Comparison of classic terminology with the FIGO PALM‐COEIN system for classification of the underlying causes of abnormal uterine bleeding

Töz, Emrah; Şancı, Muzaffer; Özcan, Aykut; Beyan, Emrah; İnan, Abdurrahman Hamdi

doi:10.1016/j.ijgo.2015.09.033

Cited by 9 publications

(8 citation statements)

References 23 publications

(34 reference statements)

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“…The AUB-A prevalence has a wide range of fluctuations, reported from 4.94% to 53.4%. 17,19,20 That is mainly because adenomyosis was characterized by the presence of endometrial tissue locally or globally through the uterine musculature, so the most accurate diagnosis should be based on histopathology after hysterectomy. But for patients with fertility requirements, the integrity of the uterus is crucial, so the clinical value is limited only from specimens obtained from hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, in our study, we used pathology as the gold standard for diagnosing polyps. The AUB‐A prevalence has a wide range of fluctuations, reported from 4.94% to 53.4% 17,19,20 . That is mainly because adenomyosis was characterized by the presence of endometrial tissue locally or globally through the uterine musculature, so the most accurate diagnosis should be based on histopathology after hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

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Etiology distribution of abnormal uterine bleeding according to FIGO classification system: A combined study of ultrasound and histopathology

Guan

et al. 2022

J of Obstet and Gynaecol

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Aim To classify the FIGO's PALM‐COEIN etiology for abnormal uterine bleeding (AUB) patients according to the ultrasound and histopathology and to evaluate the etiology prevalence distribution for AUB patients. Methods A total of 1065 women with AUB in the Second Hospital of Shandong University between January 2019 and March 2021. The intrauterine histopathological and ultrasound results were reviewed retrospectively.PALM‐COEIN etiology classification was performed according to histopathology and ultrasound. The classification system was stratified into nine basic categories: Polyp (AUB‐P), adenomyosis (AUB‐A), leiomyoma (AUB‐L), malignancy and hyperplasia (AUB‐M), coagulopathy (AUB‐C), ovulatory disorders (AUB‐O), endometrium (AUB‐E), Iatrogenic(AUB‐I), and not classified (AUB‐N). The number of cases and composition ratio were also calculated. Results According to the FIGO's classification system, the PALM group (656,61.60%), which were defined as structural entities that can be measured visually with ultrasound and/or histopathology. 176 (16.53%) patients were classified as AUB‐P,102 (9.58%) patients were classified as AUB‐A, 487(45.73%) patients were classified as AUB‐L, 31 (2.91%) patients were classified as AUB‐M. The COEIN group (409,38.40%), which were defined as nonstructural entities that cannot be measured by ultrasound and/or histopathology. Nobody were classified as AUB‐C in our group, and 383 (35.96%) patients were classified as AUB‐O, 4 (0.38%) patients were classified as AUB‐E,14 (1.31%) patients were classified as AUB‐I,8 (0.75%) patients were classified as AUB‐N. Conclusion In our study, AUB‐L was the most common cause, followed by AUB‐O, AUB‐P, AUB‐A, AUB‐M, AUB‐I, AUB‐N, and AUB‐E.PALM‐COEIN etiology classification system played an important role in the epidemic and management standardization of AUB patients, provided an effective communication between physicians and researchers also. Ultrasonography was the preferred examination for AUB patients, especially with structural abnormalities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Etiology distribution of abnormal uterine bleeding according to FIGO classification system: A combined study of ultrasound and histopathology

Guan

et al. 2022

J of Obstet and Gynaecol

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“…Thus, in hypertension, there is a tendency to hypercoagulability, which contributes to the rapid depletion of coagulation factors and disseminated intravascular coagulation; vasospasm disrupts the blood supply to the vascular wall; increased pressure directly has an adverse effect on the vascular wall, which aggravates bleeding. Secondary to metabolic endocrine disorders, in particular obesity, dyslipidemia causes atherosclerotic damage of the vascular wall; an increase in leptin leads to hyperinsulinemia and insulin resistance, hyperglycemia as a result of various hormonal and metabolic disorders has a vasospastic, damaging effect on the vascular wall and an increase in the thrombogenic potential of the endothelium, aggravating bleeding [10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Clinical and diagnostic aspects of abnormal uterine bleeding in reproductive aged women with extragenital pathology

