Farnoush Sedaghati - Department of pathology, medicine school, Iran University of Medical Sciences, Tehran, Iran
Maryam Kadivar - Department of pathology, Rasoul Akarm Hospital, Iran University of Medical Sciences, Tehran, Iran

Introduction: Abnormal uterine bleeding (AUB) is a common clinical problem in the reproductive ages, affecting more than 20 % of premenopausal women over the age of 35. Normal menstruation is defined according to the median, 5th and 95th percentiles obtained from large population-based studies. Four basic parameters are used to describe the menstrual bleeding including regularity of the onset, frequency of the onset, duration of menstrual flow and heaviness (or volume) of menstrual flow. The classification system is stratified into nine basic categories that are arranged according to the acronym PALM-COEIN: Polyp; Adenomyosis; Leiomyoma; Malignancy and hyperplasia; Coagulopathy; Ovulatory Disorders; Endometrium; Iatrogenic; and Not Classified. In general, the components of the PALM group are discrete ( structural ) entities that are measurable visually, using imaging techniques, and/or with histopathology, while the COEIN group comprises uteruses that are structurally normal. Methods: The descriptive cross-sectional study comprised all non-gravid women of reproductive age with Abnormal Uterine Bleeding coming to the inpatient department of Rasoul Akram Hospital, Tehran, from March 2002 to March 2012. Endometrium biopsy, curettage and hysterectomy specimen were obtained for histopathology where applicable. Possible underlying causes were categorized according to the new classification system. Data was analyzed by SPSS version 22. Descriptive statistics were presented as frequencies and percentages, and bar chart. Result: from 1230 patients presenting with abnormal uterine bleeding the most common age group was 41–50 years (61%). This include (37.8%) with Leiomyoma as the commonest pathology, (30.1%) with polyp, (18.7%) with adenomyosis, (14.7%) with malignancy and hyperplasia, (11.4%) with ovulatory dysfunction, (4.2%) with endometrial cause, (4.1%) with iatrogenic and the remaining (0.4%) cases were categorized as AUB-N. The relationship between causes of AUB and age pattern was studied and according to this,there is a significant correlation between age and Adenomayosis, Leiomyoma, Malignancy, Ovulatory disorders and Endometrial causes (P value<0.05). Conclusion: The FIGO classification should be used by pathologist, radiologist and gynecologist to facilitate investigation of epidemiology, etiology, diagnosis and treatment of women with abnormal uterine bleeding.

Abnormal uterine bleeding, Histopathologic findings, Reproducvtive ages, FIGO classification