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Abnormal Bleeding

Abnormal Bleeding. CAPT Mike Hughey, MC, USNR. Causes of Abnormal Bleeding. 1. Pregnancy 2. Malignancy 3. Mechanical Problems 4. Hormonal Problems. Rule out Pregnancy. Patients of childbearing age with unexplained abnormal bleeding should have a pregnancy test. Rule out Malignancy.

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Abnormal Bleeding

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  1. Abnormal Bleeding CAPT Mike Hughey, MC, USNR

  2. Causes of Abnormal Bleeding 1. Pregnancy 2. Malignancy 3. Mechanical Problems 4. Hormonal Problems

  3. Rule out Pregnancy • Patients of childbearing age with unexplained abnormal bleeding should have a pregnancy test

  4. Rule out Malignancy • Cervical cancer (Pap) • Vaginal cancer (Exam) • Ovarian cancer (Exam) • Uterine cancer (Endometrial biopsy, but under age 40, cancer very rare) Invasive Cancer of the Cervix

  5. Mechanical Problems Polyps Fibroids

  6. Hormonal Problems • Anovulation • Ovulatory bleeding • Delayed menses

  7. Clinical Management: Evaluation 1. Pregnancy Test 2. CBC (anemia) 3. Recent negative Pap smear 4. Pelvic exam

  8. Clinical Management: Treatment BCPs Bedrest

  9. Clinical Management: MEDEVAC If BCPs/Bedrest fail to resolve the bleeding and it is heavy, MEDEVAC is the next step. Surgery (D&C, hysteroscopy, etc.) will be needed. This is best undertaken in other than operational settings.

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