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Abnormal uterine bleeding

Última revisión: 19 Jun 2025
Última actualización: 10 Dec 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • uterine bleeding
Todos los datos

Otros factores de diagnóstico

  • use of medications
  • menstrual irregularity
  • anemia
  • premenstrual molimina
  • hirsutism, acne, acanthosis nigricans
  • existing medical illness
Todos los datos

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
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • pregnancy test
  • CBC
Todos los datos

Pruebas diagnósticas que deben considerarse

  • coagulation profile
  • serum TSH level
  • ultrasound scan
  • hysteroscopy
  • endometrial biopsy
Todos los datos

Algoritmo de tratamiento

Inicial

emergency management of excessive uterine bleeding

Agudo

anovulatory AUB: progestogens and estrogens not contraindicated

anovulatory AUB: progestogens and estrogens contraindicated

En curso

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

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

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.
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