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Endometrial Pipelle biopsy

Abnormal bleeding ≥45 or risk factors; PMB with endometrium ≥4 mm.

Source: NICE NG12 · NG88

Steps

  1. Exclude pregnancy; speculum; clean cervix.
  2. Insert Pipelle to fundus without force.
  3. Pull piston fully back for suction.
  4. Rotate and move in–out 3–4 times.
  5. Sample into formalin.
An inadequate sample does not exclude cancer — arrange hysteroscopy if symptoms persist or high risk.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.