The Clinical Spectrum of AUB and Women’s Attitude towards Its Management in Poor Resource Setting

Background: Abnormal uterine bleeding (AUB) has significant impact on quality of life of women related to health especially in developing countries including India. FIGO AUB systems are universally accepted. FIGO AUB systems are universally accepted for normal and abnormal uterine bleeding symptoms and classification of causes known by the acronym PALM- COEIN.

Aim: This study highlights the clinical spectrum of AUB according to the FIGO AUB systems and women’s attitude towards its management.

Methods: This Cross Sectional prospective study was carried out in the department of Obstetrics and Gynaecology, ANMMCH, Gaya, a tertiary care center, among women of 15-55 years age groups having complain related to abnormal uterine bleeding, for 1 year from 1stMay 2019 to 30thApril 2020 on 1000 patients. Data was collected and analyzed by percentage and proportions. Statistical tool used was MS office Excel and SPSS version 17.

Results: Prevalence of AUB was maximum among 15-30 years age group of patients (46.80%). Most of the patients belonged to lower (62.5%) class, rural area (68%) and were anemic (62.5%). Ovulatory dysfunction (55%) was the most common cause for AUB, maximum patients choose surgical management (hysterectomy) but after counseling, most of them shifted to medical management. The effects of counseling were that about 50% of patients shifted from surgical options to medical options. In this study we found that maximum patients were illiterate, poor, belong to remote areas, have myths related to AUB, wanted cheaper and faster management of AUB.

Conclusions: It is concluded that a more conservative approach for management of AUB and emphasizes the importance of awareness for the clinical spectrum of AUB among women so that they can be self-motivated for early treatment and unnecessary hysterectomy can be avoided.