scholarly journals Diagnosis of abnormal uterine bleeding using PALM COEIN classification and its management: An institutional experience

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chandana Chandregowda ◽  
Swathi Aswath Reddy ◽  
Sujatha Datti ◽  
Shreedhar Venkatesh
Keyword(s):  
Classification System ◽  
Intrauterine Device ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Diagnosis And Treatment ◽  
Research Centre ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Institutional Experience ◽  
Lost To Follow Up

Aims: Categorization and treatment of abnormal uterine bleeding based on FIGO - PALM COEIN classification system Methods: A prospective cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru for a period of 1year from January 2019 to December 2019. All cases with abnormal uterine bleeding in 20 - 50 years of age were taken. Clinical details and imaging tests recorded, and categorized by FIGO- PALM COEIN classification for diagnosis and treatment. Statistical Package for Social Sciences version 21 was used to analyse the data and presented as frequencies and percentages. Results: Out of 300 women of AUB, 190 had structural (PALM) and 110 women had nonstructural (COEIN) aetiology; 138 women among 300 underwent hysterectomy and 20 patients underwent hysteroscopic polypectomy. Levonorgestrel intrauterine device inserted in 40 patients, 85 women were managed medically and 17 women lost to follow-up for further management. Conclusion: FIGO PALM-COEIN classification system for the diagnosis and treatment of abnormal uterine bleeding was adopted for the uniform standard.

scholarly journals Thyroid abnormality in abnormal uterine bleeding: an observational study from Medical College in Eastern UP, India

2017 ◽  
Vol 7 (1) ◽  
pp. 308
Author(s):  
Prachi Singh ◽  
Prashant Dubey ◽  
Shweta Yadav ◽  
Sachin Singh Yadav
Keyword(s):  
Observational Study ◽  
Thyroid Function ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Thyroid Function Tests ◽  
Cross Sectional ◽  
Medical College ◽  
Hormonal Imbalance ◽  
Euthyroid Status

Background: Abnormal Uterine Bleeding (AUB) is one of the commonest gynecological complain in reproductive age group. Menstrual abnormalities are commonly seen when there is any alteration in thyroid function. Objective of present study was to investigate the prevalence of AUB and to determine the menstrual pattern in cases with thyroid dysfunction.Methods: The present cross sectional observational study was conducted Teerthankar Mahaveer Medical College and Research Center Moradabad. Total 400 cases presenting with AUB were included in the study. Routine blood test, ultrasonography and thyroid function tests were done in these cases.Results: Among all the cases presenting with menstrual abnormalities 26% had hypothyroidism and 9% have hyperthyroidism and rest had euthyroid status. Menorrhagia (45.2%) and polymenorrhoea (37.5%) were commonest menstrual abnormality seen in cases with hypothyroidism. Most cases with hyperthyroidism presented with hypomenorrhoea (27.8%).Conclusions: Thyroid function abnormality is common in cases presenting with AUB and it gets relieved in correcting hormonal imbalance.

scholarly journals AN OBSERVATIONAL CLINICAL STUDY TO EVALUATE SHONITADUSHTI NIDANA IN ASRIGDARA

2021 ◽  
Vol 9 (8) ◽  
pp. 1642-1647
Author(s):  
Silviniya Anitharaj Fernandes ◽  
Prasanna N Mogasale ◽  
Arun Kumar M ◽  
Nagaraj S
Keyword(s):  
Risk Factors ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
The Body ◽  
Descriptive Statistics ◽  
Menstrual Blood ◽  
Blood Components ◽  
Disease Manifestation ◽  
Cross Sectional ◽  
Recorded Data

Asrigdara is a disease produced by Dosha Prakopa (vitiation of Dosha) along with Rakta Dushti (vitiation of blood components) primarily in Artavaha Srotas characterised by excessive excretion of menstrual blood where the increased Rakta mix with Raja (menstrual blood) thus, the quantity of Raja increases. It refers to all types of Abnormal Uterine Bleeding (AUB), in which Asrigdara is traditionally expressed as menorrhagia, metrorrhagia, polymenorrhea etc. Up to 1/3rd of women is experiencing abnormal uterine bleeding most commonly in menarche and menopause. Still, the cure of Asrigdara is facing difficulty, which shows that the understanding of Asrigdara is still incomplete, and this motivates to determine further, the other risk factors or other pathology involved in asrigdara. Objective: This calls for an evaluation of the possible Shonitha Dushti Nidana in Asrigdara to identify more risk factors. Methods: In this cross-sectional observational study, 36 subjects diagnosed with Asrigdara were selected. The probable incidence of Nidana (causes), in patients, were assessed through a questionnaire de- veloped for the study. The recorded data were analysed with descriptive statistics. Results: Aharaja Nidanas of Asrigdara acts as Viprakrushta Hetu (remote cause) causes Dhatu Pradooshana (vitiation of tissues) in the body. The Nidana Viruddha Ahara causes Rakta Dushti directly. The Manasika Nidanas such as Krodha (anger) is found to act as Vyanjaka Hetu (weak cause) in the manifestation of Asrigdara. Conclusion: Bahya Hetu (externalfactors) triggers Dosha Kopa or causes Dhatu Pradooshana. In Asrigdara patients, Pitta Pradhana Tridosha and Rakta were vitiated to initiate the disease manifestation. Keywords: Asrigdara, Rakta, Abnormal uterine bleeding, Raja.

