Clinical spectrum and causes of abnormal uterine bleeding in reproductive age according to two FIGO systems

Abstract

Objectives: To analyse various causes of abnormal bleeding and their bleeding patterns in accordance with FIGO classification system in reproductive age women. Materials and methods: This was a cross-sectional, retrospective study done at All India Institute of Medical Sciences, Gorakhpur. Total of 116 women aged 15 to 55 years with chronic AUB between October 2019 and March 2020 were evaluated. Results: Most patients of AUB were in the age group between 30-39 years and 40-49 years (31.8%), structural cause accounts for 32.6% and non structural cause accounts for 67.4% of cases. AUB-O i.e. ovulatory dysfunction (OD) was the commonest (non structural) finding in 55.2% women, followed by AUB-L i.e. leiomyoma (structural) in 18.6 % of women. In adolescent, all cases (100%) and in younger age group, 91.4% cases were due to OD. Most cases of AUB-O were due to anovulation (33.8%) and PCOS (27.9%). Most common age of presentation in AUB-L was 40-49 years (35.1%). Irregular cycle (44.1%) and infrequent cycle (33.8%) was most common bleeding pattern with AUB-O. AUB-L and AUB-A (adenomyosis) most commonly presented with heavy menstrual bleeding (HMB) i.e 86.9% and 66.7% of cases. AUB-P (polyp) presented with HMB (40%) and intermenstrual bleeding (20%). Conclusion: Non structural causes were the most common cause and AUB-O was the commonest cause occupying more than half of cases. Most common menstruation pattern in AUB –O was irregular cycles and in AUB-L it was HMB.

Keywords

• abnormal uterine bleeding
• bleeding pattern in reproductive age group women
• figo system
• palm coien classification