Snippets

Abstract

/Aims: Menstrual disorders and abnormal uterine bleeding (AUB) are among the most frequent gynecological complaints of adolescents. AUB has been defined in the past by a variety of terms and there have been inconsistencies and lack of categorization of various potential causes of AUB. To have standard nomenclature internationally, PALM COEIN Classification of AUB was introduced in 2011 by FIGO Menstrual disorder group for non-pregnant, reproductive age women. In the present study we aimed to classify adolescent AUB by PALM COEIN approach.The study was conducted prospectively on all adolescent girls attending OPD at Sir Ganga Ram Hospital. Menstrual complaints were classified according to PALM COEIN approach after a thorough history taking, examination and investigations.Prevalence of menstrual disorders in adolescents was 68.5%, of which 86.9% were attributed to AUB. PALM COEIN approach was applied to AUB cases. Ovulatory disorders (AUB-O) formed a major chunk of adolescent AUB (93.7%), of which 60% were due to immaturity of Hypothalamic Pitutary Ovarian axis, 32% due to Polycystic ovarian syndrome and 8% due to Thyroid disorders. Contribution of coagulopathy to AUB was 3.75%. Polyps and leiomyoma were seen in 1.2% and 0.6% of cases respectively. No case remained unclassified when PALM COEIN was applied.AUB in adolescents can also be classified by PALM COEIN to standardize nomenclature and abandonment of terms like menorrhagia, metrorrhagia and dysfunctional uterine bleeding.