ABNORMAL UTERINE BLEEDING

Abnormal Uterine Bleeding

Table of Content

Abnormal Uterine Bleeding3

Introduction3

Background of the Study3

Purpose of the Study6

Financial Aspects7

The normal menstrual cycle:8

Risk analysis and diagnosis, investigation:9

Treatment:12

Clinical and proposed approach:14

Adolescents (13-18 years)14

Age women (19-39):15

Surgical versus medical management:17

The efficacy of surgical methods:18

Conclusion19

References21

Abnormal Uterine Bleeding

Introduction

Abnormal uterine bleeding (DUB) is abnormal bleeding from the uterine endometrium that is not related to an anatomical lesion of the uterus (ACOG, 1989). It is associated with abnormal ovarian function and an ovulation May but occur in ovulatory cycles. Pre-menopausal uterine bleeding or is a separate entity that warrants a different diagnostic and therapeutic review. The wide variation in patterns of menstrual cycle is often the cause of the difficulty in identifying abnormal bleeding. In practice, excessive bleeding is that in the duration, frequency or amount for a patient should be considered abnormal and investigated accordingly.

Background of the Study

Juvenile bleeding occurs more frequently in the first 2 years after menarche (first menstruation). The patient's condition depends on the extent and severity of blood loss anemia. Characterized by weakness, lack of appetite, fatigue, headaches, pale skin and mucous membranes, tachycardia. Determined by changes in the rheological and coagulation properties of blood. Diagnosis is difficult, as in menopause increases the incidence of endometriosis , fibroids , and adenocarcinoma of the uterus, endometrial polyps, which are the cause of uterine bleeding, acyclic nature of which may be due to age- an ovulation .

In order to identify organic pathology of endometrial curettage is carried out separately endocervix and uterus. After that, perform hysteroscopy historiography and ultrasonography of the uterus and ovaries. The latter reveals an increase of one that should be seen as a sign of hormonally-active tumors. The main therapeutic activity is the separation of mucosal scraping the cervical canal and uterus. Application of conservative hemostatic hormones before curettage is unacceptable. In the future treatment strategy is determined by concomitant gynecological diseases, diseases of other organs and systems, age of the patient. Absolute indication for hysterectomy is a combination of dysfunctional uterine bleeding with recurrent adenomatous or atypical endometrial hyperplasia, nodular form of endometriosis (adenomyosis) of the uterus, submucosal myoma.

To prevent a recurrence of bleeding in the period after curettage is used only pure gestagens. Keep in mind that therapy with progestogens and estrogens at any age is contraindicated in thrombophlebitis, varicose veins of the lower limbs and rectum, chronic hepatitis and cholecystitis, cholelithiasis, chronic pyelonephritis. Relative contraindications to receive them are marked obesity, hypertension (when blood pressure above 160/100 mm Hg), heart disease, accompanied by edema. Drugs prescribed in a continuous mode for 3 - 6 months under the supervision of the endometrium by ultrasound (vaginal sensor). Under the supervision of resecting laser knife lining of the uterus, after which the walls of the cavity undergo cicatrices itself cavity partially or completely obliterating.

Purpose of the Study

The purpose of this document is to provide management guidelines for the treatment of patients with menstrual irregularities associated with an ovulation on the basis of best available ...