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AUB PRESENTATION

abnormal uterine bleeding

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AUB PRESENTATION

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  1. ABNORMAL UTERINE BLEEDING(AUB) by Suzan Tahawy FM diploma SCU

  2. DEFINITION IRREGULAR UTERINE BLEEDING THAT OCCURS IN ABSENCE OF PELVIC PATHOLOGY, MEDICAL CONDITION OR PREGNANCY.

  3. NORMAL MENSTRUATION CYCLE INTERVAL 28 DAYS MENSTRUAL FLOW 4-5 DAYS ANOVULAR AUB REPRESENTS 80% WHEREAS OVULAR AUB 20%

  4. PUBERTY MENORRHAGIA • AUB IN 1ST YEAR OF MENARCHE. • ANOVULATORY CYCLES • DUE TO IMMATURITY OF • HYPOTHALAMO-PITUITARY-OVARIAN AXIS • TAKES 18 MONTHS TO 2 YEARS TO BE REGULARIZED • NO DYSMENORRHEA

  5. RULE OUT: HYPOTHYROIDISM BLEEDING DISORDER LIVER DISORDERS GENITAL TB MALIGNANCY D&C NOT DONE…

  6. AUB IN REPRODUCTIVE AGE GROUP: • NO DYSMENORRHEA AS CYCLES ARE ANOVULATORY • RULE OUT PREGNANCY • RULE OUT MALIGNANCY

  7. INVESTIGATIONS: CBC HCG ENDOMETRIAL SAMPLING PAP SMEAR THYROID FUNCTIONS AND PROLACTIN LIVER FUNCTIONS COAGULATION STUDIES P.S D&C IS AN IMPORTANT DIAGNOSTIC STEP IN CASE OF FAILED MEDICAL TREATMENT

  8. MANAGEMENT: • ORAL CONTRACEPTIVES • ALSO LOWERS THE RISK OF IRON DEFICIENCY ANEMIA • ESTROGEN FOR PROLONGED UTERINE BLEEDING • PROGESTINS FOR CHRONIC MANAGEMENT OF AUB

  9. DESMOPRESSIN IN PATIENTS WITH DOCUMENTED COAGULATION DISORDER (LAST OPTION)

  10. SURGERY 1- HYSTRECTOMY 2- ENDOMETRIAL ABLATION

  11. HYSTRECTOMY IN CASE OF FAILED MEDICAL TREATMENT WITH ANEMIA AND DISRUPTED QUALITY OF LIFE, ITS NOT ADVISED FOR WOMEN IN REPRODUCTIVE AGE…

  12. ENDOMETRIAL ABLATION IS MORE CONSERVATIVE THAN HYSTRECTOMY IT’S NOT A METHOD OF CONTRACEPTION REBLEEDING RAISE THE CONCERN OF OCCULT ENDOMETRIAL CARCINOMA

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