DOI: 10.36347/sjams.2016.v04i08.009

Pages: 2771-2773

In an effort to create a universally accepted system of nomenclature to describe uterine bleeding abnormalities, an alternative classification system polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified, known by the acronym PALM-COEIN, was published in 2011 by the International Federation of Gynecology and Obstetrics. The PALM-COEIN system classifies uterine bleeding abnormalities by bleeding pattern and etiology.The purpose of this study is to categorize 300 women with AUB presenting to the Gynaecology outpatient department (OPD) of Mahatma Gandhi Medical college and Hospital, Jaipur according to PALM-COEIN classification system. It is a retrospective study carried out on 300 patients presenting with complaint of abnormal uterine bleeding. They were evaluated on the basis of history, physical and local examination, USG pelvis, endometrial biopsy if required and other necessary investigations. Categorization was done according to the PALM-COEIN FIGO Classification and then the required treatment was given to the patient. After classifying the patients according to PALM-COEIN classification, it was found that ovulatory dysfunction was the most common cause of AUB in patients presenting to the Gynecology OPD (n=85, 28.33%). It was followed by leiomyoma (n= 68, 22.67%), endometrial causes (n= 62, 20.66%), adenomyosis (n=28, 9.33%), not classified (n = 25, 8.33%), iatrogenic (n= 13, 4.33%), malignancy, polyp (n = 8, 2.66%) and coagulation abnormalities contributing least to the classification (n= 3, 1%). Standardization of related terminology, a systematic approach to diagnosis and investigation, and a step-wise approach to intervention is necessary.