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Review
. 2014 Dec;64(6):388-93.
doi: 10.1007/s13224-014-0641-1. Epub 2014 Nov 19.

Diagnosis and Management of Formerly Called "Dysfunctional Uterine Bleeding" According to PALM-COEIN FIGO Classification and the New Guidelines

Mohamed Khrouf  1 , Khaled Terras  2
Affiliations
Review

Diagnosis and Management of Formerly Called "Dysfunctional Uterine Bleeding" According to PALM-COEIN FIGO Classification and the New Guidelines

Mohamed Khrouf et al. J Obstet Gynaecol India. 2014 Dec.

Abstract

In 2011, the FIGO classification system (PALM-COEIN) was published to standardize terminology, diagnostic and investigations of causes of abnormal uterine bleeding (AUB). According to FIGO new classification, in the absence of structural etiology, the formerly called "dysfunctional uterine bleeding" should be avoided and clinicians should state if AUB are caused by coagulation disorders (AUB-C), ovulation disorder (AUB-O), or endometrial primary dysfunction (AUB-E). Since this publication, some societies have released or revised their guidelines for the diagnosis and the management of the formerly called "dysfunctional uterine bleeding" according new FIGO classification. In this review, we summarize the most relevant new guidelines for the diagnosis and the management of AUB-C, AUB-O, and AUB-E.

Keywords: Abnormal uterine bleeding; Dysovulation; Menorrhagia.

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Figures

Fig. 1
Fig. 1
A summary of a global strategy for the diagnosis of causes of non-structural abnormal uterine bleeding. L-IUD levonorgestrel Intrauterine device; AUB-C abnormal uterine bleeding related to Coagulopathy; AUB-O abnormal uterine bleeding related to Ovulatory dysfunction; AUB-E abnormal uterine bleeding related to Endometrial dysfunction; AUB-I abnormal uterine bleeding related to iatrogenic causes. (*) Patients over 45 years (40 years for Canadian society), and those at higher risk of endometrial cancer: Nulliparous, high BMI > 30 kg/m2, PCOS, diabetic, history of family cases of hereditary non-polyposis colorectal cancer syndrome and when treatment failed to stop AUB. (**) Refer to Diagnosis and investigation strategy section AUB-C
Fig. 2
Fig. 2
Summary of first-line laboratory exams for the diagnosis of abnormal uterine bleeding
See this image and copyright information in PMC

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