Abnormal Uterine Bleeding / Pipelle sampling

Module created by Waitemata DHB for primary healthcare providers practicing in the ADHB and/or WDHB areas.

With an ageing population and a rising BMI status, the population at risk of developing endometrial cancer is increasing.  In order to identify these women in a timely and acceptable way, the option of endometrial sampling in the community needs to be widely available.  This means more GPs will be able to perform pipelle samples in their practices.

This module will provide the knowledge necessary to identify, assess and manage people with Abnormal Uterine Bleeding (AUB). Primary care practitioners will undertake this work as part of the AUB Pathway. 

Learning objectives:

• Understand the causes of different types of AUB.
• Understand the important elements of history and vaginal examination.
• Determine when endometrial Pipelle sampling is indicated.
• Counsel women for this procedure including the risks and side effects.
• Describe potential complications and how to manage them.
• Interpret and respond appropriately to histology results.

Further training

• For Credentialed GPs - Direct contact with secondary care consultants will be available through the On-Call Gynaecology Senior Medical Officer (SMO) at your hospital. Written advice is also available via the “Specialist Advice” option on e-referrals.
• Training video - Endometrial biopsy YouTube 
• GP Liaison - Dr Sue Tutty, General Practitioner Liaison (GPL) Women’s Health, 021 875 002 or email [email protected].
• To arrange pipelle training in outpatient clinic:
• Manukau Health Park, please contact: Terri Norton, Charge Nurse Manager – email [email protected]
• Greenlane Hospital, please contact: Emma Battersby, Gynaecology Ops Manager - email [email protected]

Acknowledgements

This content has been developed by:

• Dr Helen Roberts, Consultant ADHB Contraception/Menopause clinic, First Certifying Consultant at Epsom Day Unit, Honorary Associate Professor of Women’s Health at University of Auckland, Pipelle/Jadelle/IUD insertion trainer. 
• Dr Sue Tutty, General Practitioner Liaison (GPL) Women’s  Health, Counties Manukau DHB. 
• Dr Wendy Burgess, Ngāti Kahungunu/Ngāti Hawea. Obstetrician Gynaecologist, Waitematā DHB.