Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine University Hospital, University of Tokyo, Tokyo, Japan.
J Obstet Gynaecol Res. 2023 Jan;49(1):321-330. doi: 10.1111/jog.15464. Epub 2022 Oct 18.
To investigate the status of abnormal uterine bleeding (AUB) in Japan using the International Federation of Gynecology and Obstetrics (FIGO) classification (AUB system 1 and 2; PALM-COEIN) and to clarify the relationship between AUB symptoms and the diseases causing AUB.
In a nationwide study, we enrolled first-time patients who visited target facilities during two consecutive weeks from December 1, 2019 to January 31, 2020. The FIGO classification was used to investigate patients with symptoms and causative diseases of AUB. Based on the proportion of patients in the nationwide study, 373 cases were included in the detailed survey. Survey items included symptoms of AUB according to AUB system 1, examination details, and causative diseases according to the PALM-COEIN classification.
Within the study period, we encountered 61 740 first-time patients, of which 8081 (13.1%) were diagnosed with AUB. Among them, 39.9% had abnormal menstrual cycles and 56.9% had abnormal menstrual bleeding. In the survey, PALM had the highest percentage of AUB-L and COEIN had the highest percentage of AUB-O. Correspondence analysis showed that COEIN was strongly associated with abnormal menstrual cycles and PALM with abnormal menstrual bleeding.
We conducted the first nationwide survey of AUB in Japan. The FIGO classification was a useful tool for the diagnosis of AUB, with a strong correlation between symptoms of AUB by AUB system 1 and the causative disease of AUB by PALM-COEIN. Conversely, a high percentage of AUB-N and AUB-E suggests that AUB system 1 and PALM-COEIN are ambiguous as diagnostic tools.
使用国际妇产科联合会（FIGO）分类（AUB 系统 1 和 2；PALM-COEIN）调查日本异常子宫出血（AUB）的现状，并阐明 AUB 症状与导致 AUB 的疾病之间的关系。
在一项全国性研究中，我们招募了 2019 年 12 月 1 日至 2020 年 1 月 31 日连续两周内首次就诊于目标医疗机构的患者。使用 FIGO 分类调查 AUB 症状和病因的患者。根据全国性研究中患者的比例，对 373 例患者进行了详细调查。调查项目包括根据 AUB 系统 1 调查 AUB 症状、检查详情和根据 PALM-COEIN 分类的病因疾病。
在研究期间，我们遇到了 61740 名首次就诊的患者，其中 8081 名（13.1%）被诊断为 AUB。其中，39.9%有异常月经周期，56.9%有异常月经出血。在调查中，PALM 导致的 AUB-L 比例最高，COEIN 导致的 AUB-O 比例最高。对应分析表明，COEIN 与异常月经周期密切相关，PALM 与异常月经出血密切相关。
我们在日本进行了首次全国性的 AUB 调查。FIGO 分类是诊断 AUB 的有用工具，AUB 系统 1 的 AUB 症状与 PALM-COEIN 的 AUB 病因之间存在很强的相关性。相反，AUB-N 和 AUB-E 的高比例表明 AUB 系统 1 和 PALM-COEIN 作为诊断工具不够明确。
