PALM-COEIN Classification in Patients with Abnormal Uterine Bleeding

Abstract

Introduction: Abnormal uterine bleeding, (AUB) is the commonest menstrual problem during reproductive age. However, if the menstrual cycles are too short or too long, and the bleeding amount is too much, or a woman bleeds out of their normal menstrual cycle, that is classified as abnormal uterine bleeding. Abnormal uterine bleeding can have many causes. It is important to identify the type and cause of abnormal uterine bleeding among women to make proper treatment easily accessible and affordable. The FIGO classification system, otherwise known as PALM- COEIN classification system in non- gravid women, is a great method for the determination of types and causes of AUB. Aim of the Study: The aim of the study was to observe the PALM-COEIN classification among abnormal uterine bleeding cases in Bangladesh. Methods: This prospective observational study was conducted at the Department of Gynecology, Cumilla Medical College Hospital, Cumilla, Bangladesh. The study duration was 1 year, from July 2021 to June 2022. During this period, a total of 111 cases were selected following the inclusion and exclusion criteria. A purposive sampling method was used for the selection of the patients. Result: Mean age of the participants was 39.90 years, and the age range was 18-66 years in the present study. Lower abdominal pain was observed in 63.06% of abnormal bleeding cases. The average menstrual cycle length was 15-30 days for 46.85% of participants, and the age at menarche was 11-13 years for 62.16% of participants. 18.02% of the participants had been nulliparous, and 81.99% had been multiparous. Age at marriage was 15 years or lower for 11.71% of the participants, while the majority (54.95%) had been between the ages of 16-20 years. 46.85% had no associated risk factors. 36.04% had obesity, and 21.62% had hypertension. Anemia was a very common clinical finding, observed in 87.39% of cases. USG findings of the patients revealed a bulky uterus for 36.04% of cases, and fibroid was ..