Tuchkina

Vygivska

Blagoveshchensky

et al. 2021

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Study objective: to determine the clinical and diagnostic features of the abnormal uterine bleeding (AUB) in women of reproductive age with extragenital pathology.Materials and methods. The study involved a retrospective assessment of 400 case histories of reproductive aged women with AUB who underwent inpatient treatment.The main clinical group (I) consisted of 300 case histories of women with AUB and concomitant extragenital disorders, control group (II) consisted of 100 case histories of somatically healthy women with AUB. An ultrasound scan with Doppler mapping was performed to assess the pelvic organs. All women underwent hysteroscopy and/or separate diagnostic curettage with further morphological assessment of the endometrium.Results. The most common extragenital disorder was diseases of the circulatory system and endocrine system, diseases of the digestive system. 123 patients (41%) had concomitant hypertension and obesity, 76 (25.3%) – obesity and varicose veins, 53 (17.6%) – somatoform autonomic dysfunction and chronic gastritis, 39 (13%) – obesity and diabetes mellitus, 24 (8%) – chronic gastritis and obesity. AUB was complicated by anemia of varying severity in 176 (58.6%) women. According to ultrasound data the most common endometrial disorder in women of group I was glandular hyperplasia of the endometrium.Conclusion. A retrospective analysis of case histories showed a high prevalence of AUB among women with extragenital pathology, which is a clinical indicator of major menstrual disorders in this category of patients and can be a serious problem for women's health in general. The need to study the prevalence and identify the main risk factors for the AUB development will make it possible to provide a general strategy for its prevention, improve the reproductive potential of women and avoid serious abnormal changes in the process of fulfilment of the reproductive function in young women.

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“…Clinically, the main causes of ODUB are luteal dysplasia and luteal atrophy, which lead to irregular shedding of the endometrium and prolonged menstruation. Sometimes, patients may have continuous bleeding before or after menstruation, and large menstrual volume [1][2][3][4]. ODUB is harmful to patients' quality of life and physical and mental health.…”

Section: Introductionmentioning

confidence: 99%

Dissecting the mechanism of Yuzhi Zhixue granule on ovulatory dysfunctional uterine bleeding by network pharmacology and molecular docking

Luo

Liu

et al. 2020

Chin Med

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Background Yuzhi Zhixue Granule (YZG) is a traditional Chinese patent medicine for treating excessive menstrual flow caused by ovulatory dysfunctional uterine bleeding (ODUB) accompanied by heat syndrome. However, the underlying molecular mechanisms, potential targets, and active ingredients of this prescription are still unknown. Therefore, it is imperative to explore the molecular mechanism of YZG. Methods The active compounds in YZG were screened by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The putative targets of YZG were collected via TCMSP and Search Tool for Interacting Chemicals (STITCH) databases. The Therapeutic Target Database (TTD) and Pharmacogenomics Knowledgebase (PharmGKB) databases were used to identify the therapeutic targets of ODUB. A protein–protein interaction (PPI) network containing both the putative targets of YZG and known therapeutic targets of ODUB was built. Furthermore, bioinformatics resources from the database for annotation, visualization and integrated discovery (DAVID) were utilized for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Finally, molecular docking was performed to verify the binding effect between the YZG screened compounds and potential therapeutic target molecules. Results The study employed a network pharmacology method, mainly containing target prediction, network construction, functional enrichment analysis, and molecular docking to systematically research the mechanisms of YZG in treating ODUB. The putative targets of YZG that treat ODUB mainly involved PTGS1, PTGS2, ALOX5, CASP3, LTA4H, F7 and F10. The functional enrichment analysis suggested that the produced therapeutic effect of YZG against ODUB is mediated by synergistical regulation of several biological pathways, including apoptosis arachidonic acid (AA) metabolism, serotonergic synapse, complement and coagulation cascades and C-type lectin receptor signaling pathways. Molecular docking simulation revealed good binding affinity of the seven putative targets with the corresponding compounds. Conclusion This novel and scientific network pharmacology-based study holistically elucidated the basic pharmacological effects and the underlying mechanisms of YZG in the treatment of ODUB.

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Comparison of classic terminology with the FIGO PALM‐COEIN system for classification of the underlying causes of abnormal uterine bleeding

Cited by 9 publications

References 23 publications

Etiology distribution of abnormal uterine bleeding according to FIGO classification system: A combined study of ultrasound and histopathology

Etiology distribution of abnormal uterine bleeding according to FIGO classification system: A combined study of ultrasound and histopathology

Clinical and diagnostic aspects of abnormal uterine bleeding in reproductive aged women with extragenital pathology

Dissecting the mechanism of Yuzhi Zhixue granule on ovulatory dysfunctional uterine bleeding by network pharmacology and molecular docking

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