Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- uterine bleeding
Otros factores de diagnóstico
- use of medications
- menstrual irregularity
- anemia
- premenstrual molimina
- hirsutism, acne, acanthosis nigricans
- existing medical illness
Factores de riesgo
- women at the extremes of reproductive age (just after puberty and before menopause)
- polycystic ovary syndrome
- endocrine disorders
- other anovulatory disorders
- obesity
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- pregnancy test
- CBC
Pruebas diagnósticas que deben considerarse
- coagulation profile
- serum TSH level
- ultrasound scan
- hysteroscopy
- endometrial biopsy
Algoritmo de tratamiento
emergency management of excessive uterine bleeding
anovulatory AUB: progestogens and estrogens not contraindicated
anovulatory AUB: progestogens and estrogens contraindicated
significant uterine bleeding resistant to medical treatment; desiring future fertility
significant uterine bleeding resistant to medical treatment; not desiring future fertility
Colaboradores
Autores
Janesh Gupta, MSc, MD, FRCOG
Professor of Obstetrics and Gynaecology
Centre for Women's and Newborn Health
Institute of Metabolism and Systems Research
University of Birmingham
Birmingham Women’s and Children’s Hospital
Birmingham
UK
Divulgaciones
JG is a clinical advisor for Femcare UK.
Akanksha Sood, MBBS, MS (OBGY), DNB, MRCOG, FACOG
Senior Clinical Fellow
Department of Reproductive Medicine
St. Mary’s Hospital
Manchester
UK
Divulgaciones
AS declares that she has no competing interests.
Rohan Chodankar, MBBS, MD, MRCOG
ST6 Obstetrics and Gynaecology
Royal Infirmary of Edinburgh
Scotland
UK
Divulgaciones
RC is supported as a Clinical Research Fellow by Bayer AG; RC is an author of references cited in this topic.
Agradecimientos
Professor Gupta, Dr Sood, and Dr Chodankar would like to gratefully acknowledge Dr Mohamed Mitwally and Dr Intisar Elnahhas, the previous contributors to this topic.
Divulgaciones
MM owns a patent on the use of aromatase inhibitors for endometrial thinning before hysteroscopic surgery. The patent is licensed to Meditrina Company. IE declares that she has no competing interests.
Revisores por pares
Janet Albers, MD
Associate Professor
Department of Family and Community Medicine
Southern Illinois University School of Medicine
Springfield
IL
Divulgaciones
JA is an author of a reference cited in this topic.
Sarina Schrager, MD, MS
Associate Professor (CHS)
Department of Family Medicine
University of Wisconsin
WI
Divulgaciones
SS declares that she has no competing interests.
Referencias
Artículos principales
Munro MG, Critchley HO, Broder MS, et al. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011 Apr;113(1):3-13. Resumen
National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. May 2021 [internet publication].Texto completo
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Jul 2012 [internet publication].Texto completo
American College of Obstetricians and Gynecologists. ACOG committee opinion no. 557: management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Apr 2013 [internet publication].Texto completo
American College of Obstetricians and Gynecologists. Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction. Jul 2013 [internet publication].Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
დიფერენციული დიაგნოზები
- Pregnancy-related bleeding
- Menstrual-related migraine
- Genital lesions
Más Diferencialesგაიდლაინები
- General approaches to medical management of menstrual suppression
- Heavy menstrual bleeding: assessment and management
Más გაიდლაინებიპაციენტის ბროშურები
Heavy periods
მეტი პაციენტის ბროშურებიშედით სისტემაში ან გამოიწერეთ BMJ Best Practice
ამ მასალის გამოყენება ექვემდებარება ჩვენს განცხადებას