Definition
An endometrial biopsy is a medical procedure in which a small sample of tissue is removed from the lining of the uterus (the endometrium) for examination under a microscope. This test is commonly performed to diagnose conditions such as abnormal uterine bleeding, endometrial cancer, or hormonal imbalances. It can also help evaluate fertility issues or monitor the effects of hormone therapy.
Purposes
- To rule out endometrial hyperplasia or cancer.
- To check if the body’s endometrial hormone levels are balanced in cases of infertility.
- To find out the cause of problems leading to heavy or irregular bleeding.
Indications
- Heavy or very long menstrual periods.
- Irregular menstruation.
- Abnormal bleeding in women taking tamoxifen, a breast cancer medicine.
- Thickened uterine lining determined by an ultrasound.
Articles
- Povidone-iodine solution (Betadine).
- Lidocaine 2% jelly.
- Required laboratory forms histopathology, microbial growth, and other tests as ordered.
- Perineal drapes.
- Formalin container for sample collection.
- Normal saline.
Sterile articles:
- Gloves.
- Gauze pieces and cotton balls in bowls.
- Cusco’s vaginal speculum.
- Uterine sound.
- Sponge holding forceps.
- Tenaculum/Vulsellum.
- Endometrial suction catheter.
- Cervical dilators.
- Sample containers for microbial and other tests.
- 10 ml syringe with cannula.
- Toothed forceps.
- Straight forceps.
- Biopsy instrument-pipelle (metallic or flexible plastic tubes with side opening at the tip).
Procedure
| Nursing action | Rationale | |
| 1. | Explain to patient the need, purpose, and procedure. | Reduces anxiety and promotes cooperation. |
| 2. | Assemble articles near the patient. | To save time and for smooth performance of procedure. |
| 3. | Ensure that informed consent is signed. | To avoid legal issues. |
| 4. | Instruct patient to empty her bladder. | To avoid discomfort and injury to bladder. |
| 5. | Assist her to lie at the lower edge of the examination table with knees flexed. | To promote convenience of performance. |
| 6. | Clean the perineum and vulva using antiseptic solution. | Provides germ free space for procedure. |
| 7. | Drape the perineal area. | To maintain sterile field for procedure. |
| 8. | Assist physician for insertion of instruments (speculum and Vulsellum) and removal of endometrial tissue and any secretion. | |
| 9. | Communicate with patient during the procedure. | Reduces fear and anxiety. |
| 10. | Following tissue/specimen removal, clean the vulval area, place sanitary pad, and assist patient to a comfortable position. | Promotes comfort of feeling of relief. |
| 11. | Inform patient that minor discomfort and slight bleeding are normal and expected. | Promotes relaxation. |
| 12. | Discard waste, wash and clean the reusable items, and replace articles as required. | Prepares articles for next use. |
| 13. | Dispatch samples collected for laboratory tests. | For accurate diagnosis of patient’s condition. |
| 14. | Document the procedure done and patient’s state of health in the clinical records. | Provides for communication among medical personnel. |
Post procedural care
- Have patient rest in bed for 20-30 minutes.
- Check vital signs.
- Assess bleeding, pain, and other discomforts.
- Instruct to report to doctor, occurrence of any of the following problems after she goes home:
- Bleeding for more than 2 days.
- Heavy bleeding.
- Fever with chills.
- Severe pain in lower abdomen.
- Offensive (foul-smelling) vaginal discharge.
Special Considerations
- Provide instructions for managing light vaginal bleeding or spotting, which is common after the biopsy.
- Advise the patient to avoid tampons or douching for a few days to reduce infection risk.
- Observe for immediate complications, such as excessive bleeding or signs of infection.
- Encourage the patient to report symptoms like fever or severe abdominal pain.
- Discuss follow-up care, including when and how the biopsy results will be shared.
- Advise the patient to rest and stay hydrated to support recovery.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
Stories are the threads that bind us; through them, we understand each other, grow, and heal.
JOHN NOORD
Connect with “Nurses Lab Editorial Team”
I hope you found this information helpful. Do you have any questions or comments? Kindly write in comments section. Subscribe the Blog with your email so you can stay updated on upcoming events and the latest articles.
