Clinical and diagnostic aspects of abnormal uterine bleeding in reproductive aged women with extragenital pathology
Keywords:abnormal uterine bleeding, extragenital pathology, reproductive age, ultrasound examination, Doppler imaging, hysteroscopy, diagnostic curettage
Study objective: to determine the clinical and diagnostic features of the abnormal uterine bleeding (AUB) in women of reproductive age with extragenital pathology.
Materials and methods. The study involved a retrospective assessment of 400 case histories of reproductive aged women with AUB who underwent inpatient treatment.
The main clinical group (I) consisted of 300 case histories of women with AUB and concomitant extragenital disorders, control group (II) consisted of 100 case histories of somatically healthy women with AUB. An ultrasound scan with Doppler mapping was performed to assess the pelvic organs. All women underwent hysteroscopy and/or separate diagnostic curettage with further morphological assessment of the endometrium.
Results. The most common extragenital disorder was diseases of the circulatory system and endocrine system, diseases of the digestive system. 123 patients (41%) had concomitant hypertension and obesity, 76 (25.3%) – obesity and varicose veins, 53 (17.6%) – somatoform autonomic dysfunction and chronic gastritis, 39 (13%) – obesity and diabetes mellitus, 24 (8%) – chronic gastritis and obesity. AUB was complicated by anemia of varying severity in 176 (58.6%) women. According to ultrasound data the most common endometrial disorder in women of group I was glandular hyperplasia of the endometrium.
Conclusion. A retrospective analysis of case histories showed a high prevalence of AUB among women with extragenital pathology, which is a clinical indicator of major menstrual disorders in this category of patients and can be a serious problem for women's health in general. The need to study the prevalence and identify the main risk factors for the AUB development will make it possible to provide a general strategy for its prevention, improve the reproductive potential of women and avoid serious abnormal changes in the process of fulfilment of the reproductive function in young women.
- Oberman, E., Rodriguez-Triana, V. “Abnormal Uterine Bleeding: Treatment Options.” Clin Obstet Gynecol 61.1 (2018): 72–5.
- Tuchkina, I.O., Vygivska, L.A., Novikova, A.A. “Abnormal uterine bleeding in adolescents: current state of the problem.” Wiad Lek LXXIII.8 (2020): 1752–5. DOI: 10.36740/WLek202008130
- Munro, M.G., et al. “The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions.” Int J Gynaecol Obstet 143.3 (2018): 393–408.
- Bofill, R.M., Lethaby, A., Farquhar, C. “Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding.” Cochrane Database Syst Rev 9.9 (2019): CD000400.
- Kotagasti, T. “Prevalence of different menstrual irregularities in women with abnormal uterine bleeding (AUB) – an observational study.” Int J Cur Res Rev 7.10 (2015): 66–70.
- Karlsson, T.S., Marions, L.B., Edlund, M.G. “Heavy menstrual bleeding significantly affects quality of life.” Acta Obstet Gynecol Scand 93.1 (2014): 52–7.
- Hapangama, D.K., Bulmer, J.N. “Pathophysiology of heavy menstrual bleeding.” Womens Health (Lond) 12.1 (2016): 3–13.
- Nikitina, T.I., Osadchev, V.B., Babkov, K.V. “The structure of abnormal uterine bleeding in women of reproductive age. Application of the modern PALM-COEIN classification.” Pharmacy 3 (2016): 47–50.
- Hale, K. “Abnormal Uterine Bleeding: A Review.” US Pharm 43.9 (2018): HS2–HS9.
- Tananakina, E.N. “Efficacy of melatonin in women of reproductive age with abnormal uterine bleeding and combined extragenital disorders.” Obstetrics, Gynecology and Reproduction 8.3 (2014): 31–8.
- Tuchkina, I.A., Gnatenko, O.V., Tuchkina, M.Y. “Diagnosis and treatment of adolescents and young women with abnormal uterine bleeding and retention ovarian cysts secondary to extragenital disorders.” Collection of scientific works of the Association of Obstetricians and Gynecologists of Ukraine 2.42 (2018): 191–7.
- Tuchkina, I.A., Tuchkina, M.Y., Novikova, A.A. “Treatment of adolescent girls with abnormal uterine bleeding taking into account psychoemotional and: vegetative status.” Journal of Education, Health and Sport 9.5 (2019): 575–82.
- Patent No. 132207 Ukraine, MPK G01N 33/48 (2006.01). Method for evaluating the effectiveness of preventive treatment of atypical endometrial hyperplasia in perimenopause in women with abdominal obesity / Tuchkina, I.O., et al.; No. 201810104; appl. 10.10.2018; publ. 11.02.2019.
- Töz, E, Sanc, M., Özcan, A., et al. “Comparison of classic terminology with the FIGO PALM-COEIN system for classification of the underlying causes of abnormal uterine bleeding.” Int J Gynaecol Obstet 133.3 (2016): 325–8.
- Fraser, I.S., Munro, M.G., Critchley, H.O. “Best Practice Issue on «Abnormal Uterine Bleeding.” Best Pract Res Clin Obstet Gynaecol 40 (2017): 1–2.
- Knol, H.M., et al. “The prevalence of underlying bleeding disorders in patients with heavy menstrual bleeding with and without gynecologic abnormalities.” Am J Obstet Gynecol 209.3 (2013): 202.e1–202.e7.
- Dickerson, K.E., Menon, N.M., Zia, A. “Abnormal Uterine Bleeding in Young Women with Blood Disorders.” Pediatr Clin North Am 65.3 (2018): 543–60.
- Munro, M.G., et al. “FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age.” Int J Gynaecol Obstet 113.1 (2011): 3–13.
- Wouk, N., Helton, M. “Abnormal Uterine Bleeding in Premenopausal Women.” Am Fam Physician 99.7 (2019): 435–43.
- Davis, E., Sparzak, P.B. Abnormal uterine bleeding (dysfunctional uterine bleeding). StatPearls Publishing (2018). Available from: [https://www.ncbi.nlm.nih.gov/books/NBK532913].
- Chernukha, G.E., Nemova, Y.I. “Diagnosis and drug therapy of uterine bleeding according to international recommendations.” Obstetrics and Gynecology 2 (2013): 2–7.
- Wheeler, K.C., Goldstein, S.R. “Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.” Clin Obstet Gynecol 60.1 (2017): 11–17.
- Pecchioli, Y., Oyewumi, L., Allen, L.M., Kives, S. “The Utility of Routine Ultrasound in the Diagnosis and Management of Adolescents with Abnormal Uterine Bleeding.” J Pediatr Adolesc Gynecol 30.2 (2017): 239–42.
- Davies, J., Kadir, R.A. “Heavy menstrual bleeding: An update on management.” Thromb Res 151.1 (2017): S70–S77.
- Kolhe, S. “Management of abnormal uterine bleeding – focus on ambulatory hysteroscopy.” Int J Womens Health 10 (2018): 127–36.
How to Cite
Copyright (c) 2021 І.О. Тучкіна, Л.А. Вигівська, Є.В. Благовещенський, Р.Є. Благовещенський
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.