Abnormal dysfunctional uterine bleeding in pediatrics. Dysfunctional uterine bleeding, although not usually lifethreatening, can cause disruption and discomfort for many women. Article pdf available in obstetrics and gynecology 1201. Morphological spectrum of endometrium in patients presenting. Abnormal uterine bleeding aub is a common and debilitating condition with high direct and indirect costs. Dysfunctional uterine bleeding during adolescence springerlink.
Rarely, advanced cervical cancer presents with heavy and erratic vaginal bleeding. Vaginal bleeding may be heavy, or last for longer than a week. Desmopressin, a synthetic analog of arginine vasopressin, has been used as a last resort to treat abnormal uterine bleeding in patients with documented coagulation disorders. Abnormal uterine bleeding due to ovulatory dysfunction is the most common cause of abnormal uterine bleeding. Chronic heavy or prolonged uterine bleeding can result in anemia, interfere with daily activities, and raise concerns about uterine. Her undergraduate degree is in biochemistry from uc davis, where she did research in genetics. Menorrhagia is heavy or prolonged menstrual bleeding that can be caused by many problems, including hormonal imbalance, fibroids, pelvic inflammatory disease, or using an iud. Feb 03, 2020 dysfunctional uterine bleeding dub is abnormal uterine bleeding that is caused by a problem with your hormones. Severe acute bleeding irregular bleeding menorrhagia secondary amenorrhea pregnant figure 3 figure 4 figure 5 figure 6 figure 2 any abnormal pattern associated with certain. Abnormal uterine bleeding prognosis bmj best practice.
Ovulatory abnormal uterine bleeding, or menorrhagia, presents as bleeding that occurs at normal, regular intervals but that is excessive in volume or duration. Management of abnormal uterine bleeding associated with ovulatory dysfunction. Health care practitioners deal with this problem frequently. Management of dysfunctional uterine bleeding based on. Uterine bleeding in nonpregnant reproductiveaged women. When an organic cause cannot be found, then by exclusion, a diagnosis of dysfunctional uterine bleeding dub is assumed. Guidelines for the management of abnormal uterine bleeding. Evaluation and management of abnormal uterine bleeding in.
Fatigue, heavy menstrual bleeding, irregular menstrual. 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. Abnormal uterine bleeding is a broad term that indicates a change in frequency of menses, duration of flow or. It is more often seen in the pubertal and perimenopausal periods, and in most cases, it is associated with anovulation, leading to lack of estrogeninduced negative feedback on the pituitary gland, resulting in unopposed estrogen stimulation to the. The normal cycle is triggered by signals from hormones. Chronic abnormal uterine bleeding aub, a term that refers to menstrual bleeding of abnormal quantity, duration, or schedule, is a common gynecologic problem, occurring in approximately 10 to 35 percent of women. It has often been poorly researched in the past, possibly because of the difficulty in measuring menstrual blood loss. Dysfunctional uterine bleeding dub, a nonspecific term for abnormal uterine bleeding aub, is classically defined as excessively heavy, prolonged, or frequent bleeding of uterine origin that is not caused by pregnancy or recognizable pelvic or systemic disease. Several different therapies are available and individual women can choose from a number of options. Jul 19, 2014 dysfunctional uterine bleeding anovulatory estrogen withdrawal estrogen breakthrough threshold bleeding suprathreshold bleeding progesterone breakthrough ovulatory irregular ripening irregular shedding abnormal local haemostatic mechanisms 31.
Data sources include ibm watson micromedex updated 4 may 2020, cerner multum updated 4 may 2020, wolters kluwer updated. High and graduated from newport harbor high school. Abnormal uterine bleeding the menstrual bleed that is abnormally heavy or abnormal in timing assessment causes 1. You may have bleeding from your uterus at times other than your normal monthly period. Abnormal uterine bleeding aub is defined as changes in frequency of menses, duration of flow or amount of blood loss. Chronic abnormal uterine bleeding aub, a term that refers to menstrual bleeding of. Dysfunctional uterine bleeding describes the sp ectrum of abnormal bleeding patterns in the abscence of a medical illness or pelvic pathology. Assessment of the patient with acute abnormal uterine bleeding. Abnormal uterine bleeding has various definitions and. Aetiology of abnormal uterine bleeding general causes local causes dysfunctional 1. Clinical policy effective11012011 1996 2012, oxford health plans, llc 3 manual endometrial ablation.
Most commonly, dysfunctional uterine bleeding dub is due to an immature hypothalamuspituitaryovarian axis leading to anovulatory cycles. Abnormall uterine bleeding is the most common cause of abnormal vaginal bleeding during a womans reproductive years. Bleeding disorders and anticoagulant use may be causative or contributory. Abnormal uterine bleeding is a common presenting symptom in the family practice setting. Abnormal uterine bleeding is one of the most common reasons for women to seek for care. Aub and its sub group, heavy menstrual bleeding hmb, are common conditions affecting 1425% of women of reproductive age, and may have a significant impact on their physical, social, emotional and material quality of life. Dysfunctional uttering bleeding dub is an abnormal uterine bleeding in the absence of organic cause. Clinical policy effective11012011 1996 2012, oxford health plans, llc 1 clinical policy dysfunctional uterine bleeding and uterine fibroids the services described in oxford policies are subject to the terms, conditions and limitations of the members contract or certificate.
