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Sample records for dysfunctional uterine bleeding

  1. Dysfunctional Uterine Bleeding

    OpenAIRE

    1987-01-01

    Dysfunctional uterine bleeding (DUB) is defined as abnormal uterine bleeding that results from an ovarian endocrinopathy. It may be associated with ovulatory and anovulatory cycles. The diagnosis of DUB depends on a thorough history and physical examination to exclude organic disorders. In older women, endometrial biopsy should be done before starting therapy. The treatment depends on an understanding of the menstrual cycle. In less urgent cases, anovulatory cycles are managed using progester...

  2. Dysfunctional Uterine Bleeding (DUB) (For Teens)

    Science.gov (United States)

    ... the Right Sport for You Shyness Abnormal Uterine Bleeding (AUB) KidsHealth > For Teens > Abnormal Uterine Bleeding (AUB) ... español Hemorragia uterina disfuncional What Is Abnormal Uterine Bleeding? Abnormal uterine bleeding (AUB) is the name doctors ...

  3. Dysfunctional Uterine Bleeding: Questions to Discuss with Your Doctor

    Science.gov (United States)

    ... delivered to your inbox ! When You Visit Your Doctor - Dysfunctional Uterine Bleeding Dysfunctional Uterine Bleeding Questions to Discuss with Your Doctor: Do you have regular menstrual cycles? When was ...

  4. Vaginal or uterine bleeding - overview

    Science.gov (United States)

    There are many causes of abnormal vaginal bleeding. HORMONES Most often, abnormal uterine bleeding is caused by a hormone imbalance. When hormones are the cause, doctors call the problem dysfunctional uterine bleeding (DUB) . DUB is more ...

  5. The Mechanisms of Abnormal Bleeding in Patients with Anovulatory Dysfunctional Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    Lu LUO; Feng-chuan ZHU; Yao-ying ZENG

    2002-01-01

    Objective To investigate the mechanisms of abnormal bleeding in patients with anovulatory dysfunctional uterine bleeding (DUB) and to analyze the correlation between vascular endothelial growth factor (VEGF) and microvessel density in the endometrium Materials & Methods Immunohistochemistry was used to study the expression of VEGF protein in the proliferative and hyperplastic endometrium. CD34 ,a marker of microvessel, was selected to measure microvessel density (MVD) in the endometrium.Fifteen women who were found to have no condition with normal menstrual cycles were set as control group.Results VEGF immunoreactivity in glandular epithelia cells was significantly lower in the hyperplastic endometrium than that of controls(P < 0. 05). There was no significant difference in VEGF protein level between proliferative DUB endometrium and that of controls. A positive correlation was found between glandular VEGF and MVD in the endometrium(r=0. 666, P<0.05). Conclusion The anovulatory DUB is associated with down-regulation of VEGF in the endometrium, and decreased secretion of VEGF will result in the disruption of angiogenesis, as a clinical manifestation of irregular bleeding.

  6. Comparative study between ormeloxifene and oral contraceptive pills in the treatment of dysfunctional uterine bleeding

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    Jimitkumar Jamanadas Chhatrala

    2015-04-01

    Full Text Available Background: Dysfunctional uterine bleeding is the most common cause of abnormal uterine bleeding. It can cause anemia, reduces the quality of life and increases healthcare costs. The present study was carried out to study the efficacy of ormeloxifene and compare it to combined oral contraceptive pills in the treatment of dysfunctional uterine bleeding. Methods: 140 patients with dysfunctional uterine bleeding were selected randomly and divided into 2 groups of 70 each. Group A was given ormeloxifene tablet 60 mg twice a week for 12 weeks followed by 60 mg once a week for next 12 weeks. Group B was given low dose oral contraceptive pills containing 30 and #956;g of ethinyl estradiol and 150 and #956;g levonorgestrel from day 1 of the menstrual cycle to day 21 for 6 consecutive cycles. Follow up for six months on every cycle was done to assess the symptoms in the form of amount of bleeding (which was assessed by pictorial blood loss assessment chart score, recurrence of symptoms and also the side effects of each drug. Patient's improvement was assessed by performing blood hemoglobin level. Patient's level of satisfaction was judged by general health, limitation of social activity, sexual life and patient's wish to continue treatment with the same drug. Results: The reduction in mean pictorial blood loss assessment score with ormeloxifene (174 to 75 was significantly more than with oral contraceptive pills (171 to 106 at 6 months (P 0.05. Recurrence of symptoms was 11% with ormeloxifene and 24% with oral contraceptive pills. The side effects were minimal in both the groups. 68.6% patients with ormeloxifene and 47.2% with oral contraceptive pills were highly satisfied with their treatment. Conclusions: Ormeloxifene is more effective, with convenient dose schedule, well tolerated, with better compliance and shows less recurrence rate in treatment of dysfunctional uterine bleeding than oral contraceptive pills. [Int J Reprod Contracept Obstet Gynecol

  7. CLINICAL EVALUATION OF DHANVANTARI TAILA IN THE MANAGEMENT OF INFERTILITY WITH DYSFUNCTIONAL UTERINE BLEEDING

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    Kamidi Vijaya Kumari

    2011-04-01

    Full Text Available This is a clinical study of dysfunctional uterine bleeding in infertile patients. After evaluating the cause for infertility is dysfunctional Uterine bleeding I choose treatment with Dhanvantari Taila as Uttara Vasti into uterine cavity after completion of bleeding during that particular cycle. All the patients were suffering with either Menorrhagia Metrorrhagia dysfunctional uterine bleeding are taken for treatment. The uttara vasti is performed to the patient according to the Ayurvediya chikitsa vidhi vidhana. Before subjecting the procedure the patient was given Snehana and Sodhana vasti they are Anuvasana and Niruhavasti. After that she subjected for uttara vasti with Dhanvantari taila continuously for seven days for three months. Dhanvantari taila having efficacy over Tridoshas with its ingredients like Balamula that is Sida accuta, Manjista that is Rubia cordifolia, Tila taila vacha chandana triphala dasamoola etc drugs with their vata pitta kapha samana kara bhavas the dhatus and upadhatus will be normalized. Here arthavam is upadhatu to Rasa dhatu so it can be regularized according to their properties. This study was studied at outpatient department of prasuthi stree roga at Dr A L Govt. Ayurvedic Hospital, Vijayawada.

  8. Hysterectomy for dysfunctional uterine bleeding in women with previous tubal sterilization

    OpenAIRE

    Hethyshi Ranganna; Nirmala Shivlingiaha

    2014-01-01

    Background: Post tubal ligation syndrome has been a topic of debate with various studies concluding contradictory results. Hysterectomy can be considered as a continuum of the post ligation syndrome due to prolonged menstrual complaints. The present study was done to evaluate any association of tubal sterilization with hysterectomy in patients presenting with dysfunctional uterine bleeding. Methods: The study was conducted in a medical college hospital. Analysis of case files of patients...

