By physical examination, laboratory and imaging tests, pregnancy. While evident nub is relatively rare, biochemical proofs of vaginal bleeding can be found in 2561% of neonates, depending on different methods used to detect it. Application with clinical presentations through diagnostic workup and treatment strategies. Michael evans developed the onepager concept to provide clinicians with useful clinical information on primary care topics. National collaborating centre for womens and childrens health, national institute of clinical excellence. Management of abnormal uterine bleeding in reproductive period. Ask questions and get answers about abnormal uterine bleeding. Polyps or fibroids small and large growths in the uterus can also cause bleeding. Dec 07, 2018 dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of pathology or medical illness.
Signs of hypothyroidism are irregu lar periods with weight gain, lethargy, obstipation, hair loss especially at the eyebrows and a dry skin. Abnormal uterine bleeding aub is a broad term that describes irregularities in the menstrual cycle involving frequency, regularity, duration. Anovulatory uterine bleeding abnormal uterine bleeding aub. Abnormal uterine bleeding in the premenopausal period. Management of abnormal uterine bleeding wesley obgyn.
Abnormal uterine bleeding has various definitions and. Once a woman who is not taking hormone therapy enters menopause and the menstrual cycles have ended, any uterine bleeding is considered abnormal. Aub leads to loss of productivity1 and may result in surgical interventions including hysterectomy2. Clinical policy effective11012011 19962012, oxford health plans, llc 3 manual endometrial ablation. Being one of the common gynecological problems we did this study to find out the hospital prevalence, causes and management at chitwan medical college. This can include alternating periods that are heavy and light, spotting or unpredictable shorter and longer. Patients may see a health care provider because of infrequent menses, prolonged and heavy menses menorrhagia, intermenstrual bleeding or spotting, postcoital spotting, or irregular and heavy menses menometrorrhagia. A reproductiveaged woman presented abnormal uterine bleeding of unknown reason with a heavy bleeding intermenstrual period. Pdf abnormal uterine bleeding is a frequent condition in gynecology. May 09, 20 dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Abnormal uterine bleeding is a broad term that indicates a change in frequency of menses, duration of flow or amount of blood loss. Abnormal uterine bleeding aub is a common and debilitating condition with high direct and indirect costs.
Abnormal uterine bleeding aub is a chronic debilitating condition affecting women worldwide with a significant negative impact on their quality of life. In women of childbearing age, a methodical history, physical examination, and. Abnormal uterine bleeding describes any variation from normal. Figo classification system palmcoein for causes of. Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. Modern management of abnormal uterine bleeding crc press. Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. Your health care provider should explain the types of bleeding patterns to expect with your hormone prescription.
It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. Terms used to describe patterns of abnormal uterine bleeding are based on periodicity and. Formerly, it was known as dysfunctional uterine bleeding dub. Dysfunctional uterine bleeding dub a state of abnormal uterine bleeding aub without any clinically detectable organic, systemic, and iatrogenic cause. The term dysfunctional uterine bleeding was used when no underlying cause was present. Howeve r, there are rare hormonal conditions that cause abnormal uterine bleeding in ovulatory cycles.
To design a universally accepted system for describing bleeding problems in reproductiveaged women, a new classification system was created named for the acronym palmcoein polyp, adenomyosis, leiomyoma, malignancy and hyperpla. In cases of acute and severe bleeding, women may need urgent treatment with. Dub is defined as abnormal uterine bleeding with no demonstrable organic cause. Abnormal uterine bleeding british medical bulletin oxford academic. Abnormal uterine bleeding national health portal of india. Abnormal uterine bleeding is bleeding that is different from a womans normal menstrual cycle, unrelated to menstruation, or unusual for her age. Abnormal uterine bleeding organic causes functional uterine bleedingdub deseases of genitaltract pregnancy related irregularity abnormal bleeding from genitaltract without any demonstrable organic cause. This revision is part of the series, guidelines and recommendations. Acute aub refers to an episode of heavy bleeding that, in the opinion of the clinician, is of sufficient quantity to require immediate intervention to prevent further blood loss 1. It may impact physical, emotional sexual and professional aspects of the lives of. Describe the different options for both the medical and surgical management of aub objectives no financial disclosures to report financial disclosure. This has been highlighted in the rcog guidelines with an exception of. Abnormal uterine bleeding is a frequent condition in gynecology.
