Outpatient Pipelle Endometrial Biopsy Results: A Quality Improvement Project in Kuwait

Authors Dr. Islam Elkhateb¹˒², Dr. Wael Ragab¹, Kenzy Elessawy³, Dr. Abeer Alziyadi¹
Affiliations ¹ Department of Obstetrics and Gynecology, Adan Hospital – Kuwait Ministry of Health, Ahmadi, Kuwait ² Department of Obstetrics and Gynecology, Cairo University Students’ Hospital, Cairo, Egypt ³ School of Medicine, Newgiza University, Giza, Egypt

INTRODUCTION

Pipelle biopsy is the most common outpatient method for diagnosing endometrial cancer (90% detection rate).
First-line test for abnormal peri-/post-menopausal bleeding.
Insufficient samples range from 5–23% in literature.
At Adan Hospital, the rate was 32% (136/429) from April–October 2024.

OBJECTIVE
Identify contributing factors and improve outcomes via targeted interventions.

METHODOLOGY

Design: Retrospective audit at Adan Hospital, Ministry of Health, Kuwait. Interventions included:
Procedure proformas for each case.
Visual diagram of essential steps posted.
Case discussed in morning meetings.
Presented in departmental scientific sessions.
Reminder messages sent to team group.

 

Insufficient Pipelle biopsy samples were significantly higher than expected (32%). A multi-level intervention was launched to improve this rate.

 

RESULTS
Re-audit of insufficient samples planned for May 2025.
CONCLUSION
Clinical audit is a key quality improvement tool that enhances patient care and outcomes. This project aims to reduce the rate of insufficient outpatient endometrial biopsy samples at Adan Hospital, Kuwait. Continued efforts and future audits are recommended to sustain and further improve clinical standards.