Perm Medical JournalPerm Medical Journal0136-14492687-1408Eco-Vector570610.17816/pmj33532-37Research ArticlePECULIARITIES OF MANAGEMENT IN WOMEN OF DIFFERENT AGE GROUPS WITH ABNORMAL UTERINE BLLEDINGTenA Rtenar79@mail.ruOboskalovaT A-LavrentievaI V-VorontsovaA V-15102016335323718112016Copyright © 2016, Ten A.R., Oboskalova T.A., Lavrentieva I.V., Vorontsova A.V.2016Ключевые слова. Аномальное маточное кровотечение, гиперплазия эндометрия. Aim. To assess management of women with abnormal uterine bleeding (AUB), who underwent surgical hemostasis. Materials and methods. Seventy nine ambulatory and hospital medical records were analyzed. There were women of two age groups: group I - 39 women with stages 4 and 3b, group II - 40 women with stages 3a and 2 by "STRAW+10" classification. In patients of menopausal transition, cases of arterial hypertension, obesity and type 2 diabetes mellitus were fixed reliably more often, while hepatobiliary diseases were revealed with similar frequency in women of both groups. Six (15,3 %) women in group I, and eleven (27,5 %) women in group II had repeated hemorrhage. The interval between the first and the repeated episode of AUB in group I was 8,4 ± 1,6 months, but in group II - 5,6 ± 2,4 months ( p = 0,03). Results. While performing histological study of endometrium, presence of simple endometrial hyperplasia (EHP) without atopy was detected in 32 (82,5 %) patients of group I; in 7 (17,9 %) patients - deficient secretory endometrial transformation was observed. In women of group II there were 2 cases (5 %) of complicated EHP without atopy and 12 (30 %) cases of multiple endometrial polyposis, in the rest 23 cases (57,5 %) glandular and glandular-fibrous EHP was developed ( p = 0,02). Only 21 (53,8 %) patients of group I and 35 (87,5 %) patients of group II underwent ambulatory antirelapsing therapy. Patients of reproductive age received progesteron drugs - 12 (57 %), "Mirena" - 7 (33,3 %) and only 2 (9,5 %) women took combined oral contraceptives. Women of group II received therapy with gonadotropin-releasing hormone agonists for 3-4 months. Conclusions. Menstrual cycle disorders are the predisposing factor for AUB development. In most cases, simple endometrial hyperplasia is a morphological substrate of AUB. Rehabilitation measures are to be conducted for prevention of abnormal uterine bleedingAbnormal uterine bleedingendometrial hyperplasiaАномальное маточное кровотечениегиперплазия эндометрия[Об утверждении Порядка оказания медицинской помощи по профилю «Акушерство и гинекология (за исключением использования вспомогательных репродуктивных технологий)»: Приказ № 572-н от 1 ноября 2012 г., available at: http://www.opc.kursk.ru/ files/Приказ%20Минздрава%20России%20от%2001_11_2012%20N%20572н%20(ред_%20от%2017_01_.pdf][Чернуха Г.Е., Немова Ю.И. Диагностика и медикаментозная терапия маточных кровотечений с позиций международных рекомендаций // Акушерство и гинекология 2013; 2.][Fraser I.S., Langham S., Uhl-Hochgraeber K. Health-related quality of life and economic burden of abnormal uterine bleeding. Expert Rev Obstet Gynecol 2009;][4 (2): 179-189.][Harlow S.D., Gass M., Hall J.E., Lobo R., Maki P., Rebar R.W. STRAW 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Menopause 2012; 19 (4): 387-395.][Iram S., Musonda P., Ewies A.A. Premenopausal bleeding: When should the endometrium be investigated? A retrospective non-comparative study of 3006 women. European Journal of Obstetrics & Gynecology and Reproductive Biology 2010; 148 (1): 86-89.][Munro M.G., Critchley H.O., Broder M.S. FIGO classification system (PALM-COEIN) of causes of abnormal uterine bleeding in nongravid women of reproductive age. FIGO Working Group on Menstrual Disoders. Int J Gynecol Obstet 2011; 113: 3-13.]