Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Sep:288:90-107.
doi: 10.1016/j.ejogrb.2023.07.001. Epub 2023 Jul 17.

Management of women with abnormal uterine bleeding: Clinical practice guidelines of the French National College of Gynaecologists and Obstetricians (CNGOF)

J L Brun  1 , G Plu-Bureau  2 , C Huchon  3 , X Ah-Kit  4 , M Barral  5 , P Chauvet  6 , F Cornelis  5 , M Cortet  7 , P Crochet  8 , V Delporte  9 , G Dubernard  7 , G Giraudet  9 , A Gosset  10 , O Graesslin  11 , J Hugon-Rodin  2 , L Lecointre  12 , G Legendre  13 , L Maitrot-Mantelet  2 , L Marcellin  2 , L Miquel  8 , M Le Mitouard  7 , C Proust  14 , A Roquette  2 , P Rousset  15 , E Sangnier  11 , M Sapoval  16 , T Thubert  17 , A Torre  18 , F Trémollières  10 , H Vernhet-Kovacsik  19 , F Vidal  10 , H Marret  14
Affiliations
Review

Management of women with abnormal uterine bleeding: Clinical practice guidelines of the French National College of Gynaecologists and Obstetricians (CNGOF)

J L Brun et al. Eur J Obstet Gynecol Reprod Biol. 2023 Sep.

Abstract

Objective: To provide French guidelines for the management of women with abnormal uterine bleeding (AUB).

Design: A consensus committee of 26 experts was formed. A formal conflict-of-interest policy was developed at the beginning of the process and enforced throughout. The entire guidelines process was conducted independently of any industry funding (i.e. pharmaceutical or medical device companies). The authors were advised to follow the rules of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasized.

Methods: The last guidelines from the Collège National des Gynécologues et Obstétriciens Français on the management of women with AUB were published in 2008. The literature seems now sufficient for an update. The committee studied questions within 7 fields (diagnosis; adolescents; idiopathic AUB; endometrial hyperplasia and polyps; type 0-2 fibroids; type 3 or higher fibroids; and adenomyosis). Each question was formulated in a PICO (Patients, Intervention, Comparison, Outcome) format and evidence profiles were compiled. The GRADE® methodology was applied to the literature review and the formulation of recommendations.

Results: The experts' synthesis work and the application of the GRADE method resulted in 36 recommendations. Among the formalized recommendations, 19 are strong and 17 weak. No response was found in the literature for 14 questions. We chose to abstain from recommendations rather than providing advice based solely on expert clinical experience.

Conclusions: The 36 recommendations make it possible to specify the diagnostic and therapeutic strategies for various clinical situations practitioners encounter, from the simplest to the most complex.

Keywords: Abnormal uterine bleeding; Diagnosis; Guidelines; Treatment.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Matthias Barral has been invited to a congress in 2019 by Guerbet. Jean-Luc Brun has been a member of the Gedeon Richter board until 2019. He has been a speaker for Ipsen in 2018 and Bayer in 2019. Pauline Chauvet has been a speaker for Gedeon Richter in 2018 and 2019. Marion Cortet has been invited to a congress in 2019 by Roche. Gil Dubernard has been a member of the Hologic board and organized a symposium for Hologic in 2018 and 2019. Géraldine Giraudet has been a member of the Gedeon Richter board since 2016. She has been a consultant for Boston Scientific since 2017. She has been carried out training sessions for AMI and Olympus since 2018 and participated to symposium for Applied in 2019. Olivier Graesslin has been a member of the Gedeon Richter board until 2019, and the MSD board until 2018. He has been a speaker for Bayer until 2019 and for MSD between 2016 à 2018. Cyrille Huchon has been a speaker for Gedeon Richter from 2012 to 2019. He has been invited to congresses by Nordic Pharma from 2014 to 2019. He has been a speaker for Astra Zeneca in 2017. He has been a consultant for A+A, Icomed, M3 Global Research Ltd and WorldOne Group B.V. from 2012 to 2019, and for the society Ziwig since 2020. Justine Hugon Rodin has been a speaker for Effik in 2019. Guillaume Legendre has been chairing scientific meetings for Gedeon Richter and Bayer Healthcare from 2018 to 2020. Lorraine Maitrot Mantelet has been a speaker for Astra Zeneca in 2015 and 2019, Effik in 2019 and Ferring in 2015 and 2018. She has been invited to congresses by Bayer in 2015 and 2016, Besins in 2019 and Gedeon Richter since 2016. She had signed hospitality agreement with Mithra in 2019, MSD in 2015 and 2016, Nordic Pharma in 2015 and 2018 and Roche in 2015 and 2016. Louis Marcellin has been a speaker for Ipsen in 2020. Henri Marret has been a member of the Gedeon Richter board until 2019. Thibault Thubert has been a consultant for Pierre Fabre in 2019 and Pileje in 2020. Antoine Torre has been invited to congresses by Guerbet in 2019 and 2020. Florence Trémollières has been a consultant for Theramex in 2018. She has been a speaker for Theramex, Arrow and Amgen in 2018 and 2019. She has been invited to a congress by Besins Healthcare in 2018. Hélène Vernhet-Kovacsik has been a consultant for the société Télédiag until 2017. She has been a speaker for General Electric and Guerbet in 2021. None, for Xavier Ah-Kit, François Cornelis, Patrice Crochet, Victoire Delporte, Anna Gosset, Lise Lecointre, Laura Miquel, Marine Le Mitouard, Geneviève Plu-Bureau, Claire Proust, Alix Roquette, Pascal Rousset, Eva Sangnier, Marc Sapoval, and Fabien Vidal.

LinkOut - more resources