  9. ROLE OF THYROID FUNCTION TEST IN CASES WITH PROVISIONAL DIAGNOSIS OF DYSFUNCTIONAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    Shiva Kumar

    2016-02-01

    Full Text Available BACKGROUND AND OBJECTIVES Dysfunctional uterine bleeding is an abnormal bleeding from the uterus in absence of organic disease of genital tract and demonstrable extragenital cause. Thyroid dysfunction is marked by large number of menstrual aberrations. This study aimed at detecting thyroid dysfunction and further evaluating in patients with a provisional diagnosis of DUB. METHODS One hundred cases of clinically diagnosed DUB were taken from Gynaecology OPD and in patients of OBG Department VIMS, Bellary. All patients from puberty to premenopausal age groups presenting as menorrhagia, acyclical metropathia, polymenorrhagia, metrorrhagia, oligomenorrhoea, polymenorrhoea and hypomenorrhoea were tested for their thyroid function by T3, T4, TSH estimations in their serum. Patients who had clinical symptoms and signs of thyroid disease, was on hormonal treatment, IUCD users, or had bleeding disorders were excluded from the study. RESULTS A 23% of patients who were studied had thyroid dysfunction of which 13% of patients had subclinical hypothyroidism, 7% of patients had hypothyroidism and only 3% of patients had hyperthyroidism. The commonest bleeding abnormality in subclinical hypothyroid patients were polymenorrhoea and menorrhagia. All hyperthyroid cases were oligomenorrhoeic. CONCLUSION Both subclinical hypothyroid and profoundly hypothyroid cases together were the commonest thyroid dysfunction and menorrhagia was their commonest menstrual abnormality. So this study concludes that biochemical evaluation of thyroid functioning should be made mandatory in all provisionally diagnosed cases of DUB to detect thyroid dysfunction.

  10. Abnormal Uterine Bleeding FAQ

    Science.gov (United States)

    ... FREQUENTLY ASKED QUESTIONS FAQ095 GYNECOLOGIC PROBLEMS Abnormal Uterine Bleeding • What is a normal menstrual cycle? • When is bleeding abnormal? • At what ages is abnormal bleeding more ...

  11. Comparison on serum biomarkers for anovulatory and ovulatory dysfunctional uterine bleeding in Lizu females

    Institute of Scientific and Technical Information of China (English)

    Shan Bao; Shu-Ying Yang; Zhuo-Ri Li; Ge-Bo Wen

    2014-01-01

    Objective:To screen, identify, and compare the serum biomarkers between anovulatory dysfunctional uterine bleeding(ADUB) and ovulatory dysfunctional uterine bleeding(ODUB) in Lizu females.Methods:The subjects included128ADUB patients,63ODUB patients, and93 controls.The serum and supernate of the subjects’ mense were collected and stored at -80°C until use.Differential proteins in the sera of three groups were screened using surface-enhanced laser desorption ionization time-of-flight mass spectrometry.The screened proteins were then identified by tricine-SDS-PAGE gel and spectrometry.Protein expression levels in the menses ofADUB,ODUB, and control subjects were determined usingELISA,RT-PCR, andWestern blotting.SPSS14.1 was used for statistical analysis and chart drawing(α =0.05).Results:Three differential protein peaks with peak values of11.80,13.59, and14.68 km/z were screened and identified as serum amyploid proteinA(SAA), vascular endothelial growth factor, and vitamin K epoxide reductase, respectively.TheSAA was highly expressed in the menses ofADUB and ODUB patients but poorly expressed in the controls.The vascular endothelial growth factor was highly expressed in the menses ofODUB and controls but poorly expressed inADUB patients. Meanwhile, the vitaminK epoxide reductase was highly expressed in the menses ofADUB and control subjects but poorly expressed inODUB patients.Conclusions:TheSAA is the common serum biomarker ofADUB andODUB.ADUB may be related to angiogenesis impairment, whereas ODUB may be associated with blood coagulation disruption.

  12. Effect of small-dose mifepristone in combined with Gongxuening capsule on perimenopasual dysfunctional uterine bleeding and sex hormone levels

    Institute of Scientific and Technical Information of China (English)

    Wei-Feng Zhang

    2016-01-01

    Objective:To explore the clinical efficacy of small-dose mifepristone in combined with Gongxuening capsule in the treatment of perimenopasual dysfunctional uterine bleeding and their effects on sex hormone levels. Methods: The perimenopasual women with dysfunctional uterine bleeding who were admitted in our hospital from October, 2014 to October, 2015 and received small-dose mifepristone in combined with Gongxuening capsule were served as the observation group. They were orally administered with mifepristone, 6.25 mg/time, 1 time/d, taken before bedtime, and Gongxuening capsule, 2 pills/time, 3 times/d, for 7 d after each menstruation, and continuously for 3 months. The perimenopasual women with dysfunctional uterine bleeding who were received mifepristone were served as the control group. They were orally administered with mifepristone, 12.5 mg/time, 1 time/d, taken before bedtime, and continuously for 3 months. The HGB level and endometrial thickness before and after treatment were detected. The bleeding control time, total blood stopping time, and adverse reactions in the two groups were compared. The levels of FSH, E2, P, and LH before and after treatment in the two groups were determined. Results:After treatment, HGB level in the observation group was elevated, and the altered degree of endometrial thickness was significantly superior to that in the control group (P0.05). Conclusions: Small-dose mifepristone in combined with Gongxuening capsule in the treatment of perimenopasual dysfunctional uterine bleeding can effectively improve the endometrial thickness, timely control bleeding, and improve the serum sex hormone levels, with a satisfactory effect;therefore, it deserves to be widely recommended in the clinic.

  13. A retrospective study on estrogen or contraceptives in the treatment of dysfunctional uterine bleeding in adolescent patients

    Institute of Scientific and Technical Information of China (English)

    Liu Ying; Xu Ling

    2006-01-01

    Objective: To investigate the clinical efficacy of estrogen or contraceptives in the treatment of acute bleeding of dysfunctional uterine bleeding (DUB) in adolescent patients and the optimal starting dosage of drugs.Methods: The clinical records of 106 girls who with DUB and moderate or severe anemia from February 1990 to July 2005 were analyzed retrospectively.Results: All 106 patients received hormonal therapy. 56 patients were treated with estradiol benzoate(E2), 30 patients with conjugated equine estrogen(CEE) and 20 patients with combined oral contraceptives (COCs). The rates for rapidly controlling bleeding and for rapidly stopping bleeding in E2 group were higher than those in CEE group ,but similar to those in COCs group. The days for controlling and completely stopping bleeding were not significantly different between the starting dosages (≤8 mg/d and >8 mg/d) of E2 groups, and also there were no statistical difference between the starting dosages (<7.5 mg/d and ≥7.5 mg/d) of CEE groups, but during the treatment the rate of increasing the dosage in <7.5 mg/d group was higher than that of ≥7.5 mg/d group(40% vs. 5%),while there were no statistical difference between the starting dosages (≤3 pills/d and >3 pills/d) of COCs groups. Conclusions: The clinical efficiency of E2 treatment on DUB in adolescent patients is similar to that of COCs. And the efficacies of treatment of DUB with E2, CEE and COCs in the different dosages are similar.

  14. Abnormal Uterine Bleeding

    Science.gov (United States)

    ... first few months of a normal pregnancy. Some birth control pills or the intrauterine device (IUD) can also cause ... this type can significantly reduce abnormal bleeding. Like birth control pills, sometimes IUDs can actually cause abnormal bleeding. Tell ...

