ABNORMAL UTERINE BLEEDING IN REPRODUCTIVE WOMEN: DIAGNOSIS, MANAGEMENT AND TREATMENT
Abnormal Uterine Bleeding (AUB) is a common cause for concern among reproductive women and their families, as well as a frequent cause of visits to the Emergency Department and/or health care provider. In the pilot study which was conducted in 50 patients, observed that majority of patients were admitted due to menorrhagia and most of them were peri-menopausal women. Fibroid uterus is the most common cause in the study population, other than cyst and adenomyosis. Among the 50 patients, 54% were managed with drugs, 32% with surgery & drugs and the remaining with surgery alone. Among the drugs used, tranexamicacid is an effective therapy for the management of aub. The adolescents were treated with oral progestins. Anemia which was assessed in 20% and was corrected with folic acid supplements, iron sucrose and blood transfusions if required. Hysterectomy was done in majority of patients with cyst and fibroid excisions.Key words: AUB, Menorrhagia, fibroid uterus, tranexamic acid, progestins, anemia, hysterectomy
2. Committee on Practice Bulletinsâ€”Gynecology. Practice bulletin no. 128: Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol 2012;120(1):197-206.
3. World Health Organization multicenter study on menstrual and ovulatory patterns in adolescent girls. II. Longitudinal study of menstrual patterns in the early postmenarcheal period, duration of bleeding episodes and menstrual cycles. World Health Organization Task Force on Adolescent Reproductive Health. J Adolesc Health Care 1986;7(4):236-44.
4. Widholm O, Kantero RL. A statistical analysis of the menstrual patterns of 8,000 Finnish girls and their mothers. Acta Obstet Gynecol Scand Suppl 1971;14 Suppl 14:1-36.
5. Hickey M, Balen A. Menstrual disorders in adolescence: Investigation and management. Hum Reprod Update 2003;9(5):493-504.
6. Dietz WH. Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics 1998;101:518-25.
7. James AH, Kouides PA, Abdul-Kadir R, Edlund M, Federici AB, Halimeh S, et al. Von Willebrand disease and other bleeding disorders in women: consensus on diagnosis and management from an international expert panel. Am J Obstet Gynecol 2009;201:12.e1-8.
8. Claessens EA, Cowell CA. Acute adolescent menorrhagia. Am J Obstet Gynecol 1981;139(3):277-80.
9. Minjarez DA, Bradshaw KD. Abnormal uterine bleeding in adolescents. Obstet Gynecol Clin North Am 2000;27(1):63-78.
10. American College of Obstetricians and Gynecologists Committee on Adolescent Health Care, American College of Obstetricians and Gynecologists Committee Gynecologic Practice. ACOG Committee Opinion No. 451: Von Willebrand disease in women. Obstet Gynecol 2009;114(6):1439-43.
11. ACOG Committee on Practice Bulletins â€“ Gynecology. ACOG Practice Bulletin No 108: Polycystic ovary syndrome. Obstet Gynecol 2009;114:936-49.
12. McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Maturitas 1992;14(2):103-15.
13. McKinlay SM, Bifano NL, McKinlay JB. Smoking and age at menopause in women. Ann Intern Med 1985;103(3):350-6.
14. Vihko R, Apter D. Endocrine characteristics of adolescent menstrual cycles: impact of early menarche. J Steroid Biochem 1984;20(1):231-6.
15. Brown DL. Congenital bleeding disorders. Curr Probl Pediatr Adolesc Health Care 2005;35(2):38-62.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.