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PALM-COEIN classification system of FIGO vs the classic terminology in patients with abnormal uterine bleeding

Bekir Kahveci1, Mehmet Sukru Budak2, Serhat Ege3

  • 1Cukurova University, Adana, Turkey. drbekirkahveci@hotmail.com.

Ginekologia Polska
|March 23, 2021
PubMed

Insights

The FIGO's PALM-COEIN system offers a more detailed classification for abnormal uterine bleeding than classic terms. This novel system improves etiological understanding and physician communication for women's reproductive health.

Area of Science:

  • Gynecology
  • Pathology
  • Reproductive Medicine

Background:

  • Abnormal uterine bleeding (AUB) diagnosis relies on various classification systems.
  • The International Federation of Gynecology and Obstetrics (FIGO) introduced the PALM-COEIN system for a standardized etiological classification of AUB.
  • Classic terminology for AUB often lacks specificity regarding underlying pathologies.

Purpose of the Study:

  • To compare the diagnostic utility of the FIGO's PALM-COEIN classification system against traditional terminology in patients presenting with abnormal uterine bleeding.
  • To assess the etiological accuracy and clinical relevance of the novel PALM-COEIN system for abnormal uterine bleeding.

Main Methods:

  • A retrospective study was conducted involving 515 women with abnormal uterine bleeding.
  • Pathology reports were analyzed and classified using both the FIGO's PALM-COEIN system and classical terminology.
  • Fibroid classifications were further detailed into subgroups within the PALM-COEIN framework.

Main Results:

  • Classical terminology identified hypermenorrhea (26.6%), menorrhagia (14.4%), metrorrhagia (11.1%), and menometrorrhagia (47.8%).
  • The PALM-COEIN system revealed polyps (16.3%), adenomyosis (38.1% diffuse, 6.2% local), leiomyoma (31.1% submucous, 43.9% other), and malignancy/hyperplasia (9.1%).
  • Leiomyoma and adenomyosis were the most frequent findings under the PALM-COEIN classification.

Conclusions:

  • Classical terminology is insufficient for identifying specific etiological causes of abnormal uterine bleeding in non-pregnant reproductive-aged women.
  • The FIGO's PALM-COEIN classification system provides a more comprehensive and etiological approach to abnormal uterine bleeding.
  • Widespread adoption of the PALM-COEIN system will enhance physician-researcher communication and diagnostic precision in abnormal uterine bleeding management.
Abstract

Keywords:
PALM-COEIN classificationabnormal uterine bleedingclassic terminologymenstrual disorders

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