  15. Role of levonorgestrel releasing intra-uterine system in the treatment of menorrhagia due to dysfunctional uterine bleeding and fibroid uterus

    Directory of Open Access Journals (Sweden)

    Reena Gupta

    2014-06-01

    Full Text Available Background: This study was carried out to assess the clinical effectiveness of levonorgestrel releasing intrauterine device (LNG-IUS in the treatment of menorrhagia due to either Dysfunctional Uterine Bleeding (DUB or fibroid in Indian patients, and to assess patient satisfaction with this treatment modality. Methods: Sixty women with menorrhagia, 30 due to fibroid and 30 due to DUB, meeting inclusion criteria, received LNG-IUS and were prospectively followed up for 9 months with periodic clinical assessments and transvaginal ultrasounds. Patient satisfaction was assessed on a five-point scale. Results: One patient in DUB group was lost to follow-up. In DUB patients, the treatment failure rate was only 3.4% (1 out of 29 patients. The median PBAC score reduced by 95% at 9 months. Fibroid patients also had an equally impressive 97.7% reduction of PBAC score at 9 months, although the failure rate was higher (23.3%; 7 out of 30. Majority of patients were either and lsquo;very satisfied' or and lsquo;satisfied' with the treatment, although this percentage was more in DUB (82.8% than in the fibroid group (66.7%. Haemoglobin and serum ferritin levels significantly increased in both groups. No major side effect was noted. Conclusions: LNG-IUS is an excellent treatment modality for patients of DUB, with good patient satisfaction. It is also a useful treatment option in non-submucosal small fibroids for the symptoms of menorrhagia, can reduce uterine volume and can help avoid hysterectomy, but there is no effect on fibroid volume. Majority of patients are satisfied, although satisfaction rates are less than in DUB patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 671-677

  16. Dysfunctional uterine bleeding (DUB)

    Science.gov (United States)

    ... Jan;115(1):206-18. PMID: 20027071 www.ncbi.nlm.nih.gov/pubmed/20027071 . Committee on Practice ... Jul;122(1):176-85. PMID: 23787936 www.ncbi.nlm.nih.gov/pubmed/23787936 . Kaunitz AM, Meredith S, ...

  17. Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.

    Science.gov (United States)

    Wheeler, Karen C; Goldstein, Steven R

    2017-03-01

    Transvaginal ultrasound is the first-line imaging test for the evaluation of abnormal uterine bleeding in both premenopausal and postmenopausal women. Transvaginal ultrasound can be used to diagnose structural causes of abnormal bleeding such as polyps, adenomyosis, leiomyomas, hyperplasia, and malignancy, and can also be beneficial in making the diagnosis of ovulatory dysfunction. Traditional 2-dimensional imaging is often enhanced by the addition of 3-dimension imaging with coronal reconstruction and saline infusion sonohysterography. In this article we discuss specific ultrasound findings and technical considerations useful in the diagnosis of abnormal uterine bleeding.

  18. ENDOVASCULAR HEMOSTASIS IN UTERINE BLEEDING IN PATIENTS WITH UTERINE LEIOMYOMA

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    M. M. Damirov

    2017-01-01

    Full Text Available We report results of treatment for 72 patients with uterine leiomyoma (LM of various sizes and location, who had arrived with excessive uterine bleeding. All patients underwent urgent or urgently-delayed endovascular hemostasis by performing uterine arteries embolization (UAE. We analyzed clinical features of the disease after UAE in various sizes of tumors and studied immediate and long-term results of UAE in patients with LM.

  19. PALM-COEIN Nomenclature for Abnormal Uterine Bleeding.

    Science.gov (United States)

    Deneris, Angela

    2016-05-01

    Approximately 30% of women will experience abnormal uterine bleeding (AUB) during their life time. Previous terms defining AUB have been confusing and imprecisely applied. As a consequence, both clinical management and research on this common problem have been negatively impacted. In 2011, the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Group (FMDG) published PALM-COEIN, a new classification system for abnormal bleeding in the reproductive years. Terms such as menorrhagia, menometrorrhagia, metrorrhagia, dysfunctional uterine bleeding, polymenorrhea, oligomenorrhea, and uterine hemorrhage are no longer recommended. The PALM-COEIN system was developed to standardize nomenclature to describe the etiology and severity of AUB. A brief description of the PALM-COEIN nomenclature is presented as well as treatment options for each etiology. Clinicians will frequently encounter women with AUB and should report findings utilizing the PALM-COEIN system.

  20. Evaluation and management of abnormal uterine bleeding in premenopausal women.

    Science.gov (United States)

    Sweet, Mary Gayle; Schmidt-Dalton, Tarin A; Weiss, Patrice M; Madsen, Keith P

    2012-01-01

    Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the endometrium, and increased risk of endometrial cancer. Causes include polycystic ovary syndrome, uncontrolled diabetes mellitus, thyroid dysfunction, hyperprolactinemia, and use of antipsychotics or antiepileptics. Women 35 years or older with recurrent anovulation, women younger than 35 years with risk factors for endometrial cancer, and women with excessive bleeding unresponsive to medical therapy should undergo endometrial biopsy. Treatment with combination oral contraceptives or progestins may regulate menstrual cycles. Histologic findings of hyperplasia without atypia may be treated with cyclic or continuous progestin. Women who have hyperplasia with atypia or adenocarcinoma should be referred to a gynecologist or gynecologic oncologist, respectively. Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia. The levonorgestrel-releasing intrauterine system is an effective treatment for menorrhagia. Oral progesterone for 21 days per month and nonsteroidal anti-inflammatory drugs are also effective. Tranexamic acid is approved by the U.S. Food and Drug Administration for the treatment of ovulatory bleeding, but is expensive. When clear structural causes are identified or medical management is ineffective, polypectomy, fibroidectomy, uterine artery embolization, and endometrial ablation may be considered. Hysterectomy is the most definitive treatment.

  1. Histopathological study of endometrium in cases of abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Saroj A. Bolde

    2014-08-01

    Full Text Available Background: Abnormal uterine bleeding is one of the commonest complaints in women and when it occurs without organic lesions like tumor, inflammation, it is called as dysfunctional uterine bleeding. Aim of current study was to find out the histopathological pattern of endometrium in Abnormal Uterine Bleeding (AUB also to study organic causes of AUB. Methods: Specimens received as endometrial curettage and hysterectomy specimens were studied followed by correlation of histopathology with age and clinical presentation. Results: The patients were mainly from the age group of 30-49 years (74.24%. The most common menstrual disorder was menorrhagia (46.86%. In dysfunctional uterine bleeding the most common histological pattern of endometrium includes proliferative endometrium (22.8% followed by endometrial hyperplasia (19.40%, atrophic endometrium (7.16%, secretory endometrium (5.97%, irregular shedding [1.80%], irregular ripening (1.20% and anovulatory endometrium (0.59%. Organic lesions encountered in AUB cases were leiomyoma (17.92%, endometrial polyp (1.79%, endometrial carcinoma (1.50%, endometriosis (0.59% and choriocarcinoma (0.29%. Conclusion: It is important to know the histological pattern of the endometrium like proliferative endometrium, endometrial hyperplasia, atrophic endometrium, secretory endometrium, irregular ripening and shredding and organic lesions in patients diagnosed as AUB in different age groups since recognition of these conditions will help and will avoid further complications. [Int J Res Med Sci 2014; 2(4.000: 1378-1381

  2. Treatment of uterine fibroids for abnormal uterine bleeding: myomectomy and uterine artery embolization.

    Science.gov (United States)

    Al-Mahrizi, Sharifa; Tulandi, Togas

    2007-12-01

    Uterine myoma is a common benign tumour in women and most cases do not require treatment. Excessive uterine bleeding is usually due to a submucous myoma or an intramural myoma that is encroaching into the uterine cavity. After eliminating endometrial malignancy, perimenopausal women could be managed expectantly or with gonadotrophin-releasing hormone agonist until menopause. Hysteroscopic myomectomy is highly effective in controlling menorrhagia that is related to submucous myoma. Concomitant endometrial ablation improves menorrhagia; however, the subsequent hysterectomy rate remains the same. For those with an intramural myoma, abdominal myomectomy results in good bleeding control. It could also be done by laparoscopic approach; however, the surgeon should have expertise in laparoscopic suturing and the uterine incision should be properly sutured. In women who have completed their family, hysterectomy remains the most effective treatment for excessive uterine bleeding. Compared with uterine artery embolization (UAE), it is associated with better improvement in pelvic pain. Nevertheless, UAE is a good alternative to hysterectomy.

