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Abnormal Bleeding

Abnormal Bleeding

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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.