Evaluation of palm coein classification and management of abnormal uterine bleeding in Latvian population

Abstract

Objective: About 14-25% of women may experience abnormal uterine bleeding (AUB) during their lifetime. There are a variety of approaches to evaluate the causes of AUB. The basic principle is to use the cheapest and least invasive method, but at the same time an effective method, to emphasize the need to use appropriate diagnostic methods before the intervention. Objectives of our study were to analyze the outcomes of clinical and histopathological diagnosis in women, who had AUB according to Palm-Coein classification. Materials and Methods: Dates were obtained from Riga East Clinical University Hospital in Gynaecology Clinic. The study included nongravid reproductive age patients with AUB. The clinical diagnose based on transvaginal ultrasound (TVUS) findings. The histopathological diagnosis confirmed by histological examination. Results: The most common histopathological diagnoses were endometrial polyps 35.0%, endometrial hyperplasia 35.0%, submucosal leiomyomas 23.3%, leiomyomas 18.3%, endometrial adenocarcinomas 5.0%, adenomyosis 3.3% and others 6.7%. The most common TVUS diagnoses were endometrial polyps 26.7%, leiomyomas 23.3%, submucosal leiomyomas 21.6%, endometrial hyperplasia 21.6%, ovarian dysfunction 1.7% and others 16.7%. The study compared the clinical diagnoses with histopathological diagnoses. The results showed that the most coincided diagnoses were endometrial polyp 42.3%, submucosal leiomyoma – 42.1%, leiomyoma 47.1%, endometrial hyperplasia 40.0% and others 20%. Conclusion: The most common causes of AUB were endometrial polyps, endometrial hyperplasia, leiomyomas and submucosal leiomyomas. Comparing the histopathological diagnosis with a clinical diagnosis, TVUS is not a sufficiently accurate method to diagnose the cause of AUB.