  3. ABNORMAL UTERINE BLEEDING IN PERIMENOPAUSE

    Directory of Open Access Journals (Sweden)

    Shivaji

    2016-06-01

    endometrial carcinoma. Perimenopausal women with heavy or irregular menstrual bleeding should have an endometrial biopsy taken to exclude endometrial disease and early evaluation and diagnosis of the complications of AUB, and thus arrive at timely and effective therapeutic strategies.

  4. 功能失调性子宫出血的相关分子机制的研究进展%Research Advancement in Molecular Mechanisms of Dysfunctional Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    孙燕; 袁媛

    2011-01-01

    功能失调性子宫出血(DUB)是妇科内分泌疾病,临床表现为非器质性病变引起的异常子宫出血,严重危害妇女健康,近年来其发病率有逐年上升的趋势.其发病机制不明,可能与调节生殖的神经内分泌机制失常所致的子宫内膜微环境异常有关.现对子宫内膜的血管功能、性激素及其受体,细胞凋亡及基质金属蛋白酶在DUB中的研究进展予以综述.%Dysfunctional uterine bleeding ( DUB ) is a gynecological endocrine disease, which clinically manifests mainly as non-organic abnormal uterine bleeding. DUB compromises women's health and with an annually increasing incidence. The etiology of DUB remains unknown, possibly associated with the abnormal uterine microenvironment disorders caused by the neuroendocrine malfunction. This article reviews endometrial vascular function, sex hormones and receptors, apoptosis, and matrix metalloproteinases in the sense of the pathogenesis of DUB.

  5. The clinical effects of gestodene-ethinylestradiol in the treatment of adolescent dysfunctional uterine bleeding%去氧孕烯炔雌醇治疗青春期功能性子宫出血的临床疗效

    Institute of Scientific and Technical Information of China (English)

    顾志群; 周晔; 蔡蓉

    2015-01-01

    Objective To study the clinical effects of gestodene - ethinylestradiol in the treatment of adolescent dys-functional uterine bleeding. Methods A total of 50 adolescent dysfunctional uterine bleeding patients were selected from Janu-ary 2014 to January 2015 in the Second People's Hospital of Wuxi City,they were randomly divided into the observation group (25 cases)and the control group(25 cases). The control group was treated with progesterone capsule,the observation group was treated with gestodene - ethinylestradiol. The clinical effects,control bleeding time,complete hemostasis time and amount of bleeding,incidence of adverse reactions between the two groups were compared. Results The total effective rate of the obser-vation group was 100. 00% ,which was higher than 80. 00% of the control group(P ﹤ 0. 05). The control bleeding time,com-plete hemostasis time of the observation group were shorter than those of the control group,amount of bleeding were less than those of the control group(P ﹤ 0. 05). There was no statistically significant difference in the adverse reactions rate between the two groups(P ﹥ 0. 05). Conclusion Gestodene - ethinylestradiol has good clinical efficacy in the treatment of adolescent dys-functional uterine bleeding,can significantly shorten the control bleeding time,complete hemostasis time,decrease the amount of bleeding,and has less adverse reactions.%目的:探讨去氧孕烯炔雌醇治疗青春期功能性子宫出血(青春期功血)的临床疗效。方法选择2014年1月—2015年1月无锡市第二人民医院收治的50例青春期功血患者,采用随机数字表法将患者分为观察组(25例)和对照组(25例)。对照组给予黄体酮胶囊治疗,观察组给予去氧孕烯炔雌醇治疗,比较两组临床疗效、控制止血时间、完全止血时间和出血量、不良反应发生情况。结果观察组总有效率为100.00%,高于对照组的72.00%,差异有统计学意义(P

  6. 增强妇科内分泌和健康意识预防功能失调性子宫出血%Enforce the consciousness of gynecologic endocrinology and health, prevent the dysfunctional uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    林守清

    2006-01-01

    @@ 1 功能失调性子宫出血是常见病、多发病 当子宫出血超出了月经周期、经期、经量和出血模式的正常范围时,称为子宫异常出血(abnormal uterine bleeding,AUB),它可由多种病因引起[1-3].功能失调性子宫出血(dysfunctional uterine bleeding,DUB,功血)是AUB的一个常见病因.女性一生的分期是根据卵巢功能的生理状态,功血的发生与这种基于卵巢功能进行分期的生理阶段密切关联,并与常见的妇科内分泌功能失调病,如多囊卵巢综合征(PCOS)有关,因此多发、常见[1].

  7. Acquired uterine arteriovenous fistula following dilatation and curettage: an uncommon cause of vaginal bleeding

    Directory of Open Access Journals (Sweden)

    Adam Evans, DO

    2017-06-01

    Full Text Available Dysfunctional uterine bleeding is a common presentation of women in the emergency department. We describe the case of a 33-year-old female who presented with intermittent spotting due to an acquired uterine AVF. The patient underwent a transvaginal pelvic ultrasound as well as a CT angiogram. The patient was treated conservatively and elected to undergo uterine artery embolization in an effort to preserve fertility. She successfully delivered a healthy baby boy at 39-week gestation via an emergent caesarian section due to a prolapsed umbilical cord 17 months after undergoing the uterine artery embolization.

  8. Abnormal Uterine Bleeding: American College of Nurse-Midwives.

    Science.gov (United States)

    2016-07-01

    Variations in uterine bleeding, termed abnormal uterine bleeding, occur commonly among women and often are physiologic in nature with no significant consequences. However, abnormal uterine bleeding can cause significant distress to women or may signify an underlying pathologic condition. Most women experience variations in menstrual and perimenstrual bleeding in their lifetimes; therefore, the ability of the midwife to differentiate between normal and abnormal bleeding is a key diagnostic skill. A comprehensive history and use of the PALM-COEIN classification system will provide clear guidelines for clinical management, evidence-based treatment, and an individualized plan of care. The purpose of this Clinical Bulletin is to define and describe classifications of abnormal uterine bleeding, review updated terminology, and identify methods of assessment and treatment using a woman-centered approach.

  9. Abnormal uterine bleeding: a clinicohistopathological analysis

    Directory of Open Access Journals (Sweden)

    Anupamasuresh Y

    2014-06-01

    Methods: In our prospective study of 359 Patients of the age between 46 and 73 years, clinical characteristics and the pattern of endometrial histopathology and their association in women, who present with abnormal uterine bleeding, are categorised into six groups. Results: In our study, a significant correlation of histopathology and BMI was observed with endometrial hyperplasia and malignancy in obese patient i.e. 37 out 96 and 13 out of 23 respectively. The incidence of malignancy has been increasing with the age being 1.6% in 46-50 years to 60% in 70-75 years. In our study 116 (32.3% had hypertension, 33 patients (9.2% had diabetes mellitus, 40 patients (11.1% had hypothyroidism. Conclusions: We found a maximum incidence of AUB in multiparous women. Clinicohistopathological analysis of AUB revealed endometrial hyperplasia in majority of patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 656-661

  10. 米非司酮在绝经过渡期功能失调性子宫出血中的研究进展%Research Progress of Mifepristone in the Menopausal Transition Dysfunctional Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    李燕雄

    2012-01-01

    功能失调性子宫出血(简称功血)是由于调节生殖的神经内分泌机制失常引起的异常子宫出血,而全身及内外生殖器官无器质性病变存在,其中50%发生于绝经过渡期.绝经过渡期功血的药物治疗效果差,部分患者因反复出血或严重贫血行子宫切除.近年研究发现,小剂量米非司酮治疗这一类型的功血效果良好,但其具体作用机制尚不十分清楚.现将米非司酮在绝经过渡期功血中的临床应用及其作用机制进行综述.%Dysfunctional uterine bleeding(DUB)is abnormal uterine bleeding caused by neuroendocrine system disorders. 50% DUB occurred in the menopausal transition. Menopausal transition DUB has poor effects of drug treatment, some cases with severe anemia or recurrent bleeding had undergone hysterectomy. Studies found that Small dose of mifepristone worked well,but the specific mechanism is not yet clear. Here is to make a review on the mechanism of action of mifepristone and its clinical application in the menopausal transition DUB.

