Application of PALM-COEIN FIGO classification in diagnosis of abnormal uterine bleeding (AUB) patients Ahmed Sharda B1,*, Mogri Sushma2 1Associate Professor, Dept. of Obstetrics and Gynaecology, American International Institute of Medical Sciences, Udaipur, Rajasthan, India 2Assistant Professor, Dept. of Obstetrics and Gynaecology, American International Institute of Medical Sciences, Udaipur, Rajasthan, India *Corresponding Author: Email: drshardaahmed@gmail.com
Online published on 24 September, 2018. Abstract Objective The aim is 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 9 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. Materials and Methods The study comprises 350 women of reproductive age with AUB for minimum 3 months time span. It describes and observes AUB in amount, interval and frequency for women attending outpatient Gynae department of AIIMS, Udaipur (Raj) from Nov 16 to Oct 17. 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 & Hyperplasia (n=28, 8.1%), Polyp (n=9, 2.5%), Iatrogenic (n=7, 2.2%) and Coagulopathy (n=1, 0.3%). Conclusion The PALM-COEIN classification helps to practically ascertain the cause of AUB, and thereby effectively adopt the correct treatment for AUB patients. Top Keywords Abnormal uterine bleeding, AUB, Classification system, Polyp leiomyoma, Adenomyosis, Ovulation, Malignancy. Top |