scholarly journals Distribution of causes of abnormal uterine bleeding using new FIGO classification system-PALM COEIN: a rural tertiary hospital based study

2017 ◽  
Vol 6 (8) ◽  
pp. 3523 ◽  
Author(s):  
Kalpana Betha ◽  
Lavanya Malavatu ◽  
Sreeveena Talasani
Keyword(s):  
Classification System ◽  
International Comparisons ◽  
Abnormal Uterine Bleeding ◽  
Tertiary Hospital ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Histopathological Diagnosis ◽  
Common Cause ◽  
Tertiary Teaching ◽  
The Difference

Background: Abnormal Uterine Bleeding (AUB) is a significant debilitating clinical condition. It may have a significant impact on women’s quality of life with significant burden to the country’s economy. The primary aim was to categorize women with Abnormal Uterine Bleeding (AUB) according to PALM COEIN classification system and to correlate the clinical diagnosis and histopathologic features of various causes of AUB.Methods: A retrospective study was carried out on 250 non-gravid reproductive age women between 25-45 years with complaints of AUB at Mediciti Institute of Medical Sciences, a rural tertiary teaching hospital during the period January 2014 to December 2015.Results: The PALM and COEIN groups accounted for 60.4% and 39.6% respectively. Leiomyoma was the most common cause of AUB (30.4%) and Ovulatory disorders was the 2nd most common cause of AUB (13.6%). A total of 172 (68.8%) were classified as having chronic AUB and 78(31.2%) as having acute AUB. In AUB-L, the difference in clinical and histopathological diagnosis was significant (p=0.03).Conclusions: Structural causes of AUB contributed more to the cause of AUB. The PALM COEIN classification system helps us in understanding various etiological causes of AUB and can be used by clinicians and researchers for international comparisons. 

scholarly journals STUDY TO CORRELATE CLINICAL AND HISTOPATHOLOGICAL FINDINGS OF ABNORMAL UTERINE BLEEDING ACCORDING TO FIGO’S PALM-COEIN CLASSIFICATION

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Disha Patel ◽  
Kanaklata D Nakum ◽  
Aditi Vithal
Keyword(s):  
Clinical Diagnosis ◽  
Classification System ◽  
International Comparisons ◽  
Indirect Costs ◽  
Abnormal Uterine Bleeding ◽  
Final Diagnosis ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Histopathological Findings ◽  
Group A

Abnormal uterine bleeding (AUB) is a common and debilitating condition with high direct and indirect costs. AUB frequently co-exists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint.  Abnormal uterine bleeding (AUB) is one of the common presenting complaints encountered by a Gynaecologist. The International Federation of Gynaecology and Obstetrics working group on menstrual disorders has recently developed a classification system (PALM–COEIN) for causes of the AUB in non-gravid women. The present study was conducted with the aim to study and analyse the structural (PALM) and the functional (COEIN) component of the PALM–COEIN system of AUB in perimenopausal age group. A total of 200 perimenopausal women (aged 40 years and above till 1 year beyond menopause) who were admitted with complaints of abnormal uterine bleeding comprised the study population. Clinical diagnosis and allocation to PALM–COEIN was done. Endometrial biopsy and hysterectomy specimens (wherever applicable) were obtained and sent for histopathology. As per the histopathological findings, possible underlying causes were categorized. Clinical diagnosis was then correlated with histopathology-based final diagnosis. PALM and COEIN components contributed almost equally for AUB when assessed clinically. The histological examination revealed significantly more cases of PALM (structural or anatomical) component of AUB. The PALM COEIN classification system helps us in understanding various etiological causes of AUB and can be used by clinicians and researchers for international comparisons. Keywords: Abnormal uterine bleeding (AUB) , PALM–COEIN . Perimenopause

scholarly journals Palm-coein classification of abnormal uterine bleeding and clinicohistopathological correlation

2021 ◽  
Vol 10 (4) ◽  
pp. 1587
Author(s):  
Vimal H. Vasava ◽  
Bhavesh B. Airao ◽  
Milan R. Shingala
Keyword(s):  
Classification System ◽  
Imaging Techniques ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Correct Treatment ◽  
Medical College ◽  
Ovulatory Dysfunction

Background: The aim was to categorize women with AUB as per the PALM-COEIN classification system as this is a step towards cause based diagnosis and focused management of patients. The acronym PALM-COEIN comes from arranging basic categories of the classification system. The PALM group comprises the structural entities, which can be measured visually or by using imaging techniques and histopathology. The COEIN group comprises the non- organic types which cannot be defined by imaging or histopathology.Methods: The study comprised 350 women of reproductive age with AUB for minimum 3 month time span. It describes and observes AUB in amount, interval and frequency for women attending out-patient Gynaecology department of C. U. Shah Medical College and Hospital, Surendranagar (Gujrat) over a period of 1year from November 17 to October 18. They were assessed on the basis of structured history, physical examination, local pelvis examination, investigations, USG findings and endometrial histopathological report. Cause of AUB was determined and treatment was given to the patient as appropriated by categorization done in agreement with the PALM-COEIN classification.Results: The most prevalent cause of AUB was ovulatory dysfunction (n=99, 28.2%). Next common cause was leiomyoma (n=90, 25.7%), followed by endometrial causes (n=52, 14.5%), adenomyosis (n=30, 8.5%) not yet classified (n=32, 9.7%), malignancy and hyperplasia (n=28, 8.1%), polyp (n=9, 2.5%), iatrogenic (n=7, 2.2%) and coagulopathy (n=1, 0.3%).Conclusions: The PALM-COEIN classification helps to practically as certain because of AUB, and there by effectively adopt the correct treatment for AUB patients.

scholarly journals Histopathological study of precursor and neoplastic lesions of endometrium in endometrial samplings