  11. High-intensity focused ultrasound treatment of abnormal vaginal bleeding secondary to uterine myoma.

    Science.gov (United States)

    Lim, Jung Hyun; Chung, Dong Jin; Lim, Young Tec; Cho, Sae Hyun; Lee, Jae Mun; Hahn, Seong-Tae

    2011-03-01

    We describe the use of high-intensity focused ultrasound for acute vaginal bleeding secondary to uterine myoma in 2 young female patients. Both patients had episodes of abnormal vaginal bleeding with severe dysmenorrhea that was not efficiently controlled by medical treatment. After high-intensity focused ultrasound ablation, both vaginal bleeding control and symptom relief were achieved without postinterventional complications. The patients remained free of symptoms during 2 months of follow-up and regained normal menstruation after high-intensity focused ultrasound therapy. High-intensity focused ultrasound treatment is one of the least invasive options for dysfunctional vaginal bleeding and may be an effective and safe alternative to other procedures in women of reproductive age with abnormal vaginal bleeding secondary to uterine myoma.

  12. Abnormal uterine bleeding in reproductive-aged women.

    Science.gov (United States)

    Matthews, Michelle L

    2015-03-01

    Abnormal uterine bleeding is a common medical condition with several causes. The International Federation of Gynecology and Obstetrics published guidelines in 2011 to develop universally accepted nomenclature and a classification system. In addition, the American College of Obstetrics and Gynecology recently updated recommendations on evaluation of abnormal uterine bleeding and indications for endometrial biopsies. This article reviews both medical and surgical treatments, including meta-analysis reviews of the most effective treatment options.

  13. 去氧孕烯炔雌醇片治疗青春期功能性子宫出血临床观察%Desogestrel and Ethinylestradiol Tablets Clinical Observation on the Treatment of Adolescent Dysfunctional Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    李树芹

    2015-01-01

    Objective To investigate the therapeutic effect of Desogestrel and Ethinylestradiol Tablets treatment of puberty dysfunctional uterine bleeding clinical curative effect. Methods 72 cases of adolescent dysfunctional uterine bleeding in our hospital were randomly divided into an experimental group and a control group, each group has 36 cases, the experimental group were treated with Desogestrel and Ethinylestradiol Tablets treatment, patients in control group were treated with premarin. The clinical efifcacy and adverse reactions of the two groups were analyzed and compared. Results The total effectiveness of the experimental group is 94.44%, while the control group is75%, the total effective rate of the experimental group was significantly higher than that of the control group,(P < 0.05), the controlled time of bleeding and complete hemostasis time in the experimental group were signiifcantly less than the control group, (P< 0.01), the adverse reaction rateof the patients in the experimental group was 11.11%, while in the control group the rate was 30.56%, which was significantly higher than that of experimental group, (P < 0.05). Conclusion Desogestrel and Ethinylestradiol Tablets in the treatment of adolescent dysfunctional uterine bleeding have remarkable clinical curative effect, good hemostatic effect and high safety,which is worthy of clinical popularization and application.%目的:探讨去氧孕烯炔雌醇片治疗青春期功能性子宫出血的临床疗效。方法将我院收治的72例青春期功能性子宫出血患者随机分成实验组与对照组两组,每组各36例,实验组患者采用去氧孕烯炔雌醇片进行治疗,对照组患者采用结合雌激素片进行治疗。比较分析两组临床疗效与不良反应发生情况。结果实验组患者的总有效率是94.44%,对照组患者的总有效率是75.00%,实验组的总有效率明显高于对照组,两组之间的差异具有统计学意义(P<0.05);实验

  14. Management of abnormal uterine bleeding in women with mechanical heart valve prosthesis and anticoagulant therapy.

    Science.gov (United States)

    Saha, Pradip Kumar; Rakshit, Bibek Mohan; Jana, Narayan; Dutta, Sanjib; Roy, Subesha Basu; Sengupta, Gautam

    2011-12-01

    In a prospective observational case series, we assessed the effects and management and outcome of oral anticoagulant associated abnormal uterine bleeding in women with mechanical heart valve prosthesis. Six women with mechanical heart valve prosthesis, who were admitted with persistent severe vaginal bleeding between 2003 and 2010, were evaluated. For each woman, detailed history, treatment received, if there was any complication and their final outcome and satisfaction were recorded. All the 6 women were parous, with their ages ranging from 27 to 50 years. They were receiving oral anticoagulant therapy for mechanical heart valve prosthesis. Of the 6 women, 4 had uterine fibroids, and the other 2 had dysfunctional uterine bleeding.Three patients with uterine fibroids underwent abdominal hysterectomy, and one underwent balloon thermal ablation of endometrium. While 1 patient with dysfunctional uterine bleeding underwent hysterectomy, the other patient desirous for further children, required levonorgestrel intra-uterine system. Two women requiring hysterectomy, developed postoperative complications, one a massive intraperitoneal haemorrhage and another a rectus sheath haematoma. At follow-up, 5 women were satisfied, and 1 woman had died suddenly at home 1 year after hysterectomy. Because of the twin problem of heart disease and anticoagulant therapy, treatment of abnormal vaginal bleeding in these women is extremely challenging. Although medical treatment yields only temporary relief, endometrial ablative procedures or levonorgestrel intra-uterine system provides more durable solution. As anticoagulant associated peri-operative haemorrhage can be potentially fatal, hysterectomy should be reserved for women with major pelvic pathologies. Proper counselling and integrated management involving gynaecologist, cardiologist, haematologist and anaesthesiologist is essential to tackle this problem.

  15. Clinical, histopathological and therapeutic considerations in non-neoplastic abnormal uterine bleeding in menopause transition.

    Science.gov (United States)

    Corniţescu, F I; Tănase, Florentina; Simionescu, Cristiana; Iliescu, D

    2011-01-01

    With the decline of ovarian hormonal function, from the fifth decade of life, women enter the menopause transition, during which bleeding becomes irregular in duration and time of occurrence. Secondary to ovarian dysfunction, developmental and maturation endometrial anomalies occur, which are clinically translated by abnormal uterine bleeding, which in many cases at this age can be caused by organic lesions (fibroma, polyps, endometritis, endometrial hyperplasia, adenomyosis, etc.). The retrospective study included a total of 256 patients with abnormal uterine bleeding in menopause transition. Statistics showed that the incidence of these types of bleeding increases with age (64.5%) and parity (30.5%), with symptoms consisting mostly in different clinical forms of abnormal uterine bleeding (62.1%), and leiomyomas prevailing at histopathological examination (49.6%). Progesterone replacement therapy was the first therapeutic choice for correcting these types of bleeding. Progesterone therapy is useful not only for therapeutic purposes to amend the bleeding, but also as a precaution against the development of endometrial carcinoma. Progestogens cancel the proliferative and mitogenic effect of estrogens, even when administered in sequential regimen 10-12 days per month.

  16. Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.

