Role of hysteroscopy in categorization of abnormal uterine bleeding in a multispecialty hospital in Bahrain

Abnormal uterine bleeding is a broad term involving various irregularities of the menstrual cycle. Previously, various terms were used to define abnormalities in menstrual bleeding. To create a universally accepted system of nomenclature, the Federation of Obstetrics and Gynecology proposed the new terminology PALM-COIEN. The current study aims to classify cases of abnormal uterine bleeding as per PALM-COIEN. It is a retrospective, observational study using the data from 110 patients, who underwent hysteroscopic evaluation and endometrial biopsy and were categorized based on PALM-COIEN. Patients were grouped under these categories after detailed history, examination, investigations, hysteroscopic findings, and histopathology. Results showed that polyp was the commonest group (n=45, 40.9%) in our study, which was followed by leiomyoma (n=30, 27.27%), ovulatory disturbances (n=28, 25.45%), adenomyosis (n=5, 4.54%), malignancy (n=2, 1.81%) respectively. In conclusion, hysteroscopic evaluation is a simple and useful tool to find out the structural pathologies of PALMCOIEN classification. Further histopathological confirmation of clinical diagnosis can enhance the diagnosis and treatment modalities.