scholarly journals Evaluation of the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (10) ◽  
pp. 3885
Author(s):  
Kushla Pathania ◽  
Surbhi Sharma
Keyword(s):  
Diagnostic Accuracy ◽  
Postmenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Cross Sectional ◽  
Predictive Values ◽  
Menopausal Women ◽  
Submucous Fibroid ◽  
Post Menopausal

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.

scholarly journals Thyroid disorders in women with dysfunctional uterine bleeding

2016 ◽  
Vol 6 (12) ◽  
pp. 1018-1020
Author(s):  
S Subedi ◽  
B Banerjee ◽  
C Manisha
Keyword(s):  
Reproductive Function ◽  
Hormonal Treatment ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Dysfunctional Uterine Bleeding ◽  
Cross Sectional ◽  
Menstrual Pattern

Background: Thyroid hormones play a key role in the menstrual and reproductive function of women .It is recognized universally that menstrual disturbances may accompany clinical alteration in thyroid function and every clinician has encountered altered menstrual pattern among women suffering from thyroid disorders. The aim of this study was to find the incidence of thyroid disorders in Dysfunctional uterine bleeding and its correlation with menstrual patterns.Materials and Methods: A hospital based cross-sectional study including 75 cases with dysfunctional uterine bleeding attending the OPD of Nobel Medical College, where incidence of thyroid disorder was evaluated along with its correlation with menstrual patterns and histopathology.Results: The incidence of Gynecological OPD attendance due to abnormal uterine bleeding was 3%.and the incidence of thyroid dysfunction was 10.6% with hypothyroidism being the commonest. (9.3%). The commonest menstrual pattern found was menorrhagia/polymenorrhoea in 8 percent.Conclusion: Prevalence of hypothyroidism was more common in DUB. Thus every woman with menstrual irregularities should undergo thyroid assessment and this will ultimately avoid unnecessary intervention like misuse of hormonal treatment and hysterectomy.

scholarly journals Prevalence of thyroid dysfunction in women with abnormal uterine bleeding in reproductive age

2020 ◽  
Vol 9 (7) ◽  
pp. 2792
Author(s):  
Hema K. R. ◽  
Girish B. L. ◽  
Dhananjaya B. S. ◽  
Riyaj Ahmad Kalaburgi
Keyword(s):  
Thyroid Dysfunction ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
Thyroid Profile ◽  
Definitive Management

Background: Abnormal uterine bleeding (AUB) is one of the commonest presentations encountered in gynecological outpatient department. Menstruation is also regulated by many mechanisms, including thyroid hormone. So, for definitive management of AUB, it becomes imperative to assess thyroid status in those with abnormal uterine bleeding.Methods: Cross sectional study was conducted on all woman attending to OPD at Sri Siddhartha Medical College, Tumukuru, with complaints of abnormal uterine bleeding (AUB). Thyroid test was done for those who were eligible under inclusion criteria. Incidence of thyroid disorders among AUB and type of abnormal menstrual pattern associated with specific type of thyroid dysfunction were noted in this study.Results: Total of 522 presented with AUB. AUB was most common among woman age >40 years at 49.23% (257 of total 522 cases). AUB was more common in Multipara at 61.49% (321 of 522 cases). Menorrhagia was commonest pattern in AUB accounting for 51.34% (268 of 522cases). Thyroid dysfunction was present in 12.27% (64 of 522) of cases with AUB. Among them hypothyroid was most common accounting for 8.81% (46 of 522 cases). Hyperthyroidism was present in 3.44% (18 of 522 cases). Menorrhagia was most common pattern in Hypothyroidism at 65.21% (30 of 46 cases, followed by polymenorrhea at 17.39% (8 of 46 cases). Oligomenorrhea was most common in hyperthyroid group at 55.54% (10 of 18 cases) closely followed by hypomenorrhea at 44.44% (8 of 18 cases).Conclusions: Abnormal uterine bleeding (AUB) is one of the commonest gynecological complaint at gynecological OPD.  Thyroid dysfunction is noted consistently in cases of AUB. So, evaluation of thyroid profile should be part of evaluation of AUB, especially during perimenopause.

