scholarly journals Resolution of the 1st Ukrainian expert forum on abnormal uterine bleeding

2021 ◽  
pp. 64-74
Author(s):  
- -
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Well Being ◽  
Uterine Bleeding ◽  
Therapeutic Approaches ◽  
Important Indicator ◽  
Gynecological Disorders ◽  
Current Thinking ◽  
Ovulatory Dysfunction ◽  
Pathogenetic Therapy

The menstrual cycle is an important indicator not only of the female reproductive system health but also an integral part of women's health. The issues of therapeutic approaches for menstrual disorders, considering the general trend towards an increase in the proportion of this pathology among the total gynecological disorders in Ukraine, are susceptible and require close attention. The problem of abnormal uterine bleeding (AUB) has a significant impact on women and health care worldwide. Algorithms for the diagnosis and therapy of AUB need to be regularly revised as international recommendations are updated, clinical trials are published, and a new look at pathogenetic mechanisms is made.The prerequisites for holding of this Expert Forum were the updating of the FIGO classification of uterine bleeding in 2018, the NICE guidelines “Heavy menstrual bleeding: assessment and management” in 2018 and 2021, as well as the new conditions of the pandemic era, which has taken its toll on the care of patients with AUB.The Resolution summarized all data unaccounted for in the current clinical protocol for AUB issued in 2016 and updated data from international guidelines and key studies in patients with AUB; highlighted in detail current thinking on the pathogenetic therapy of functional AUB, with an emphasis on chronic AUB associated with ovulatory dysfunction (AUB-O) and endometrial disorders (AUB-E), as the most common; provided modern approaches to the management of chronic AUB associated with non-structural causes (ovulatory dysfunction and endometrial factors), and prevention of acute AUB for implementation in clinical practice and improving the provision of evidence-based medical care and individualized patient care.The Resolution aims to optimize clinical approaches to patient management and ensure therapy personalization, which together will improve the reproductive health and general well-being of Ukrainian women.

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.

Endometrial Ablation in Women with Abnormal Uterine Bleeding Associated with Ovulatory Dysfunction (AUB-O): A Cohort Study

2014 ◽  
Vol 21 (6) ◽  
pp. S107-S108
Author(s):  
A.N. Hokenstad ◽  
S.A. El-Nashar ◽  
Z. Khan ◽  
M.R. Hopkins ◽  
S.K. Laughlin-Tommaso ◽  
...  
Keyword(s):  
Cohort Study ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Ablation ◽  
Uterine Bleeding ◽  
Ovulatory Dysfunction

Utility of the PALM-COEIN classification of abnormal uterine bleeding for Indian gynecologists

2016 ◽  
Vol 133 (2) ◽  
pp. 196-198
Author(s):  
Nirmala D. Bandi ◽  
Chandrasekharan P. Arumugam ◽  
Meenakumari R.N. Venkata ◽  
Lahari Nannam
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding

scholarly journals The FIGO classification of causes of abnormal uterine bleeding

2011 ◽  
Vol 113 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Malcolm G. Munro ◽  
Hilary O.D. Critchley ◽  
Ian S. Fraser
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Figo Classification

scholarly journals Abnormal Uterine Bleeding in Adolescence: When Menarche Reveals other Surprises

2021 ◽  
Vol 43 (10) ◽  
pp. 789-792
Author(s):  
Helena Gomes ◽  
Bruna Abreu ◽  
Liliana Barros ◽  
Carlos Veríssimo
Keyword(s):  
Emergency Department ◽  
Medical Treatment ◽  
Burkitt Lymphoma ◽  
Clinical Case ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Personal History ◽  
Age Group ◽  
Appropriate Treatment ◽  
Ovulatory Dysfunction

Abstract Introduction Abnormal uterine bleeding is more frequent in adolescence. Although, most commonly, it has a non-structural etiology, it may be due to any cause described. Clinical case A 12-year-old adolescent, with no relevant personal history, menarche 1 month before, was observed in the emergency department for severe menstrual bleeding with progressive worsening, and hemodynamic repercussion in need of transfusion support. Physiological ovulatory dysfunction associated with possible previously unknown coagulopathy was considered to be the most likely diagnosis and medical treatment was initiated. Without response, the patient was submitted to sedated observation and uterine aspiration, which ultimately led to the diagnosis of a Burkitt Lymphoma. Discussion Although structural causes, and particularly malignancy, whether gynecological or not, are a rare cause of abnormal uterine bleeding in this age group, they must be considered, thus enhancing the fastest and most appropriate treatment.

Abnormal Menstrual Bleeding

2018 ◽  
Author(s):  
Chu Hsiao ◽  
Leanne Dumeny ◽  
Candice P. Holliday ◽  
Lisa Spiryda
Keyword(s):  
Intrauterine Device ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Artery Embolization ◽  
Ovulatory Dysfunction ◽  
Menstrual History ◽  
Inflammatory Drugs ◽  
Medical Therapies ◽  
Surgical Treatments

Abnormal uterine bleeding (AUB) is a common presentation that can occur in all age groups. AUB is an umbrella term for any uterine bleeding that occurs outside a woman’s normal pattern in volume, regularity, and/or timing. AUB is described by using frequency, regularity, duration, and volume or by using PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy and premalignant conditions; Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified). Workup for AUB comprises a history (with a detailed menstrual history), physical examination (including a pelvic and bimanual examination), lab tests, and imaging (primarily transvaginal ultrasonography). For treatment, medical therapies should be considered before surgical therapies, especially when fertility is desired. The decisions for treatment are based on etiology, fertility concerns, contraindications, or patient preference. Of the medical therapies, there are hormonal and nonhormonal therapies. The most common treatments for AUB are levonorgestrel intrauterine device, tranexamic acid, oral contraceptives, and nonsteroidal anti-inflammatory drugs. The most common surgical treatments are myomectomy, endometrial ablation, uterine artery embolization, and hysterectomy.   This review contains 7 figures, 10 tables and 45 references Key words: abnormal uterine bleeding, adenomyosis, contraceptives, endometrial, fibroids, hysterectomy, menorrhagia

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