    Science.gov (United States)

    Vaidya, S; Lakhey, M; Vaidya, S; Sharma, P K; Hirachand, S; Lama, S; KC, S

    2013-03-01

    Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

  17. Research Progress of Role of the Prostaglandins in Menstruation and Dysfunctional Uterine Bleeding%前列腺素在功能失调性子宫出血中作用机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    赵江红

    2013-01-01

    功能失调性子宫出血(DUB)是一种妇科内分泌疾病,严重危害妇女的身心健康.研究表明其发病主要与下丘脑-垂体-卵巢轴以及子宫内膜微环境的改变有紧密的关系.虽然其发病机制仍不明确,但是近年来,有不少学者研究表明,前列腺素在正常月经以及DUB的发病机制中有重要调控作用.%Dysfunctional uterine bleeding DUB ) is a kind of gynecology endocrine disease. The disease has seriously damaged women's physical and mental health. Lots of researches have indicated that the change of endometrial micro-environmental and HPO axis has close relation with DUB. In recent years, scientists have inclined to consider that prostaglandins play an important regulatory role in normal menstruation and the pathogenesis of DUB.

  18. Retained fetal bones: an unusual cause of abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Sonia Chawla

    2016-06-01

    Full Text Available Abnormal uterine bleeding (AUB is a common gynaecological problem with most common causes being fibroid, polyp, endometritis, neoplasia and coagulation disorder. Presence of retained intrauterine fetal bones as a cause of AUB, is a rare but well recognized entity. Patient may present with subfertility, secondary infertility, chronic pelvic pain, vaginal discharge, pelvic inflammatory disease, abnormal uterine bleeding. Incidence reported in literature is 0.15% among patients undergoing diagnostic hysteroscopy. Calcification appears as hyperechoeic area on ultrasound. Hysteroscopy guided removal of bony fragments is the gold standard and leads to complete resolution of symptoms. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 2032-2033

  19. The efficacy of 36 cases of dysfunctional uterine bleeding treatment by levonorgestrel%左炔诺孕酮对36例功能失调性子宫出血的疗效观察

    Institute of Scientific and Technical Information of China (English)

    黎凝; 朱海棉

    2012-01-01

    Objective To study the clinical efficacy of levonorgestrel (brand name:Yu Ting) in treatment for dysfunctional uterine bleeding (DUB).Methods 56 cases diagnosed as peri-menopausal patients with anovulatory DUB by gynecology outpatient department in our hospital from January 2009 to January 2011 were treated with oral administration of norethisterone,but no good effect was found in 36 cases, then changed to take levonorgestrel for 3 menstrual cycles.The bleeding time,1 month after treatment,3 months follow-up observation of menstrual flow,menstrual cycle changes were observed,and the levels of Hb,ALT,AST,BUN and CRE before and after treatment were also monitored.Results The rapid hemostatic rate of Yu Ting orally taking for 6 hours was 69.44%,hemostatic rate during 24 ~ 48 hours was 30.56%.The effective rate 1 month after treatment was 91.66%,the one of 3 months was 72.22%,there was a significant difference among them (P< 0.05); 3 months before and after treatment,the levels of Hb,ALT,AST,BUN and CRE were compared,Hb level significantly increased after treatment,with a significant difference (P< 0.05); there was no significant changes in levels of ALT,AST,BUN and CRE (P > 0.05).Conclusion Levonorgestrel has good effects in treatment for dysfunctional uterine bleeding,obvious results in hemostasis,a low incidence rate of side effects during treatment,but longterm effects need further observation.%目的 探讨左炔诺孕酮(商品名:毓婷)治疗功能失调性子宫出血的临床疗效.方法 选择2009年1月-2011年1月期间我院妇科门诊诊断为围绝经期无排卵性功血患者56例,用炔诺酮(妇康片)口服治疗效果不理想者36例,改用毓婷口服治疗3个月经周期.观察止血时间,停药后1个月、3个月随访观察月经量、月经周期变化;并对用药前后Hb、ALT、AST、BUN、CRE进行监测.结果 毓婷口服6小时内迅速止血率为69.44%,24~48小时内止血率为30.56%,停药后1

  20. Uterine vascular lesions: a rare cause of abnormal uterine bleeding, reporting of two cases

    Directory of Open Access Journals (Sweden)

    Sunita Arora

    2014-06-01

    Full Text Available Uterine vascular lesions in the form of arteriovenous malformation or pseudo aneurysm are rare but potential life-threatening source of bleeding. A high index of suspicion and accurate diagnosis of the condition in a timely manner are essential because instrumentation that is often used for other causes of uterine bleeding can lead to massive hemorrhage. We describe two cases of uterine vascular malformation, one presenting as postabortal hemorrhage and other as postpartum hemorrhage. Case one presented as postabortal hemorrhage after induced abortion following dilatation and curettage. Case two presented as delayed postpartum hemorrhage after six weeks following cesarean section. In both cases diagnosis of uterine arteriovenous malformation was made on Doppler ultrasonography which was subsequently confirmed on pelvic angiography. The embolization of affected uterine arteries was performed successfully in both cases. Uterine vascular lesion should be suspected in patient with abnormal vaginal bleeding, especially who has recent medical history of induced abortion or dilatation and curettage or cesarean section and so on. Although angiography remains the gold standard for making diagnosis, Doppler ultrasonography is also a good noninvasive technique for the same. Uterine artery embolization offers a safe and effective treatment. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 749-753

  1. 血管内皮生长因子及其受体与功能失调性子宫出血的研究进展%Research Progress of Vascular Endothelial Growth Factor and Its Receptor and Dysfunctional Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    张志革

    2012-01-01

    Vascular endothelial growth factor( VEGF )is a strong angiogenesis accelerator with extremely high expression in endometrial glands of women with anovulatory dysfunctional uterine bleeding,which is cyclically expressed and regulated by many fsctors. Researches in the last 10 years showed that VEGF was related to abnormal uterine bleeding,infertility,dysmenorrhea and other gynecological diseases,especially that tt has been paid much attention to the role of VEGF in the occurrence of abnormal uterine bleeding. Here is to make a review on the physical and chemical characteristics,mechanism,influencing factors and the effect of VEGF and its receptor in dysfunctional uterine bleeding.%血管内皮生长因子是一种极强的血管生成促进剂,在无排卵性功能失调性子宫出血妇女子宫内膜腺体中浓度极高,呈周期性表达,受多种因素的调控.近10年来研究发现,血管内皮生长因子与女性异常子宫出血、不孕、痛经等疾病相关,尤其是它在异常子宫出血的发病过程中所起的作用备受关注.现就血管内皮生长因子及其受体的理化特征、作用机制、影响因素及其在功能失调性子宫出血发病过程中的作用进行综述.

  2. Evaluation and Management of Adolescents with Abnormal Uterine Bleeding.

    Science.gov (United States)

    Mullins, Tanya L Kowalczyk; Miller, Rachel J; Mullins, Eric S

    2015-09-01

    The International Federation of Gynecology and Obstetrics and the American Congress of Obstetricians and Gynecologists support the use of new terminology for abnormal uterine bleeding (AUB) to consistently categorize AUB by etiology. The term AUB can be further classified as AUB/heavy menstrual bleeding (HMB) (replacing the term "menorrhagia") or AUB/intermenstrual bleeding (replacing the term "metrorrhagia"). Although many cases of AUB in adolescent women are attributable to immaturity of the hypothalamic-pituitary-ovarian axis, underlying bleeding disorders should be considered in women with AUB/HMB. This article reviews the new terminology for AUB, discusses important relevant features of history and examination, presents the laboratory evaluation of HMB, and describes hormonal (oral contraceptive pills, progestin-only methods, long-acting reversible contraceptives including intrauterine systems), hematologic (tranexamic acid and desmopressin), and surgical management options for AUB/HMB.