Levonorgestrel-releasing intrauterine device in the treatment of abnormal uterine bleeding: a 6- and 12-month morphological and clinical follow-up

2013 ◽  
Vol 53 (4) ◽  
pp. 381-385 ◽  
Author(s):  
Vittorio Palmara ◽  
Emanuele Sturlese ◽  
Daniela Villari ◽  
Valentina Giacobbe ◽  
Annalisa Retto ◽  
...  
Keyword(s):  
Intrauterine Device ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding

Abnormal uterine bleeding in puberty: diagnosis and treatment

2016 ◽  
Vol 22 (6) ◽  
pp. 89
Author(s):  
L. V. Adamyan ◽  
E. V. Sibirskaya ◽  
I. E. Koltunova ◽  
O. N. Loginova ◽  
N. O. Tarbaya ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Diagnosis And Treatment

scholarly journals Assessment of thyroid and prolactin levels among the women with abnormal uterine bleeding

2017 ◽  
Vol 6 (6) ◽  
pp. 2547
Author(s):  
Jovita Deepthy John ◽  
Vimala Damodaran ◽  
Shankar Radhakrishnan
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
High Serum ◽  
Uterine Bleeding ◽  
Serum Prolactin ◽  
Age Group ◽  
Free T4 ◽  
Cross Sectional ◽  
The Mean ◽  
Tsh Levels

Background: Thyroid disorders are 10 times more common in women than men.1 Menstrual disturbances usually accompany clinical alterations in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from either hypo or hyper thyroidism. A high serum prolactin level can distrurb the follicular maturation and corpus luteum function, and leads to inhibition of normal pulsatile secretion of gonadotrophin-releasing hormone in hypothalamus resulting in anovulation. The aim of the study was to assess the thyroid and the prolactin levels among the women with abnormal uterine bleeding and to evaluate the association between them by comparing with normal females.Methods: A cross sectional study was conducted for a period of one year between Jan 2016 and December 2016 in our institution at the gynaecology OPD. Patients in the age group of 15 to 45 with the complaints of abnormal uterine bleeding and with the ultrasound findings showing normal uterus and ovary were included in the study. Hundred age and sex matched controls without any complaints of abnormal uterine bleeding in the age group of 15 – 45 years were also included in the study. Free T3, Free T4, TSH and prolactin estimation was done by chemiluminescent immunoassay for both the patients and the controls.Results: The mean TSH levels among the cases were much higher than that of the controls and the difference in the levels found to be statistically significant. Similarly, hyperprolactinemia was found in 18 cases when compared to 2 cases in controls and the mean prolactin levels were higher in cases. The serum prolactin levels and the serum TSH levels showed a perfect positive correlation which indicates that as the TSH level increases prolactin levels also increases with the R value >0.5.Conclusions: Early detection of hypothyroidism in such subjects saves the patient from recurrent curettage and at times hysterectomy. The financial implications of screening for prolactin/thyroid hormone abnormalities will have to be evaluated before a general recommendation can be made.

scholarly journals Clinical bleeding patterns and management techniques of abnormal uterine bleeding at a teaching and referral hospital in Western Kenya

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243166
Author(s):  
Godfrey Shichenje Mutakha ◽  
Emily Mwaliko ◽  
Philip Kirwa
Keyword(s):  
Medical Management ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Referral Hospital ◽  
Reproductive Age ◽  
Laboratory Evaluation ◽  
Cross Sectional ◽  
Western Kenya ◽  
Prolonged Bleeding ◽  
Diagnostic Guideline

Abnormal uterine bleeding (AUB) affects 30% of reproductive age women globally. However, there are limited local studies evaluating the management of these women. The diagnostic guideline using structural and functional causes of AUB adopts the PALM-COEIN criteria, namely: Polyp; Adenomyosis; Leiomyoma; Malignancy and Hyperplasia; Coagulopathy; Ovulatory dysfunction; Endometrial; Iatrogenic; and Not yet classified. This study aimed to determine the clinical bleeding patterns, adherence to PALM-COEIN diagnosis guidelines and management of AUB among women in their reproductive age. This was a cross-sectional study among 108 women with AUB aged 18–45 years was conducted at the gynaecology department of Moi Teaching and Referral Hospital in Western Kenya between April 2018 and April 2019. Their sociodemographic and clinical characteristics were collected using interviewer administered structured questionnaire and chart reviews. Adherence to diagnosis recommendations was assessed using PALM COEIN classification. Descriptive and inferential data analysis was conducted at 95% confidence interval. The median age was 30 (IQR: 22, 41) years with prolonged bleeding as the most predominant pattern at 41.7%. Bleeding patterns were significantly associated with age (p = 0.04). Only 16.7% were diagnosed as per the PALM-COEIN criteria with PALM and COEIN accounting for 60% and 40% respectively. Leiomyoma (44.5%) was the common cause of AUB. Laboratory evaluation included: pregnancy tests, full haemogram, hormonal profile and biopsy. Most (79.6%) of the women had abdominopelvic ultrasound done. Medical management was provided for 78.7% of women. Prolonged bleeding was the most common pattern with medical management preferred. There is need for in-hospital algorithms to ensure adherence to PALM-COEIN guidelines.

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