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

Malcolm G Munro, Hilary O D Critchley, Ian S Fraser, FIGO Menstrual Disorders Committee, Rohana Haththotuwa, Alka Kriplani, Luis Bahamondes, Carlos Füchtner, Rebecca Tonye, David Archer, Jason Abbott, Ahmad Abdel-Wahed, Marina Berbic, Vivian Brache, Daniel Breitkoph, Andrew Brill, Michael Broder, Ivo Brosens, Kristoph Chwalisz, Justin Clark, Catherine d'Arcangues, Margit Dueholm, Hans Mark Emanuel, Cynthia Farquhar, Mario Festin, Yoke Fai Fong, Marc Fritz, Sun-Wei Guo, Stephan Gordts, Grigoris Grizimbis, Sioban Harlow, Oskari Heikinheimo, Martha Hickey, Jennifer Higham, William Hurd, Keith Isaacson, Julia Johnson, Ricardo Lasmar, Lee Learman, Charles Lockwood, Andrea Lukes, Diana Mansur, Kristen Matteson, Scott Monroe, Ian Milsom, Andrew Mok, Evan Myers, Anita Nelson, Shaughn O'Brien, David Olive, Colin Pollard, Rachel Pope, Elisabeth Persson, Robert Rebar, Dorothy Shaw, Shirish Sheth, Sukbir Sony Singh, Robert Schenken, James Spies, Elizabeth Stewart, Delphin Tan, David Taub, Zephne van der Spuy, Paolo Vercellini, Kirsten Vogelsong, Pamela Warner, Malcolm G Munro, Hilary O D Critchley, Ian S Fraser, FIGO Menstrual Disorders Committee, Rohana Haththotuwa, Alka Kriplani, Luis Bahamondes, Carlos Füchtner, Rebecca Tonye, David Archer, Jason Abbott, Ahmad Abdel-Wahed, Marina Berbic, Vivian Brache, Daniel Breitkoph, Andrew Brill, Michael Broder, Ivo Brosens, Kristoph Chwalisz, Justin Clark, Catherine d'Arcangues, Margit Dueholm, Hans Mark Emanuel, Cynthia Farquhar, Mario Festin, Yoke Fai Fong, Marc Fritz, Sun-Wei Guo, Stephan Gordts, Grigoris Grizimbis, Sioban Harlow, Oskari Heikinheimo, Martha Hickey, Jennifer Higham, William Hurd, Keith Isaacson, Julia Johnson, Ricardo Lasmar, Lee Learman, Charles Lockwood, Andrea Lukes, Diana Mansur, Kristen Matteson, Scott Monroe, Ian Milsom, Andrew Mok, Evan Myers, Anita Nelson, Shaughn O'Brien, David Olive, Colin Pollard, Rachel Pope, Elisabeth Persson, Robert Rebar, Dorothy Shaw, Shirish Sheth, Sukbir Sony Singh, Robert Schenken, James Spies, Elizabeth Stewart, Delphin Tan, David Taub, Zephne van der Spuy, Paolo Vercellini, Kirsten Vogelsong, Pamela Warner

Abstract

Background: The International Federation of Gynecology and Obstetrics (FIGO) systems for nomenclature of symptoms of normal and abnormal uterine bleeding (AUB) in the reproductive years (FIGO AUB System 1) and for classification of causes of AUB (FIGO AUB System 2; PALM-COEIN) were first published together in 2011. The purpose was to harmonize the definitions of normal and abnormal bleeding symptoms and to classify and subclassify underlying potential causes of AUB in the reproductive years to facilitate research, education, and clinical care. The systems were designed to be flexible and to be periodically reviewed and modified as appropriate.

Objectives: To review, clarify, and, where appropriate, revise the previously published systems.

Methodology and outcome: To a large extent, the process has been an iterative one involving the FIGO Menstrual Disorders Committee, as well as a number of invited contributions from epidemiologists, gynecologists, and other experts in the field from around the world between 2012 and 2017. Face-to-face meetings have been held in Rome, Vancouver, and Singapore, and have been augmented by a number of teleconferences and other communications designed to evaluate various aspects of the systems. Where substantial change was considered, anonymous voting, in some instances using a modified RAND Delphi technique, was utilized.

Keywords: Abnormal uterine bleeding; Adenomyosis; Anovulatory bleeding; Arteriovenous malformation; Coagulopathy; Endometrial hyperplasia; Endometrial polyp; FIGO; Heavy menstrual bleeding; Heavy uterine bleeding; Intermenstrual bleeding; Irregular menstrual bleeding; Irregular uterine bleeding; Isthmocele; Leiomyoma; Menorrhagia; Metrorrhagia; PALM-COEIN.

© 2018 International Federation of Gynecology and Obstetrics.

Source: PubMed

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