  3. Clinical profile of patients with abnormal uterine bleeding at a tertiary care hospital

    OpenAIRE

    2015-01-01

    Background: Abnormal uterine bleeding is a very common gynecological condition that affects all age groups. One third of patients attending gynaecology OPD present with complaints of abnormal uterine bleeding. Bleeding is said to be abnormal when the pattern is irregular, abnormal duration (>7 days), or menorrhagia or abnormal amount (>80 ml/menses). Methods: All patients in the perimenopausal age group (45+/- 5 years) with symptoms of abnormal uterine bleeding presenting at department of ...

  4. Comparison of 3 dimensional sonohysterography and hysteroscopy in Premenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Yasser I. Abd Elkhalek

    2016-09-01

    Conclusion: 3-D sonohysterography is a very safe, well tolerated and effective modality for evaluation of intracavitary uterine abnormalities and is an accurate alternative technique for hysteroscopy among the premenopausal women that suffers from abnormal uterine bleeding (AUB.

  5. Is a history of cesarean section a risk factor for abnormal uterine bleeding in patients with uterine leiomyoma?

    OpenAIRE

    2016-01-01

    Objectives: To determine whether a history of cesarean section was a risk factor for abnormal uterine bleeding in patients with uterine leiomyomas, and to identify other risk factors for this symptom. Methods: We analyzed retrospectively, the medical records of patients who underwent hysterectomies due to the presence of uterine leiomyomas during a 6-year period (2009 and 2014) at Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Ankara, Turkey. Uterine leiomyoma was diagnose...

  6. TO OBSERVE EFFECT OF ORMILOXIFENE IN MEDICAL MANAGEMENT OF DYSFU N CTIONAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    Deepa

    2015-01-01

    Full Text Available OBJECTIVE: To evaluate the efficacy and safety of ormeloxifene in the medical management of dysfunctional uterine bleeding. DESIGN AND SETTING: A descriptive observational study was conducted on women with dysfunctional uterine bleeding, who attended to out – patient department of Obstetrics & Gynaecology in a National Institute Of Medical Science Medical College, shobha nagar, Jaipur (Rajsthan. MATERIAL AND METHOD : 54 patient s with dysfunctional uterine bleeding were recruited for the study. Ormeloxifene 60 mg twice a week for 3 months from first day of periods and once a week for next 3 months was given. Mean blood loss (MBL was assessed using pictorial blood loss assessment chart (PBAC. And subjectively by a visual analog scale (VAS.Ultrasonography ( USG for endometrial thickness and blood hemoglobin levels were done as baseline and at 1, 3 and 6 months of treatment. Side - effects of the drug were recorded. Changes in PBAC scoring, endometrial thickness (ET and hemoglobin levels (Hb were analyzed by student’s paired ‘t’ tests using SPSS 17.0 version. p value ≤ 0.05 was taken as significant. RESULT : The mean pretreatment MBL (PBAC score was 343.13 (140 - 765, which reduced to 222.22 (80 - 398 at 1 months and 90.0 (0 - 340 at 3 months with treatment.By end of 6 months, the mean PBAC score was 68.84 (0 - 320. There was a significant reduction in MBL in patients on ormeloxifene (p - value ≤ 0.001.The rise in haemoglobin and decrease in ET,in women on ormeloxifene was also satistically significant(p value< o.oo1 . Out of 54 patients,46 womens with menorrhagia were recruited in study. Three (6.52% patients had no response, four (8.7% patients were lost to follow - up. During the one year study period, 1(2.17 of the patients underwent hysterectomy.The most common side effect reorted was amenorrhea (28.26% . CONCLUSION : Ormeloxifene is very effective in improving all the parameters of blood loss in abnormal uterine bleeding including

  7. Correlation of bleeding pattern with endometrial histopathologic results in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Zehra Yilmaz

    2015-06-01

    Full Text Available Background: Abnormal Uterine Bleeding (AUB is referred as bleeding outside of normal menstruation pattern and it is the most common gynecological problem for women of all ages. This study was evaluated the correlation of menstrual bleeding patterns and endometrial histopathological findings in perimenopausal women. Methods: This study was done on perimenopausal aged women presented with AUB for the last 6 months at a gynecology clinic of a tertiary medical center. Only the patients with isolated endometrial causes of AUB were selected for study. A total of 313 cases were included in the study. Abnormal bleeding patterns of the patients were recorded and endometrial sampling was performed to all women. AUB was classified as menorrhagia, metrorrhagia, menometrorrhagia, polymenorrhea, intermenstrual bleeding, and histopathological findings were classified as Proliferative Endometrium (PE, Secretory Endometrium (SE, Disordered Proliferative Pattern (DPP, Endometrial Polyp (EP, Chronic Endometritis (CE, Endometrial Hyperplasia (EH, and Endometrial Adenocarcinoma (CA. Results: The most common bleeding pattern was menorrhagia (45.0% and the most common histopathological finding was PE+SE (52.0% in our study. PE+SE and endometrial hyperplasia without atypia were found more common in menorrhagia group. The most histopathological findings were found PE+SE in menometrorrhagia and polymenorrhea group (P 0.05. Conclusions: We concluded that although menometrorrhagia and polymenorrhea were significantly more associated with PE+SE, intermenstrual bleeding was significantly more associated with EP and CE. It is noteworthy that endometrial hyperplasia without atypia is significantly higher in patients with menorrhagia which is the most common abnormal bleeding pattern in perimenopausal aged women. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 547-550

  8. Does coupling ofuterine contractions reflect uterine dysfunction?

    African Journals Online (AJOL)

    spontaneous nonnal labour at tenn were divided into two groups ... irregular uterine contractions during labour occurred ... Oxytocin was administered when the uterine activity was less than .... Greater cervical dilatation at the onset of labour in.

  9. Surgical management of abnormal uterine bleeding in fertile age women.

    Science.gov (United States)

    Finco, Andrea; Centini, Gabriele; Lazzeri, Lucia; Zupi, Errico

    2015-07-01

    Abnormal uterine bleeding is a common gynecological disease and represents one of the most frequent reasons for hospital admission to a specialist unit, often requiring further surgical treatment. Following the so-called PALM-COEIN system we will attempt to further clarify the surgical treatments available today. The first group (PALM) is characterized by structural lesions, which may be more appropriately treated by means of surgical management. Although hysterectomy remains the definitive and decisive choice, there are many alternative techniques available. These minimally invasive procedures offer the opportunity for a more conservative approach. Precise and accurate counseling facilitates better patient selection, based on the patient's desires, age and disease type, allowing treatment to be individually tailored to each woman.

  10. 口服雌激素、孕激素、避孕药治疗青春期功能性子宫出血的效果%The therapeutic effects of oral administration of estrogen,progestogen and contraceptive in pubertal dysfunctional uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    孙春玲; 袁桂兰; 章颖

    2011-01-01

    目的:比较口服雌激素、孕激素、避孕药治疗青春期功能性子宫出血的效果.方法:选取北京市海淀医院2006年1月~2010年8月门诊和住院收治的51例青春期功能性子宫出血患者,按照随机对照法分为3组,即雌激素组(15例)、孕激素组(16例)及口服避孕药组(20例).对3组患者的快速控制出血率、快速完全止血率、完全止血成功率、控制出血时间及完全止血时间进行记录和评价.结果:在快速控制出血、快速完全止血及完全止血成功三方面比较,孕激素组及口服避孕药组明显高于雌激素组(P<0.05);孕激素组及口服避孕药组患者的控制出血时间、完全止血时间明显低于雌激素组(P<0.01).结论:在治疗青春期功能性子宫出血效果方面,口服孕激素和口服避孕药的效果优于口服雌激素.%Objective; To compare the therapeutic effects of oral administration of estrogen, progestogen and contraceptive in pu-bertal dysfunctional uterine bleeding. Methods; 51 cases with pubertal dysfunctional uterine bleeding were selected from the hospital from January 2006 to August 2010, then they were randomly divided into estrogen group (15 cases) , progestogen group (16 cases) and contraceptive group (20 cases) . The quick control rate of bleeding, quick total hemostasis rate, success rate of total hemostasis, control bleeding time and time of total hemostasis in the three groups were recorded and evaluated. Results; The quick control rate of bleeding, quick total hemostasis rate and success rate of total hemostasis in progestogen group and contraceptive group were significantly higher than those in estrogen group ( P < 0. 05) . The control bleeding time and time of total hemostasis in progestogen group and contraceptive group were significantly lower than those in estrogen group (P <0. 01) . Conclusion; The effects of oral administration of progestogen and contraceptive are better than that of oral administration

  11. Intraoperative bleeding control during cesarean delivery of complete placenta previa with transient occlusion of uterine arteries.