Abnormal uterine bleeding due to ovulatory dysfunction. It usually results from disordered functioning of the hypothalamicpituitaryov. For claims with a date of service on or after october 1, 2015, use an equivalent icd10cm code or codes. Dysfunctional uterine bleeding may be the symptom of endometrial carcinoma in 850% of cases dangal, 2003. In the uk, over 800,000 women seek help for aub annually. Endometrial ablation in the management of abnormal uterine bleeding 2015. Dysfunctional uterine bleeding dub linkedin slideshare. Diagnosis of abnormal uterine bleeding in reproductiveaged women. A reproductiveaged woman presented abnormal uterine bleeding of unknown reason with a heavy bleeding intermenstrual period. Dysfunctional uterine bleeding is defined as abnormal uterine bleeding in the absence of uterine pathology or medical illness. Abnormal uterine bleeding aub may be acute or chronic and is defined as bleeding from the uterine corpus that is abnormal in regularity.
Dysfunctional uterine bleeding discharge care what you. Causes of menorrhagia include myometrial abnormalities including uterine fibroids and adenomyosis, and endometrial pathologies including polyps, endometritis, hyperplasia and carcinoma. 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 frequency 7 days. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
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. Facetoface meetingshave been held in rome, vancouver, and singapore, and have been augmented by a number of. By physical examination, laboratory and imaging tests, pregnancy, iatrogenic cause, systemic condition and genital tract. Anovulatory dysfunctional uterine bleeding may therefore occur and results in irregular, prolonged, and sometimes heavy menstrual bleeding. Dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to structural abnormalities of the uterus or the endometrial lining. Dysfunctional uterine bleeding dub, the most common cause of abnormal uterine bleeding, occurs most often in women 45 50% of cases and in adolescents 20% of cases. Iron deficiency anemia may occur and quality of life may. Menstrual disorders and abnormal uterine bleeding aub are among the most frequent gynecologic complaints in adolescents. Aub refers to bleeding that is excessive or occurs outside of normal cyclic menstruation. Disorders of the menstrual cycle are one of the most commonreasons for women to attend their general practitioner and.
Dysfunctional uterine bleeding may represent a normal physiological state or can be sign of a serious underlying condition. Management of acute abnormal uterine bleeding in nonpregnant. Articles in the december issue discuss various health issues affecting schoolaged children, including acne, eczema and growth disorders. Diagnosis of abnormal uterine bleeding with biopsy or hysteroscopy. Kotob grew up in newport beachattended newport elementary, ensign jr. When this happens, your periods may come less than 21 days apart, or more than 35 days apart. Figo classification system palmcoein for causes of. To manage patients with dysfunctional uterine bleeding. Common symptoms include abnormal uterine bleeding, pelvic pressure and pain, infertility, recurrent pregnancy loss, and decreased quality of life. Sep 14, 2011 dysfunctional uterine bleeding healthy living interview for sept. Description dysfunctional uterine bleeding dub is a disorder that occurs most frequently in women at the beginning and end of their reproductive lives. Pdf neonatal uterine bleeding as antecedent of pelvic. Abnormal uterine bleeding aub is any variance of the normal menstrual cycle, which is defined on the basis of four parameters frequency, regularity, duration, and volume. Full text a case of abnormal uterine bleeding of unknown.
Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. A common and often debilitating condition, affecting women of reproductive age. The site is not a shortcut for you to get your nursing homework answered for you. Feb 06, 2020 dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a womans normal menstrual cycle. Management of dysfunctional uterine bleeding based on endometrial thickness ozgul muneyyircidelale1,2, anuja gupta1,2, cynthia abraham1, ashadeep chandrareddy1, charles h bowers jr2, jed b cutler2departments of obstetrics and gynecology, 1suny downstate medical center, 2kings county hospital center, brooklyn, new york, usaobjective. In about 25% of the patients, the abnormal uterine bleeding is the result. Dysfunctional uterine bleeding linkedin slideshare.
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. Dec 07, 2018 abnormal uterine bleeding is a common presenting problem in the emergency department ed. Dub is typically characterized by heavy prolonged flow with or without breakthrough bleeding. Dysfunctional uterine bleeding an overview sciencedirect. Search results dysfunctional uterine bleeding national.
Kotobs gyn practice we understand that womens issues can be sensitive and we specialize in concise, concerned and compassionate care of women of all ages. This includes procedures that use a resectoscope to surgically remove, electrically desiccate or vaporize the endometrium, as well as laser destruction of the. The two figo systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years. Nursing diagnosis for dysfunctional uterine bleeding. It is usually a painless, excessive and irregular endometrial bleeding that may be prolonged, and it is not attributable to any underlying structural or systemic disease. Abnormal dysfunctional uterine bleeding in emergency. Abnormal uterine bleeding overview abnormal or dysfunctional uterine bleeding dub is an excess of bleeding based in the uterus without demonstrable structural or organic pathology. Aub is described by a variety of terms and may be caused by a number of genital and nongenital tract diseases, systemic disorders, and medications. On rare occasions, a young patient with anovulatory bleeding also might have a bleeding disorder.
