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Abnormal Uterine Bleeding.

Cristina Laguna Benetti-Pinto1, Ana Carolina Japur de Sá Rosa-E-Silva2, Daniela Angerame Yela1

  • 1Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.

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Abnormal uterine bleeding (AUB) significantly impacts women's quality of life. This review outlines evidence-based treatments for acute and chronic AUB, guided by the FIGO PALM-COEIN classification system.

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Area of Science:

  • Gynecologic Health
  • Reproductive Medicine
  • Clinical Evidence Synthesis

Background:

  • Abnormal uterine bleeding (AUB) is a common gynecologic condition affecting women's physical, emotional, sexual, and professional well-being.
  • Severe AUB may necessitate urgent interventions, including fluid resuscitation and hemostatic agents, while prolonged bleeding might require surgical management.
  • The International Federation of Gynecology and Obstetrics (FIGO) classification system (PALM-COEIN) categorizes AUB etiologies, providing a framework for targeted treatment.

Purpose of the Study:

  • To present evidence-based treatment strategies for women experiencing abnormal uterine bleeding (AUB).
  • To delineate management approaches for both acute and chronic AUB.
  • To align treatment recommendations with the FIGO PALM-COEIN classification system for AUB etiologies.

Main Methods:

  • Systematic review of literature from PubMed, Cochrane, and Embase databases.
  • Inclusion of studies focused on reducing uterine menstrual bleeding, written in English.
  • Exclusion of non-relevant studies, editorials, and animal models.

Main Results:

  • Treatment aims to reduce menstrual flow, alleviate morbidity, and enhance quality of life.
  • Acute phase management focuses on hemodynamic stabilization and hemorrhage control.
  • Chronic phase management targets the underlying etiology (e.g., polyps, adenomyosis, coagulopathies) through pharmacological or surgical interventions.

Conclusions:

  • Treatment of AUB requires a dual approach: immediate stabilization for acute bleeding and etiology-specific correction for chronic dysfunction.
  • Pharmacological treatments primarily involve hormonal therapy, anti-inflammatories, and antifibrinolytics.
  • Effective management of AUB, guided by the PALM-COEIN classification, is crucial for improving patient outcomes and quality of life.