© 2020 Journal of Family Medicine and Primary Care | Published by Wolters Kluwer - Medknow 3496 Introduction Approximately 1/3 rd of all gynaecological consultations are related to abnormal vaginal bleeding, and this proportion increases to 70% in the peri and postmenopausal ages. [1] It also accounts for two third cases of hysterectomy. Most gynaecologist agree that abnormal vaginal bleeding after the age of 40 years requires further evaluation to exclude the presence of endometrial polyps, hyperplasia, fibroids or carcinoma. [2] There are various methods for endometrial assessment among women with abnormal uterine bleeding which include ultrasonography, endometrial curettage (D and C), Office based methods including biopsy by hysteroscopy or endometrial samplers like Karman cannula and pipelle. [3,4] Dilatation and curettage (D and C) has for long been considered the “gold standard” in the diagnosis of endometrial pathology. [5] One of the most commonly performed gynecological surgery, it accounts for a large proportion of hospital bed use and operating room time. The procedure is expensive, invasive and time consuming. The procedure carries the complications of anaesthesia and there is risk of uterine perforation, intra‑uterine infection and cervical laceration. [6,7] For these reasons, there is a need for a simple, Accuracy of Karman endometrial aspiration in comparison to conventional D and C in women with AUB at tertiary care hospital in North West Rajasthan Ankur Nama, Swati Kochar, Neha Suthar, Arun Kumar, Kirti Solanki Department of Obstetrics and Gynaecology, S.P. Medical College and Associated Group of Hospitals, Bikaner, Rajasthan, India ABSTRACT Background: Approximately 33% of all gynaecological consultations are associated with abnormal vaginal bleeding, and this proportion increases to 70% in the peri and postmenopausal years. Aims and Objective: To compare the diagnostic accuracy of Karman`s cannula endometrial aspiration histopathology versus dilatation and curettage in patients with abnormal uterine bleeding. Methodology: In total 100 women of all age groups with a clinical diagnosis of AUB were included in this prospective comparative study. Endometrial aspiration with Karman cannula was performed in the operation theatre prior to curettage to maintain synchronization during sampling. Results: In our study, no significant difference was observed between Karman and D and C regarding sample adequacy (P = 0.07), HPE findings (P = 1) and concordance rate with hysterectomy specimen (P = 1). 95% of the samples obtained by Karman and 98% of those obtained by D and C were adequate. For obtaining an adequate sample by Karman the sensitivity and accuracy was 96.94% and 96% when compared with D and C. Karman and D and C had comparable concordance rates (95% and 95%) with hysterectomy specimen. Karman endometrial sampling is an easy procedure when compared to D and C (P = 0.007). With considering D and C as gold standard Karman endometrial sampling demonstrated 100% accuracy for diagnosing adenocarcinoma, endometrial hyperplasia. Conclusion: Endometrial aspiration with Karman cannula is an easy, safe, cost‑effective, accurate, convenient method of achieving histopathological diagnosis. It can be done as an outpatient procedure without analgesia and anaesthesia when compared to D and C which is expensive and invasive method and requires hospitalization and general anaesthesia. Keywords: Karman cannula, D and C, AUB, Endometrial aspiration, diagnostic accuracy Original Article Access this article online Quick Response Code: Website: www.jfmpc.com DOI: 10.4103/jfmpc.jfmpc_291_20 Address for correspondence: Dr. Swati Kochar, 1 B 2 Pawanpuri, Bikaner, Rajasthan, India. E‑mail: swatikochar148@gmail.com How to cite this article: Nama A, Kochar S, Suthar N, Kumar A, Solanki K. Accuracy of Karman endometrial aspiration in comparison to conventional D and C in women with AUB at tertiary care hospital in North West Rajasthan. J Family Med Prim Care 2020;9:3496-501. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com Received: 21‑02‑2020 Revised: 14‑03‑2020 Accepted: 30‑03‑2020 Published: 30‑07‑2020