Abnormal Menstrual Bleeding

2020 ◽  
Author(s):  
Chu Hsiao ◽  
Leanne Dumeny ◽  
Candice P. Holliday ◽  
Lisa Spiryda

Abnormal uterine bleeding (AUB) is a common presentation that can occur in all age groups. AUB is an umbrella term for any uterine bleeding that occurs outside a woman’s normal pattern in volume, regularity, and/or timing. AUB is described by using frequency, regularity, duration, and volume or by using PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy and premalignant conditions; Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified). Workup for AUB comprises a history (with a detailed menstrual history), physical examination (including a pelvic and bimanual examination), lab tests, and imaging (primarily transvaginal ultrasonography). For treatment, medical therapies should be considered before surgical therapies, especially when fertility is desired. The decisions for treatment are based on etiology, fertility concerns, contraindications, or patient preference. Of the medical therapies, there are hormonal and nonhormonal therapies. The most common treatments for AUB are levonorgestrel intrauterine device, tranexamic acid, oral contraceptives, and nonsteroidal anti-inflammatory drugs. The most common surgical treatments are myomectomy, endometrial ablation, uterine artery embolization, and hysterectomy. This review contains 7 figures, 11 tables and 49 references Key words: abnormal uterine bleeding, adenomyosis, contraceptives, endometrial, fibroids, hysterectomy, menorrhagia

2018 ◽  
Author(s):  
Chu Hsiao ◽  
Leanne Dumeny ◽  
Candice P. Holliday ◽  
Lisa Spiryda

Abnormal uterine bleeding (AUB) is a common presentation that can occur in all age groups. AUB is an umbrella term for any uterine bleeding that occurs outside a woman’s normal pattern in volume, regularity, and/or timing. AUB is described by using frequency, regularity, duration, and volume or by using PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy and premalignant conditions; Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified). Workup for AUB comprises a history (with a detailed menstrual history), physical examination (including a pelvic and bimanual examination), lab tests, and imaging (primarily transvaginal ultrasonography). For treatment, medical therapies should be considered before surgical therapies, especially when fertility is desired. The decisions for treatment are based on etiology, fertility concerns, contraindications, or patient preference. Of the medical therapies, there are hormonal and nonhormonal therapies. The most common treatments for AUB are levonorgestrel intrauterine device, tranexamic acid, oral contraceptives, and nonsteroidal anti-inflammatory drugs. The most common surgical treatments are myomectomy, endometrial ablation, uterine artery embolization, and hysterectomy.   This review contains 7 figures, 10 tables and 45 references Key words: abnormal uterine bleeding, adenomyosis, contraceptives, endometrial, fibroids, hysterectomy, menorrhagia


1970 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
R Baral ◽  
S Pudasaini

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16


Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 


2014 ◽  
Vol 21 (6) ◽  
pp. S107-S108
Author(s):  
A.N. Hokenstad ◽  
S.A. El-Nashar ◽  
Z. Khan ◽  
M.R. Hopkins ◽  
S.K. Laughlin-Tommaso ◽  
...  

2013 ◽  
Vol 53 (4) ◽  
pp. 381-385 ◽  
Author(s):  
Vittorio Palmara ◽  
Emanuele Sturlese ◽  
Daniela Villari ◽  
Valentina Giacobbe ◽  
Annalisa Retto ◽  
...  

Author(s):  
Dhivya Govindasamy ◽  
Padmavathi Karunakaran ◽  
Rajalakshmi Ramesh ◽  
Kamalavarshini Paramasivamsasanger ◽  
Rajalakshmi Ponnusamy

Background: The objective of the study was assessing utilization of drug in patients admitted with Abnormal Uterine Bleeding in a tertiary care teaching hospital.Methods: The observational study was conducted at Department of Obstetrics and Gynecology, Rajah Muthiah Medical College and Hospital, Annamalai University, Annamalai Nagar, Tamil Nadu, from the period of July 2019 to September 2019. A total 30 gynecology patients were included.Results: A total 30 patients most of the patients were between the age groups of 36-45 years 66.6%. The most common clinical condition AUB and co-morbidities condition were 19 (63.3%). The majority of patient were prescribed with ferrous sulfate 27 (90%). The defined daily dose (DDD) per patient for norethisterone 36 followed by ferrous sulfate 23.11. The average number of drugs per prescription 10.8, percentage of drug prescribed in generic name 69.56% and number of drugs prescribed from NLEM-2015 86.95%, number of drugs prescribed from EDL-2019 were 69.56% and percentage of prescription with antibiotic 80%, percentage of prescription with injection 70%.Conclusions: This study has shown the utilization of drugs prescribed in AUB patient. The most commonly prescribed drug was ferrous sulfate and most prescribed antifibrinolytic drug was tranexamic acid for treating AUB.


Author(s):  
Anupama Dave ◽  
Kirti Sinha ◽  
Nidhi Gupta

Background: Abnormal uterine bleeding is a common gynecological complaint affecting 10-30% of reproductive-aged women and it can result from different causes which adversely affects the woman’s quality of life, necessitating its appropriate and adequate management. Among all the pharmacological and surgical management options of AUB. LNG-IUS is emerging as a safer and effective treatment option of AUB. However apprehension about discomfort associated with the use of intrauterine device leads to its untimely removal. Aim of current study was to conduct a prospective qualitative study to observe the level of patient satisfaction with the use of LNG-IUS in patients with abnormal uterine bleeding.Methods: This study was conducted in the department of obstetrics and gynecology, MGM medical college and M.Y. Group of Hospitals, Indore from March 2017- March 2018. Follow up was done at 1, 3, 6 months.Results: In our study, majority of the women (90%) had improvement in their abnormal uterine bleeding along with significant increase in mean hemoglobin level from7.30+1.29 gm%  to 8.71+1.27 gm% at the end of six months. 86.66% of these patients were very satisfied with the use of LNG IUS,Conclusions: LNG-IUS is an effective device for medical management of AUB and it should be used as the first line therapy for the same. It should always be considered before surgical interventions. It yields promising result in terms of patient satisfaction. 


Author(s):  
Ruby Kumari ◽  
Lata Shukla Dwivedy ◽  
Sweta Gupta ◽  
Surabhi . ◽  
Madhuri Choudhary ◽  
...  

Background: AUB has significant impact on quality of life of women related to health specially in developing countries including India. FIGO AUB systems are universally accepted. Aim was to study the clinical spectrum of AUB according to the FIGO AUB systems and women’s attitude towards its management.Methods: Cross sectional prospective study was carried out in the department of Obstetrics and Gynaecology, ANMMCH, Gaya, a tertiary care center, among women of 15-55 years age groups having complain related to abnormal uterine bleeding, for 1 year from 1st May 2019 to 30th April 2020 on 1000 patients. Data was collected and analyzed by percentage and proportions.Results: Prevalence of AUB was maximum among 15-30 years age group of patients (46.80%). Most of the patients belong to lower (62.5%) class, rural area (68%) and were anaemic (62.5%). Ovulatory dysfunction (55%) was most common cause for AUB, maximum patients choose surgical management (hysterectomy) but after counselling, most of them shifted to medical management.Conclusions: This study suggests more conservative approach for management of AUB and emphasizes the importance of awareness for clinical spectrum of AUB among women so that they can be self-motivated for early treatment and unnecessary hysterectomy can be avoided.


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