الفهرس 
The other side of the COEIN
Types of hysteroscopyOnly 14 pages are availabe for public view
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Abstract
Abnormal uterine bleeding (AUB) is a common gynecologic complaint that accounts for one-third of outpatient visits to gynecologists and accounts of more than 70% of all gynecologic consults in the premenopausal and postmenopausal years. The diagnosis of AUB can be quite challenging; despite a detailed history, various blood tests, and a thorough pelvic examination often involving transvaginal ultrasonography (TVS), the cause of the bleeding is established in only 50-60% of the cases (1). The definition of AUB is “flow outside of normal volume, duration, regularity, or frequency. AUB can be caused by anatomic uterine abnormalities or nonstructural causes. In 2011, the International Federation of Gynecology and Obstetrics (FIGO) introduced a new classification system for abnormal uterine bleeding that was endorsed by the American Congress of Obstetrics and Gynecology (ACOG) in 2012, in attempt to standardize the terminology used to describe AUB(2). This system, known by the acronym PALM-COEIN, distinguishes abnormal uterine bleeding based on the suspected etiology: polyp; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; and not yet classified(2). The PALM portion of the PALM-COEIN covers the structural causes of abnormal uterine bleeding. In contrast, The COEIN acronym represents the nonstructural, hormonal, or systemic causes of abnormal uterine bleeding.