Telemedicine in the Evaluation and Management of Abnormal Uterine Bleeding: A Practical Approach

Abstract

In response to the COVID-19 pandemic, gynecologists have increased their use of telehealth services to expand access to care and minimize the need for in-person office-visits. While abnormal uterine bleeding (AUB) is the most-common complaint for patients presenting to gynecologic office visits, there is little research on the utility of telehealth in its management. A practical guide to managing AUB using telehealth services was developed for each of the common causes of AUB according to PALM-COEIN [polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified] nomenclature. Examples of applications in assessment include comprehensive history intake, electronic scheduling of transvaginal ultrasounds, laboratory work orders, patient counseling, and referrals to specialists. Telemedicine can also be incorporated into treatment of AUB. Preoperative consultations, prescribing medications (such as non–long-acting reversible hormonal contraceptives), and uncomplicated postoperative management can all be done via telehealth services. Telehealth can improve the efficiency of evaluation and treatment of AUB, including appropriate triage of patients and completing necessary workups needed prior to an in-person visit. Integration of telemedicine services may help overcome challenges with access to care such as geographical or resource limitations. (J GYNECOL SURG 20XX:000)