Low Dose Aspirin vs Placebo in Prevention of Recurrent Spontaneous Preterm Labour

Abnormal Uterine Bleeding (AUB) is a common gynecological issue affecting women globally, requiring endometrial tissue sampling to evaluate underlying causes such as hyperplasia, polyps, or malignancy. While Pipelle biopsy is a widely used outpatient sampling technique, its single-use nature makes it relatively expensive in resource-limited settings. Manual Vacuum Aspiration (MVA) using a 4 mm flexible cannula is an inexpensive, reusable alternative that requires no cervical dilation or electricity, but direct comparative evidence between MVA and Pipelle remains limited

Inclusion Criteria: * Married women aged 35 years and above. * Presentation with abnormal uterine bleeding (AUB), including metrorrhagia, menorrhagia, or postmenopausal bleeding. * Clinical indication for endometrial sampling for diagnostic evaluation. * Patient fit for both MVA and Pipelle procedures with no contraindications to either method. Exclusion Criteria: * Pregnancy or suspicion of pregnancy. * Active acute pelvic inflammatory disease (PID) or active lower/upper genital tract infection. * Current use of anticoagulant therapy or presence of underlying bleeding/coagulation disorders.