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Primary care endometrial sampling for abnormal uterine bleeding: a pilot study.

Jon M Dickson1, Brigitte Delaney1, Mary E Connor2

  • 1The University of Sheffield, The Academic Unit of Primary Medical Care, Northern General Hospital, Sheffield, UK.

The Journal of Family Planning and Reproductive Health Care
|August 22, 2017
PubMed
Summary
This summary is machine-generated.

Primary care endometrial sampling (PCES) can manage most premenopausal abnormal uterine bleeding (AUB) cases. This pilot service showed high primary care management rates and no hyperplasia or cancer, suggesting potential for reduced hospital referrals.

Keywords:
Education And TrainingGeneral PracticeHealth EconomicsPerimenopauseService Delivery

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Area of Science:

  • Gynaecology
  • Primary Care Medicine
  • Service Evaluation

Background:

  • Abnormal uterine bleeding (AUB) is a common gynaecological condition.
  • Endometrial sampling (ES) is crucial for diagnosing uterine pathologies.
  • Current ES practices are largely hospital-based, potentially leading to unnecessary referrals.

Purpose of the Study:

  • To design and evaluate a pilot primary care endometrial sampling (PCES) service.
  • To assess the feasibility and initial outcomes of PCES in general practice.
  • To determine the potential for managing AUB in primary care settings.

Main Methods:

  • Retrospective analysis of data from two service evaluations in the UK.
  • Estimated suitability of hospital-based ES cases for PCES.
  • Analyzed data from the first year of the PCES service activity.

Main Results:

  • An estimated 424 (22.4%) of 1894 hospital ES cases were suitable for PCES.
  • 108 PCES procedures were performed by GPs in the first year.
  • 97.2% of patients were managed exclusively in primary care, with 73.1% receiving Mirena intrauterine system, and no hyperplasia or cancer cases were reported.

Conclusions:

  • Premenopausal patients with AUB could potentially be managed in primary care with PCES.
  • PCES may reduce the need for hospital referrals for AUB.
  • Further research is needed to confirm the safety and cost-effectiveness of PCES.