Background: The Menstrual Disorders Working Group of the International Federation of Gynecology and Obstetrics (FIGO) created a new classification system called “PALM-COEIN” for abnormal uterine bleeding in 2011. The aim of our study is to investigate the new classification system and compare it with the classical terminology for abnormal uterine bleeding. Materials and Methods: Our study was conducted retrospectively between February 2022 and July 2022 in the gynecology clinic of Keciören Training and Research Hospital. Premenopausal women without known chronic disease were enrolled in the study. Each patient enrolled in the study was examined based on anatomical structure, physical examination, and pelvic ultrasonography. If necessary, endometrial specimens and hysterectomy material were obtained for histopathologic examination. Possible causes were classified according to the new classification system. Results: The study included 135 premenopausal women with abnormal uterine bleeding. In general, the patients with bleeding complaints had leiomyoma uteri and polyps according to the classical terminology. They were grouped under the labels of hypermenorrhea, menorrhagia, metrorrhagia, and menometrorrhagia, which were due to various causes, including polyps, adenomyosis, hyperplasia, and iatrogenic causes. According to the classification PALM-COEIN, 35 (25.9%) polyps, 16 (11.8%) adenomyosis, 38 (28.1%) leiomyomas, 4 (2.9%) malignancies and hyperplasia were detected. Conclusion: The classification of abnormal uterine bleeding is generally inconsistent. The new classification system, created for many reasons, is an important step towards understanding complex situations. Another need is that a widely accepted and known classification system should facilitate communication among clinicians and clarify the review of the target population. It is also clear that the new classification system will improve communication between patients. Widespread use of the system will also reveal new treatment options for abnormal uterine bleeding.
Amaç: Bu çalışmanın amacı, düşük riskli bir gebelikte mekonyum boyalı amniyotik sıvı için risk faktörlerini belirlemek ve mekonyum boyalı amniyotik sıvı (MSAF) varlığındaki doğumlarda doğum komplikasyonlarını ve yenidoğan sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Bu prospektif çalışma Nisan 2015-Eylül 2015 tarihleri arasında Ankara Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi'nde yapıldı. Çalışmaya 37. gebelik haftasına ulaşmış tekil gebelik ve baş pozisyonu olan 351 kadın dahil edildi. Bilinen kronik sistemik hastalıkları, gebelik komplikasyonları ve geçirilmiş uterin cerrahisi olan kadınlar çalışma dışı bırakıldı. Bu çalışmaya MSAF'lı 151 olgu ve berrak amniyotik sıvısı olan rastgele seçilmiş 200 kontrol olgusu dahil edildi. İki grubu anne yaşı, gravidite, parite, gebelik yaşı, intrapartum maternal ateş, vücut kitle indeksi (VKİ), doğum süresi, kardiyotokografik değerler (CTG), doğum şekli, neonatal sonuç ve yenidoğan yoğun bakım ünitesine yatış oranları açısından karşılaştırdık. Bulgular: Çalışmamızda doğumda mekonyum boyanması olan yenidoğanların %2,6'sında (4/151) mekonyum aspirasyon sendromu (MAS) gelişti. MSAF grubunda gebelik yaşı, intrapartum maternal ateş ve VKİ anlamlı olarak yüksekti(p=0.003). Doğumun aktif fazının süresi (6 cm'den 10 cm'ye servikal dilatasyon) her iki grupta benzerdi ve MSAF grubunda doğumun ikinci fazının süresi daha uzundu (p=0.002). MSAF, kardiyotokografik incelemelerde, doğum komplikasyonlarında ve yenidoğan sonuçlarında artan sayıda anormal sonuçla ilişkilendirildi (p < 0,001). Sonuç: Mekonyum boyalı amniyotik sıvı ile yapılan doğumlar artmış morbidite ile ilişkilidir; bu nedenle intrapartum muayeneler daha sık ve dikkatli yapılmalı ve olası olumsuz yenidoğan sonuçlarını azaltmak için doğum sırasında çocuk doktorları ile işbirliği içinde önlemler alınmalıdır.
Background: The rising incidence of endometrial cancer has been associated with increases in obesity and physical inactivity. We investigated the clinical significance of serum obestatin levels in women with endometrial cancer, endometrial hyperplasia, and age-matched healthy controls. Material and Methods: The present study was a case-control study conducted at a single center between May 2014 and July 2015. The medical records of 90 patients with a final histopathologic diagnosis after therapeutic curettage for abnormal uterine bleeding were reviewed and categorized by diagnosis. The study population included women with adenocarcinoma of the endometrium (n= 33), hyperplasia of the endometrium (n= 27), and proliferative endometrium (n=30) according to histopathological diagnosis. The women with proliferative endometrium formed the control group. Results: Endometrial cancer was diagnosed in 33 (36.6%) of the patients who presented to our clinic for abnormal uterine bleeding. In the group with endometrial cancer, the mean age was 55.2 ± 8.6 years. There were no differences in obestatin levels between groups (p > 0.05). In the ROC curve analysis, the area under the curve value was 0.574, and obestatin did not prove to be a significant marker for cancer prediction in the population involved in the study. Conclusion: This study did not demonstrate a clear association between circulating levels of obestatin and endometrial pathologies.
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