Almuhaitb Rina Abdullah, Alenazi Rinad Hamad, Almebki Rauof Ahmad, Alshehri Raghad Awadh, Alemad Monya Mohammed, AlHarbi Joud Mohammed, AlAmro Shahad Abdullah, Alshahrani Renad Mohammed, Bakhsh Hanadi
College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia.
Obstetrics and Gynecology Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia.
J Clin Med. 2024 Nov 23;13(23):7086. doi: 10.3390/jcm13237086.
Abnormal uterine bleeding (AUB) is a common gynecological complaint affecting women of reproductive age. This study aimed to explore the management of AUB using the FIGO PALM-COEIN classification system. A cross-sectional study was conducted at King Abdullah bin Abdulaziz University Hospital, reviewing 500 medical records of women aged 20-50 years with AUB. Data on demographics, clinical characteristics, PALM-COEIN classification, and treatment modalities were collected and analyzed. The majority of participants were aged 20-29 years (43%) and overweight or obese (64.2%). Ovulatory dysfunction (31.6%) was the most common identifiable cause of AUB, followed by leiomyoma (16.8%). Hormonal treatments, particularly combined oral contraceptive pills, were associated with improved outcomes (OR = 2.15, < 0.001) and reduced anemia prevalence ( = 0.042). Age (OR = 0.95, = 0.015) and BMI (OR = 1.10, = 0.005) were significant predictors of treatment response. The presence of leiomyoma decreased the odds of treatment success (OR = 0.55, = 0.007), while ovulatory dysfunction increased the likelihood of response (OR = 1.75, = 0.003). The study highlights the complex nature of AUB and the effectiveness of hormonal treatments in its management. Findings emphasize the need for individualized treatment approaches based on the underlying etiology and patient characteristics. Future research should focus on long-term outcomes and optimizing management strategies for complex cases.
异常子宫出血（AUB）是影响育龄女性的常见妇科问题。本研究旨在探讨使用国际妇产科联盟（FIGO）的PALM-COEIN分类系统对AUB进行管理。在阿卜杜拉国王本·阿卜杜勒阿齐兹大学医院进行了一项横断面研究，回顾了500例年龄在20至50岁之间患有AUB的女性的病历。收集并分析了有关人口统计学、临床特征、PALM-COEIN分类和治疗方式的数据。大多数参与者年龄在20至29岁之间（43%），超重或肥胖（64.2%）。排卵功能障碍（31.6%）是AUB最常见的可识别病因，其次是子宫肌瘤（16.8%）。激素治疗，尤其是复方口服避孕药，与改善结局相关（OR = 2.15，<0.001），并降低了贫血患病率（=0.042）。年龄（OR = 0.95，=0.015）和体重指数（BMI）（OR = 1.10，=0.005）是治疗反应的重要预测因素。子宫肌瘤的存在降低了治疗成功的几率（OR = 0.55，=0.007），而排卵功能障碍增加了反应的可能性（OR = 1.75，=0.003）。该研究突出了AUB的复杂性以及激素治疗在其管理中的有效性。研究结果强调了基于潜在病因和患者特征采取个体化治疗方法的必要性。未来的研究应关注长期结局，并优化复杂病例的管理策略。