2017 ◽  
Vol 6 (3) ◽  
pp. 989
Author(s):  
Nanda J. Patil ◽  
Heena P. Shah ◽  
Mamta Bharti
Keyword(s):  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Age Group ◽  
Precursor Lesions ◽  
Gold Standard Method ◽  
Neoplastic Lesions

Background: Endometrial lesion presenting as abnormal uterine bleeding, abdominal pain and menstrual irregularities form most common presenting complaint in women of reproductive age group and in premenopausal women. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding (AUB). The present study was carried out to establish histopathological diagnosis of precursor and neoplastic lesions of endometrial samplings in correlation with clinical details and other investigations.Methods: A two-year prospective study was carried out in the department of pathology in a tertiary care hospital from June 2013-May 2015 which included endometrial samplings of precursor and neoplastic lesions. All cases were analyzed histopathologically.Results: The study included 46 cases comprising 30% of total 153 endometrial samplings. Out of these, precursor lesions were 36 cases (23.6%) and malignant were 10 case (5.8%). The highest incidence of precursor lesions (endometrial hyperplasia) was in the age group of 41- 50 years. Among the precursor lesions, endometrial hyperplasia without atypia (86%) was the commonest observation followed by atypical hyperplasia (14%).Conclusions: For the correct evaluation of cases presenting with AUB, histopathological evaluation of endometrial samplings is the gold standard method.

scholarly journals Validity of Hysteroscopy and Transvaginal Sonography in Evaluating Abnormal Uterine Bleeding- A Retrospective Study

2021 ◽  
Author(s):  
Sangam Jha ◽  
Monika Anant ◽  
Upasna Sinha
Keyword(s):  
Diagnostic Accuracy ◽  
Abnormal Uterine Bleeding ◽  
Minimal Invasive ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Operative Notes ◽  
Sensitivity Specificity ◽  
Reproductive Age Group

Introduction: Abnormal Uterine Bleeding (AUB) affects 14-25% of women of reproductive age group and accounts for 66% of hysterectomies. Accurate diagnosis of the cause of AUB will reduce the hysterectomy burden, but the ideal evaluating tool to accurately diagnose the cause of the same is debatable. Aim: To evaluate the diagnostic accuracy of transvaginal sonography and hysteroscopy in the evaluation of abnormal uterine bleeding, using histopathological diagnosis as gold standard. Materials and Methods: This retrospective descriptive study was conducted on patients who underwent transvaginal sonography and hysteroscopy for evaluation of abnormal uterine bleeding from January 2017 to January 2020. Data including demographic details, sonographic details, pre-operative diagnosis, anaesthesia used, operative notes, complications and histopathological diagnosis were obtained from clinical record sheet of the patients. Sensitivity, specificity, diagnostic accuracy of TVS and hysteroscopy was calculated using MedCalc software version 19.2.6. Results: A total of 214 patients were enrolled in the study. Hysteroscopy reported >95% diagnostic accuracy for all intrauterine pathology compared to TVS which revealed diagnostic accuracy of 73.13% for polyp, 77.1% for endometrial hyperplasia and 73.6% for all other pathology. Hysteroscopy revealed strong to almost perfect correlation with histopathological diagnosis for all pathology compared to TVS which demonstrated weak correlation for various intrauterine pathology. Conclusion: Hysteroscopy should be used as initial evaluating tool in AUB as it is simple and minimal-invasive with high diagnostic accuracy.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

Vaginal Bleeding

2020 ◽  
Keyword(s):  
Menstrual Cycle ◽  
Vaginal Bleeding ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Cause ◽  
Key Points ◽  
Normal Menstrual Cycle

Key Points Abnormal uterine bleeding refers to bleeding that is excessive or occurs outside normal cyclic menstruationAnovulatory uterine bleeding is the most common cause of abnormal uterine bleeding adolescents within 1–2 years of menarche.It is important to exclude pregnancy and infections prior to initiating treatment for anovulatory bleedingGoals of management for abnormal uterine bleeding include return to pattern of normal menstrual cycle and prevention of anemia.

scholarly journals Histo-Pathological Study of Endometrial Biopsies in Patients With Abnormal Uterine Bleeding

2017 ◽  
Vol 15 (2) ◽  
pp. 26-31
Author(s):  
Sharmila Parajuli ◽  
Binita Thapa
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
The Elderly ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Common Cause ◽  
Histopathological Findings ◽  
Common Sign ◽  
Work Up

Introduction: Abnormal uterine bleeding is a common sign of a number of different uterine disorders ranging from dysfunctional (non organic) abnormalities or complications of pregnancy to organic lesions such as polyps, hyperplasia or carcinoma. Methods: This is a retrospective study conducted at Hospital of 2nd author during a period of 5 years (Jan 2008-Dec 2013).  Histopathology records were retrieved and searched for cases of abnormal uterine bleeding. Relevant histopathological findings and clinical data were recorded and analyzed. The aim of the study was to determine the causes for abnormal uterine bleeding in women presenting to the hospital and to compare the histopathological findings at various age groups.Results: The age of patients ranged from 17 to 71 years with an average of 43 years. The most common cause of uterine bleeding was found to be proliferative phase endometrium; that were 649 cases (56.43%). Out of the pathological causes, the most common cause was found to be endometrial hyperplasia- 44 cases (3.82%). Endometrial carcinoma was found to be more common in the elderly postmenopausal women. A total of 6 cases (0.5%) of endometrial carcinoma were present.Conclusion: Endometrial hyperplasias and malignancies are common in increasing age group, especially in perimenopausal and postmenopausal women. So, a thorough work-up and diagnostic endometrial biopsy is therefore mandatory without delay in these patients to rule out malignancies. 

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