A STUDY ON CLINICAL PROFILE OF WOMEN PRESENTING WITH ABNORMAL UTERINE BLEEDING AT A TERTIARY CARE CENTRE IN RAJASTHAN
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Keywords
Abnormal uterine bleeding; PALM–COEIN classification; Leiomyoma; Ovulatory dysfunction; Menorrhagia Anaemia
Abstract
Background: Abnormal uterine bleeding (AUB) is one of the most frequent gynaecological complaints encountered in outpatient settings and is a major cause of morbidity among women of reproductive age. It significantly affects physical health, quality of life, and work productivity, and often leads to anaemia. The FIGO PALM–COEIN classification system provides a standardized framework for diagnosing the underlying causes of AUB.
Objectives: To study the clinical profile of women presenting with abnormal uterine bleeding and to assess the etiological distribution of AUB using the PALM–COEIN classification system.
Methods: A hospital-based cross-sectional observational study was conducted from Jan 2023 to March 2023 in the gynaecology outpatient department of a tertiary care teaching hospital in Rajasthan. A total of 140 women aged 15–49 years presenting with abnormal uterine bleeding were enrolled using convenience sampling. Data were collected using a pre-designed, semi-structured proforma covering socio-demographic details, menstrual history, clinical profile, laboratory parameters, ultrasonography findings, and final diagnosis. Etiology was classified according to the FIGO PALM–COEIN system. Data were analysed using SPSS version 26. Descriptive statistics were expressed as frequencies, percentages, and mean ± standard deviation. The chi-square test was applied to assess associations, with p < 0.05 considered statistically significant.
Results: The majority of women belonged to the 35–44 years age group (40.0%) and were multiparous (67.9%). Menorrhagia was the most common presenting complaint (41.4%). Anaemia was present in over 70% of participants. Structural causes (PALM) accounted for 57.1% of cases, with leiomyoma being the most common etiology (29.3%). Among non-structural causes (COEIN), ovulatory dysfunction predominated (27.1%). Structural causes were significantly more common in women aged ≥35 years (p = 0.006).
Conclusion: Abnormal uterine bleeding is a multifactorial condition with both structural and non-structural causes. The PALM–COEIN classification system is an effective tool for systematic evaluation and management. Early diagnosis and targeted treatment are essential to reduce morbidity and improve women’s reproductive health outcomes.
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Dr. Deepti Chitra
Assistant Professor, Department of Obstetrics and Gynaecology, Government Medical College, Chittorgarh, Rajasthan, India.
Dr. Rajat Gupta
Assistant Professor, Department of Community Medicine, World College of Medical Sciences and Research, Jhajjar, Haryana, India.
Dr. Jatin Prajapati
Post Graduate Student, Department of Community Medicine, RNT Medical College, Udaipur, Rajasthan, India. ( ORCID: https://orcid.org/0009-0004-7298-4499 )
