Management of women with abnormal uterine bleeding: Clinical practice guidelines of the French National College of Gynaecologists and Obstetricians (CNGOF)

被引：5

作者：

Brun, J. L. ^{[1
]}

Plu-Bureau, G. ^{[2
]}

Huchon, C. ^{[3
]}

Ah-Kit, X. ^{[1
]}

Barral, M. ^{[4
]}

Chauvet, P. ^{[5
]}

Cornelis, F. ^{[4
]}

Cortet, M. ^{[6
]}

Crochet, P. ^{[7
]}

Delporte, V. ^{[8
]}

Dubernard, G. ^{[6
]}

Giraudet, G. ^{[8
]}

Gosset, A. ^{[9
]}

Graesslin, O. ^{[10
]}

Hugon-Rodin, J. ^{[2
]}

Lecointre, L. ^{[11
]}

Legendre, G. ^{[12
]}

Maitrot-Mantelet, L. ^{[2
]}

Marcellin, L. ^{[2
]}

Miquel, L. ^{[7
]}

Le Mitouard, M. ^{[6
]}

Proust, C. ^{[13
]}

Roquette, A. ^{[2
]}

Rousset, P. ^{[14
]}

Sangnier, E. ^{[10
]}

Sapoval, M. ^{[15
]}

Thubert, T. ^{[16
]}

Torre, A. ^{[17
]}

Tremollieres, F. ^{[9
]}

Vernhet-Kovacsik, H. ^{[18
]}

Vidal, F. ^{[9
]}

Marret, H. ^{[13
]}

机构：

[1] CHU Bordeaux, Ctr Alienor Aquitaine, Serv Chirurg Gynecol, Hop Pellegrin, Pl Amelie Raba Leon, F-33076 Bordeaux, France

[2] Hop Port Royal Cochin, AP HP, Unite Gynecol Med, 27 Rue Faubourg St Jacques, F-75014 Paris, France

[3] Hop Lariboisiere, AP HP, Serv Gynecol Obstet, 2 Rue Ambroise Pare, F-75010 Paris, France

[4] Hop Tenon, Serv Radiol Intervent, 4 Rue Chine, F-75020 Paris, France

[5] CHU Clermont Ferrand, Serv Chirurg Gynecol, 1 Pl Lucie & Raymond Aubrac, F-63000 Clermont Ferrand, France

[6] CHU Lyon, Hop Croix Rousse, Gynecol Serv, 103 Grande Rue Croix Rousse, F-69004 Lyon, France

[7] CHU Marseille, Serv Gynecol Obstet, Hop Concept, 147 Blvd Baille, F-13005 Marseille, France

[8] CHU Lille, Hop Jeanne Flandre, Gynecol Serv, 49 Rue Valmy, F-59000 Lille, France

[9] CHU, Hop Paule Viguier, Ctr Menopause & Malad Osseuses Metab, 330 Ave Grande Bretagne, F-31059 Toulouse, France

[10] CHU Reims, Serv Gynecol Obstet, Inst Mere Enfant Alix Champagne, 45 Rue Cognac Jay, F-51092 Reims, France

[11] CHU Strasbourg, Serv Chirurg Gynecol, 1 Ave Moliere, F-67200 Strasbourg, France

[12] CHU Angers, Serv Gynecol Obstet, 4 Rue Larrey, F-49933 Angers, France

[13] CHRU Tours, Hop Bretonneau, Serv Chirurg Pelvienne Gynecol & Oncol, 2 Blvd Tonnelle, F-37044 Tours, France

[14] CHU Lyon, Hop Sud, Serv Radiol, 165 Chemin Grand Revoyet, F-69495 Pierre Benite, France

[15] Hop Europeen Georges Pompidou, AP HP, Serv Radiol Intervent, 20 Rue Leblanc, F-75015 Paris, France

[16] CHU Nantes, Hotel Dieu, Serv Gynecol Obstet, 38 Blvd Jean Monnet, F-44093 Nantes, France

[17] Ctr Hosp Sud Francilien, Ctr Procreat Medicalement Assistee, 40 Ave Serge Dassault, F-91106 Corbeil Essonnes, France

[18] CHU Montpellier, Hop Arnaud de Villeneuve, Serv Imagerie Thorac & Vasc, 371 Ave Doyen Gaston Giraud, F-34295 Montpellier, France

来源：

EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY | 2023年 / 288卷

关键词：

Guidelines; Abnormal uterine bleeding; Diagnosis; Treatment; QUALITY-OF-LIFE; RANDOMIZED CONTROLLED-TRIAL; ATYPICAL ENDOMETRIAL HYPERPLASIA; THERMAL BALLOON ABLATION; LAPAROSCOPIC SUPRACERVICAL HYSTERECTOMY; LEVONORGESTREL INTRAUTERINE SYSTEM; SALINE CONTRAST SONOHYSTEROGRAPHY; INTENSITY FOCUSED ULTRASOUND; HEAVY MENSTRUAL LOSS; 2-YEAR FOLLOW-UP;

D O I：

10.1016/j.ejogrb.2023.07.001

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: To provide French guidelines for the management of women with abnormal uterine bleeding (AUB). Design: A consensus committee of 26 experts was formed. A formal conflict-of-interest policy was developed at the beginning of the process and enforced throughout. The entire guidelines process was conducted independently of any industry funding (i.e. pharmaceutical or medical device companies). The authors were advised to follow the rules of the Grading of Recommendations Assessment, Development and Evaluation (GRADE & REG;) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasized.Methods: The last guidelines from the Colle`ge National des Gyne & PRIME;cologues et Obste & PRIME;triciens Francais on the management of women with AUB were published in 2008. The literature seems now sufficient for an update. The committee studied questions within 7 fields (diagnosis; adolescents; idiopathic AUB; endometrial hyperplasia and polyps; type 0-2 fibroids; type 3 or higher fibroids; and adenomyosis). Each question was formulated in a PICO (Patients, Intervention, Comparison, Outcome) format and evidence profiles were compiled. The GRADE & REG; methodology was applied to the literature review and the formulation of recommendations.Results: The experts' synthesis work and the application of the GRADE method resulted in 36 recommendations. Among the formalized recommendations, 19 are strong and 17 weak. No response was found in the literature for 14 questions. We chose to abstain from recommendations rather than providing advice based solely on expert clinical experience.Conclusions: The 36 recommendations make it possible to specify the diagnostic and therapeutic strategies for various clinical situations practitioners encounter, from the simplest to the most complex.

引用

页码：90 / 107

页数：18

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