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Sangramento uterino anormal

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  • Обзор
  • Теория
  • Диагноз
  • Лечение
  • Последующее наблюдение
  • Источники
Последний просмотренный: 2 Apr 2026
Last updated: 14 Nov 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • sangramento uterino
Полная информация

Другие диагностические факторы

  • uso de medicamentos
  • irregularidade menstrual
  • anemia
  • molime pré-menstrual
  • hirsutismo, acne, acantose nigricans
  • Afecção clínica existente
Полная информация

Факторы риска

  • mulheres nos extremos da idade reprodutiva (logo após a puberdade e antes da menopausa)
  • síndrome do ovário policístico
  • endocrinopatias
  • outros transtornos anovulatórios
  • obesidade
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • teste de gravidez
  • Hemograma completo
Полная информация

Исследования, проведение которых нужно рассмотреть

  • perfil de coagulação
  • nível de hormônio estimulante da tireoide (TSH) sérico
  • ultrassonografia
  • histeroscopia
  • biópsia do endométrio
Полная информация

Алгоритм лечения

Начальные

tratamento emergencial do sangramento uterino excessivo

Острый

SUA anovulatório: progestogênios e estrogênios não contraindicados

SUA anovulatório: progestogênios e estrogênios contraindicados

ПРОДОЛЖЕНИЕ

sangramento uterino significativo resistente ao tratamento clínico; desejo de fertilidade futura

sangramento uterino significativo resistente ao tratamento clínico; sem desejo de fertilidade futura

Составители

Авторы

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

Раскрытие информации

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

Раскрытие информации

AS declares that she has no competing interests.

Rohan Chodankar, MBBS, MD, MRCOG

ST6 Obstetrics and Gynaecology

Royal Infirmary of Edinburgh

Scotland

UK

Раскрытие информации

RC is supported as a Clinical Research Fellow by Bayer AG; RC is an author of references cited in this topic.

Выражение благодарностей

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.

Раскрытие информации

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.

Рецензенты

Janet Albers, MD

Associate Professor

Department of Family and Community Medicine

Southern Illinois University School of Medicine

Springfield

IL

Раскрытие информации

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

Раскрытие информации

SS declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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. Аннотация

National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management. May 2021 [internet publication].Полный текст

American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Jul 2012 [internet publication].Полный текст

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].Полный текст

American College of Obstetricians and Gynecologists. Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction. Jul 2013 [internet publication].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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