Publication:

Clinicopathological correlation of abnormal uterine bleeding according to PALM-COEIN classification in reproductive age group in a tertiary care center, North India

Background AUB is a common problem encountered by women of reproductive age group with increased risk during perimenopausal period. International Federation of Gynecology and Obstetrics (FIGO) has designed a new classification system PALM-COEIN in order to standardize the causes of AUB. Aims and Objectives were to stratify causes of AUB in women of reproductive age group in context to PALM-COEIN classification system. To establish a clinico-pathological correlation among causes of AUB taking aid of radiology wherever required.

Methods All women of reproductive age group presenting with complaints of AUB in department of gynecology from January 2018 to December 2021 were included in the study. The cause were classified based on PALM-COEIN classification both clinically and histopathologically. Radiological investigation was carried out wherever required.

Results Total 560 women of reproductive age group were registered. Majority 321 (57.32%) women were between 41-50 years of age and commonest complaint was heavy menstrual bleeding in 401 (71.60%). PALM and COEIN groups accounted for 40% and 60% respectively. Among structural causes, leiomyoma was the commonest cause 153 (27.32%) of AUB whereas among the functional causes most common was endometrial 188 (33.57%). The clinico-histopathological correlation was statistically significant in cases of AUB-P, AUB-A, AUB-O and AUB-E.

Conclusions The PALM-COEIN classification system helps to understand the causes of AUB and gives simpler terminology, diagnosis and investigations of the causes of AUB and offers better patient management. It can provide better means of quality assurance and appropriateness of treatment.