Abnormal uterine bleeding due to ovulatory dysfunction aubo is abnormal uterine bleeding that, after examination and ultrasonography, cannot be attributed to the usual causes structural gynecologic abnormalities, cancer, inflammation, systemic disorders, pregnancy, complications of pregnancy, use of oral contraceptives or certain drugs. Neonatal uterine bleeding nub occurs in approximately 5% of newborns and represents, similarly as menstrual bleeding, a progesterone pg withdrawal bleeding. Dysfunctional uterine bleeding and uterine fibroids. Abnormal uterine bleeding geneva foundation for medical. Abnormal uterine bleeding american family physician. Hkcog guidelines number 5 may 2001 1 hkcog guidelines guidelines on investigation of women with abnormal uterine bleeding under the age of 40 published by the hong kong college of obstetricians and gynaecologists a foundation college of hong kong academy of medicine number 5 may 2001 1 introduction abnormal uterine bleeding aub is a. Discuss the palmcoein classification system for diagnostic workup. Management of acute abnormal uterine bleeding in nonpregnant. Abnormal uterine bleeding can be caused by many different conditions. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause. Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. This is the most common reason women visit the gynecologist and the second most common reason for a hysterectomy.
Iucd related irregularity diagnosis is made by excluding organic cause. Bleeding may be heavier or lighter than usual and occur often or randomly. Abnormal uterine bleeding aub may be acute or chronic and is defined as bleeding from the uterine corpus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy 1 2. Modern management of abnormal uterine bleeding focuses on helping gynecologists refine their operative techniques and consider new approaches to the diagnosis, and treatment, of this highly challenging condition by investigating. Abnormal uterine bleeding aub, also known as atypical vaginal bleeding, is vaginal bleeding from the uterus that is abnormally frequent, lasts excessively long, is heavier than normal, or is irregular. Dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Abnormal uterine bleeding is a common presenting symptom in the family practice setting. Abnormal uterine bleeding aub is bleeding from the uterus that is longer than usual or that occurs at an irregular time. Health care practitioners deal with this problem frequently. Its prevalence, causes and management in chitwan abstract abnormal uterine bleeding is a common morbid condition of woman seeking medical advice. Abnormal uterine bleeding healthcare baylor college of. Diagnosing the cause of abnormal uterine bleeding starts with a. Classification and the diagnostics of abnormal uterine. Abnormal uterine bleeding aub is a common but complicated clinical presentation.
Introduction it is not uncommon for a woman to suffer from abnormal uterine bleeding aub or heavy menstrual bleeding hmb at some point during her lifetime. In the treatment of women with abnormal uterine bleeding, once a thorough history, physical examination, and indicated imaging studies are performed and all significant structural causes are excluded, medical management is the firstline approach. Apr 29, 2017 dysfunctional uterine bleeding dub a state of abnormal uterine bleeding aub without any clinically detectable organic, systemic, and iatrogenic cause. Perimenopausal dysfunctional uterine bleeding the perimenopause is the time prior to the natural cessation of menses when many changes occur due to the absence of ovulation and decreased estrogen production. Bleeding that occurs erratically or excessive regular menstrual bleeding is considered to be abnormal uterine bleeding. Abnormal uterine bleeding in the premenopausal period 93 hypothyroidism, hyperthyroidism and hyperprolactinemia. Guidelines for the management of abnormal uterine bleeding. Abnormal uterine bleeding aub is a common problem among nonpregnant women in the reproductive age. It is a diagnosis of exclusion made after structural causes of bleeding and chronic medical diseases have been ruled out.
Feb 06, 2020 dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. Abnormal uterine bleeding aub is a common condition that leads to increased health care costs and decreased quality of life. Abnormal uterine bleeding request pdf researchgate. Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects most. Pdf abnormal uterine bleeding aub is a common and debilitating condition with high direct and indirect costs.
Aub is responsible for significant health problem and social embarrassment and it is one of the common reasons women seek health care. The medical management of abnormal uterine bleeding in. Abnormal uterine bleeding aub is a common problem for which pelvic sonography is indicated. Abnormal uterine bleeding aub is a common problem among women in the reproductive age.
