Iron deficiency and iron deficiency anemia can have profound effects on cognition, work productivity, and family and social life, and may be a contributor to increased maternal mortality and impaired neonatal development. Collectively, these circumstances that make AUB in the reproductive years an important and often overlooked and underappreciated health issue with insidious impact on world economies. There exists a spectrum of potential causes of AUB in the reproductive years that include abnormalities in endocrine, endometrial and hemostatic function and a number of structural anomalies that include polyps, adenomyosis and leiomyomas or fibroids. What are the challenges? Determination of the causes of AUB in the reproductive years remains a major challenge for investigators, clinicians and educators. As a result, in order to obtain clearly informative basic science as well as translational and clinical investigation, a comprehensive approach to both investigation and categorisation was needed.

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Until now, there has been no universally accepted method for classifying such patients, which has impeded basic science and clinical investigation, as well as the practical, rational, and consistent application of medical and surgical therapy. As the result of a stringent 5-year review process, a multinational group of clinician—investigators with broad experience in the investigation of AUB has now agreed on a classification system to facilitate multi-institutional investigation into the epidemiology, etiology, and treatment of women with acute and chronic AUB.

Another requirement is the development of a classification system for the causes of AUB, which can be used by clinicians, investigators, and even patients themselves to facilitate communication, clinical care, and research. The basic system comprises 9 categories: The first 4 are defined by visually objective structural criteria PALM: polyp; adenomyosis; leiomyoma; and malignancy and hyperplasia ; a second 4 that are unrelated to structural anomalies COEI: coagulopathy; ovulatory dysfunction; endometrial; and iatrogenic , and a final category reserved for entities that are not yet classified N.

A draft system was developed and revised, distributed for comments, and then discussed at a face-to-face meeting held in association with the FIGO World Congress in Cape Town, South Africa. The process was systematically designed to create a practical system that could be used by clinicians in most countries worldwide to classify patients with AUB readily and consistently. Consequently, we recommend a scheduled systematic review of the system on a regular basis by a permanent committee of an international organization such as FIGO, which has already endorsed the establishment of a suitable ongoing Working Group on Menstrual Disorders.

Therefore, FIGO is pleased to have a role in facilitating the use of this ground-breaking new classification worldwide. Munro, Hilary O. Critchley, Michael S. Broder, and Ian S. Critchley, and Ian S. Fraser doi: Notes for EditorsFull text of the articles is available to credentialed journalists upon request; contact Francesca Costanzo at or f.

To schedule an interview with the authors, please contact: Dr. Malcolm G. Hilary O. Ian S. About the International Federation of Gynecology and Obstetrics www. The mission of FIGO is to promote the well-being of women and to raise the standard of practice in obstetrics and gynecology.

FIGO has grown from an organization representing the 42 national societies that attended the founding meeting on July 26, in Geneva into a worldwide organization representing obstetricians and gynecologists in countries or territories. About Elsevier Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises.

For years, we have partnered with the research world to curate and verify scientific knowledge. Elsevier is part of RELX , a global provider of information-based analytics and decision tools for professional and business customers.


FIGO classification of uterine bleeding

In FIGO recognized two systems designed to aid research, education, and clinical care of women with abnormal uterine bleeding AUB in the reproductive years. This page is a summary of the systems and their use in contemporary gynecology. FIGO System 1. The system for definition and nomenclature of normal and abnormal uterine bleeding AUB in the reproductive years. Abnormal uterine bleeding AUB in the reproductive years, unrelated to pregnancy, is rarely life-threatening, but is frequently life altering.


FIGO’s New Classification of Causes of Abnormal Uterine Bleeding Benefits Patients



FIGO Committee for Menstrual Disorders


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