Abnormal uterine bleeding aub menstrual flow outside of normal volume, duration, regularity, or frequency diagnosis of abnormal uterine bleeding in reproductiveaged women. The normal menstrual cycle consists of a proliferative and a nonproliferative stage, separated by the midcyclic point of ovulation. Gynecology the two figo systems for normal and abnormal. Dysfunctional uterine bleeding dub is a clinical term used to describe bleeding not attributable to any. 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. Other causes of abnormal bleeding must also be ruled out, including. This has been highlighted in the rcog guidelines with an exception of. Aub can be caused by a wide variety of local and systemic diseases or related to medications. Dysfunctional uterine bleeding and uterine fibroids. Neonatal uterine bleeding nub has been carefully studied in the past through case reports, small series, clinical cohort studies, pathology investigations of fetal and neonatal. Abnormal uterine bleeding in thepremenopausal period glowm. Organic cause of abnormal uterine bleeding may be subdivided into reproductive tract disease, iatrogenic causes and systemic disease. Usually, it is due to hormonal disturbances, reduced levels of prostaglandins or progesterone, and is typically classified as ovulatory or an ovulatory. Dysfunctional uterine bleeding dub is excessive 80 ml or a significant decrease in hemoglobin, prolonged flow duration 7 to 10 days, or unpatterned 40 to 45 days in an adolescent endometrial bleeding unrelated to structural or systemic disease.
Overview of abnormal uterine bleeding in adolescents. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. Fibroidrelated symptoms are often divided into menstrual symptoms, such as heavy bleeding, or bulkrelated symptoms that result from the enlargement of the uterus. 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. In cases of acute and severe bleeding, women may need urgent treatment with. Definition dysfunctional uterine bleeding is irregular, abnormal uterine bleeding that is not caused by a tumor, infection, or pregnancy. Dysfunctional uterine bleeding is defined as bleeding that does not have an organic cause and is presumptively related to some endocrine disturbance. Abnormal uterine bleeding is a common but complicated clinical presentation that impairs the quality of life in women. 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 is responsible for about half of the women with abnormal uterine bleeding in reproductive age ewenstein, 1996. Dysfunctional uterine bleeding dub is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause. The medical management of abnormal uterine bleeding in.
Abnormal uterine bleeding aub is a condition that affects approximately 30% of women during their reproductive years. Pdf on jan 1, 2012, micah j hill and others published acog practice bulletin. Abnormal uterine bleeding is a broad term that indicates a change in frequency of menses, duration of flow or amount of blood loss. Dysfunctional uterine bleeding dub is a diagnosis of exclusion. Received october, 2011 accepted june, 2012 abstract. This is a study on histopathology of endometrium in dysfunctional uterine bleeding, undertaken in the department of pathology of our medical college over a period of two years from july 2010 to july 2012. Material for the study consisted of endometrial tissue obtained by dilatation and. Abnormal d ysfunctional uterine bleeding aub is defined as abnormal uterine bleeding in the absence of organic disease. Dysfunctional uterine bleeding by, nazni nazar 2009 mbbs 2. The term dysfunctional uterine bleeding is a diagnosis of exclusion, reached when. Ponrat pakpreo md, in pediatric clinical advisor second edition, 2007. This can include alternating periods that are heavy and light, spotting or unpredictable shorter and longer. Management of dysfunctional uterine bleeding springerlink. The term dysfunctional uterine bleeding was used when no underlying cause was present.
Tyagi department of pathology, subharti medical college, subharti puram, meerut 250005 u. Dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Association of professors of gynecology and obstetrics, 2006. Abnormal uterine bleeding between menarche and menopause do history and physical exam. Abnormal uterine bleeding is a frequent condition in gynecology. As a result, abnormal uterine bleeding is a common gynecologic complaint that may affect females of all ages. Dysfunctional uterine bleeding pdf 59kb pdf back issue. Abnormal uterine bleeding due to ovulatory dysfunction aubo. 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. Dysfunctional uterine bleeding definition of dysfunctional. Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual. Often times, dub occurs when you fail to ovulate during your menstrual cycle, which. It is a diagnosis of exclusion made after structural causes of bleeding and chronic medical diseases have been ruled out. The most common etiologies in nonpregnant women are structural.
Jul 08, 2019 dysfunctional uterine bleeding dub, a nonspecific term for abnormal uterine bleeding aub, is classically defined as excessively heavy, prolonged, or frequent bleeding of uterine origin that is not caused by pregnancy or recognizable pelvic or systemic disease. Abnormal uterine bleeding aub is a significant clinical entity. May 09, 20 dysfunctional uterine bleeding occurs when the cycles hormonal signals get thrown off. Latest issue common problems in schoolaged children december 2017 vol 4612 881960.