Pathophysiology of abnormal uterine bleeding request pdf. A variety of things can cause abnormal uterine bleeding. Abnormal uterine bleeding aub is a condition that affects approximately 30% of women during their reproductive years. Abnormal uterine bleeding can be due to a number of organic and dysfunctional causes. Our support group helps people share their own experience.
In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable. List common manifestations of abnormal bleeding that are speci. Abnormal uterine bleeding aub is a common and debilitating condition with high. This time usually starts in women in their mid to late forties and may last between one and seven years. Signs of hyperthyroidism are sweating, menorrhagia, palpitations, weight loss. Abnormal uterine bleeding dysfunctional uterine bleeding ncbi.
Abnormal uterine bleeding is a common reason for women of all ages to consult their family physicians. Hkcog guidelines number 5 may 2001 hkcog guidelines number. Abnormal uterine bleeding aub is a common clinical problem, affecting up to 14% of women during their reproductive years and impairing their quality of life by creating significant physical, emotional, sexual, social, and financial burdens. If your bleeding is different from what youve been told to expect, contact your provider.
Develop a treatment plan to include nonsurgical and surgical options. Describe an approach to evaluation of abnormal uterine bleeding on the basis of hormonal status. Other causes of abnormal bleeding must also be ruled out, including. Ppt abnormal uterine bleeding powerpoint presentation. Dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to structural abnormalities of the uterus or the endometrial lining. Abnormal uterine bleeding is defined as bleeding that occurs at unexpected times, lasting longer or shorter and varies from a typical menstrual cycle. Abnormal uterine bleeding is defined as any alteration in the volume, pattern or duration of menstrual blood flow. This includes procedures that use a resectoscope to surgically remove, electrically desiccate or vaporize the endometrium, as well as laser destruction of the.
Jul 16, 20 abnormal uterine bleeding organic causes functional uterine bleedingdub deseases of genitaltract pregnancy related irregularity abnormal bleeding from genitaltract without any demonstrable organic cause. Aub may be accompanied by pain and discomfort, cause significant social embarrassment, and have a substantial effect on healthrelated quality of life. Women who take hormone therapy may experience normal or abnormal uterine bleeding. Abnormal uterine bleeding occurs when either the frequency or quantity of uterine. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. Winner of the standing ovation award for best powerpoint templates from presentations magazine.
The normal cycle is triggered by signals from hormones. Abnormal uterine bleeding is a common but complicated clinical presentation that impairs the quality of life in women. Understand the diagnostic modalities commonly used in the workup of aub 4. A systematic approach to aub evaluation can simplify management and enhance womens wellbeing. Abnormal uterine bleeding due to ovulatory dysfunction aubo. This will depend on the cause of the abnormal uterine bleeding if a chronic illness or a blood disorder is at the root of your symptoms, treating that can help. Abnormal uterine bleeding due to ovulatory dysfunction. It is one of the most common health issues for women. Define the pathophysiology of abnormal uterine bleeding. Aub frequently coexists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint.
Evaluation and management of abnormal uterine bleeding in. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. Abnormal uterine bleeding aub describes a range of symptoms, such. Abnormal uterine bleeding formerly, dysfunctional uterine bleeding dub is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. Us of abnormal uterine bleeding1 learning objectives after reading this article and taking the test, the reader will be able to. Identify urgent or emergent conditions that manifest as abnormal bleeding, such as ectopic pregnancy, placenta or vasa previa, and preterm labor. The normal duration of menstrual bleeding is between two and seven days. Evaluation and management of abnormal uterine bleeding. Postmenopausal women with abnormal uterine bleeding should be.
Aub frequently coexists with fibroids, but the relationship between the two remains. Chronic heavy or prolonged uterine bleeding can result in anemia, interfere with daily activities, and raise concerns about uterine cancer. Full text a case of abnormal uterine bleeding of unknown. Dysfunctional uterine bleeding dub represents a particular type of abnormal uterine bleeding aub, and is defined in the usa as an excessive, prolonged and irregular bleeding of the endometrium. By physical examination, laboratory and imaging tests, pregnancy, iatrogenic cause, systemic.