemented by a more informative diagnostic curettage.

What to do after an endometrial aspiration biopsy

After the Pipel biopsy is performed, the doctor sets the date for the next visit to the patient. Usually, histological examination analyzes are ready 7-14 days after the procedure, and based on their results, the gynecologist can determine further tactics for diagnostic and therapeutic measures.

If signs of atypia or cancerous processes are detected, the doctor decides on the need for additional research and surgical treatment. If the results of histological analysis indicate the presence of inflammation, then the patient is prescribed antibiotic therapy and anti-inflammatory drugs.

When determining signs of hyperplasia or insufficient response of the endometrium to hormonal changes during the menstrual cycle, the doctor conducts additional diagnostic tests to identify endocrine disorders. After that, the patient may be prescribed hormone therapy that improves the condition of the endometrium and restores reproductive function, taking other drugs and physiotherapy.