    Science.gov (United States)

    Kim, Ju Hyun; Joung, Eun-Ju; Lee, Soo-Jung; Kwack, Jae Young; Kwon, Yong Soon

    2015-11-01

    There are few methods to control heavy intra-operative bleeding during cesarean delivery of placenta previa. Transient occlusion of uterine arteries (TOUA) during operation has previously been reported as a quick and safe method to control intra-operative uterine bleeding. We reported 2 cases of cesarean delivery with complete placenta previa in which TOUA was performed to safely reduce intra-operative complication, especially heavy intra-operative bleeding. In the 2 cases, cesarean deliveries were safe and without any complications under the TOUA method. TOUA can be a good method to control heavy intra-operative bleeding during cesarean delivery of complete placenta previa with risk of heavy bleeding.

  12. The medical management of abnormal uterine bleeding in reproductive-aged women.

    Science.gov (United States)

    Bradley, Linda D; Gueye, Ndeye-Aicha

    2016-01-01

    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 first-line approach. Determining the acuity of the bleeding, the patient's medical history, assessing risk factors, and establishing a diagnosis will individualize their medical regimen. In acute abnormal uterine bleeding with a normal uterus, parenteral estrogen, a multidose combined oral contraceptive regimen, a multidose progestin-only regimen, and tranexamic acid are all viable options, given the appropriate clinical scenario. Heavy menstrual bleeding can be treated with a levonorgestrel-releasing intrauterine system, combined oral contraceptives, continuous oral progestins, and tranexamic acid with high efficacy. Nonsteroidal antiinflammatory drugs may be utilized with hormonal methods and tranexamic acid to decrease menstrual bleeding. Gonadotropin-releasing hormone agonists are indicated in patients with leiomyoma and abnormal uterine bleeding in preparation for surgical interventions. In women with inherited bleeding disorders all hormonal methods as well as tranexamic acid can be used to treat abnormal uterine bleeding. Women on anticoagulation therapy should consider using progestin-only methods as well as a gonadotropin-releasing hormone agonist to treat their heavy menstrual bleeding. Given these myriad options for medical treatment of abnormal uterine bleeding, many patients may avoid surgical intervention.

  13. Effective salvage of acute massive uterine bleeding using intrauterine balloon tamponade in a uterine adenomyosis patient on dienogest.

    Science.gov (United States)

    Nishino, Kimihiro; Hayashi, Kazumasa; Chaya, Jyunya; Kato, Noriko; Yamamuro, Osamu

    2013-03-01

    We present the case of a 37-year-old nulliparous woman in whom acute massive uterine bleeding during dienogest therapy was successfully treated using intrauterine balloon tamponade. Abnormal uterine bleeding and several cases of profuse bleeding causing severe anemia in association with dienogest therapy have been reported, but this is the first reported case involving hypovolemic shock. While successful control of postpartum hemorrhage with intrauterine balloon tamponade has been well described, applications for non-obstetric bleeding, particularly in the presence of underlying diseases, such as adenomyosis, have only rarely been reported. This procedure can be easily, promptly, and safely implemented without analgesia, anesthesia, or laparotomy; it can be used with a minimally dilated external cervical os or narrow uterine cavity; and it can preserve fertility.

  14. Ultrasonographic evaluation of abnormal uterine bleeding in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Bindushree Kadakola

    2015-02-01

    Full Text Available Background: Objectives of current study were to diagnose causes of Abnormal Uterine Bleeding (AUB in postmenopausal women (PMW and to correlate it with curettage and histopathological findings, hysteroscopy and thereby minimizing unnecessary interventions in the form of operations and hysteroscopy where sonography depicts normal findings. Methods: After obtaining ethical clearance present prospective observational study was conducted from November 2010 to November 2012, to evaluate the endometrium in 50 postmenopausal women (PMW with bleeding per vagina referred to the department of Radio diagnosis by the department of gynaecology in Bangalore medical college and research institute. After applying inclusion and exclusion criterias the cases were evaluated with ultrasonography both transabdominal (TAS and transvaginal scan (TVS where ever necessary. Histopathological and hysteroscopic correlation was done in all cases. Results: 58% of the PMW with bleed were in the age group of 51-60 years. Most common cause of PMB was atrophic endometrium (44%, endometrial polyp (22%, followed by malignancy (14%, and hyperplastic endometrium (6%. At Endometrium thickness less than 4 mm there were nil chances of carcinoma. Conclusions: In women with AUB in postmenopausal age ultrasonography (USG can be considered as an initial imaging modality for diagnosing endometrial diseases. The sensitivity and specificity of USG for Atrophic endometrium is 100% and 84% respectively with accuracy of 100%, endometrial polyp the specificity is 100% with accuracy of 88%. For malignancy USG showed 100% specificity and accuracy of 100%. Hence USG is highly accurate for evaluating endometrial pathologies. Being noninvasive, less costly and good patient compliance USG should be considered as an initial imaging modality over invasive investigations like D and C, hysteroscopy in evaluating endometrial disorders. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 229-234

  15. 艾灸联合青功汤治疗青春期功能失调性子宫出血效果观察及护理%Observation on the effect of moxibustion combined with "Green Power Soup" in the treatment of adolescent dysfunctional uterine bleeding and nursing care

    Institute of Scientific and Technical Information of China (English)

    吴继萍

    2012-01-01

    Objective: To probe into the effect of moxibustion combined with "Green Power Soup" in the treatment of adolescent dysfunctional uterine bleeding and nursing methods. Methods: 80 patients were randomly divided into a treatment group and a control group ( 40 patients in each group ) according to the admission order. The patients in the treatment group were treated with moxibustion combined with " Green Power Soup" and were also given appropriate nursing care; the patients in the control group received conventional therapy and nursing care. Results: There were statistically significant differences in the comparison of the total effective rate and the number of menstrual days between the two groups ( P <0. 05 ). Conclusion: The moxibustion combined with " Green Power Soup" has a definite effect in the treatment of adolescent dysfunctional uterine bleeding, and the technique is simply operated and easily accepted by patients.%目的:探讨艾灸联合青功汤治疗青春期功能失调性子宫出血的临床效果及护理方法.方法:将80例青春期功能失调性子宫出血患者按入院顺序随机分为治疗组和对照组各40例,治疗组采用艾灸联合青功汤治疗,并给予相应护理措施;对照组给予常规治疗、护理措施.结果:治疗组总有效率及经期天数与对照组比较差异有统计学意义(P<0.05).结论:艾灸联合青功汤治疗青春期功能失调性子宫出血疗效确切,且操作简便,容易被患者接受.

  16. Saline contrast hysterosonography in abnormal uterine bleeding : a systematic review and meta-analysis

    NARCIS (Netherlands)

    de Kroon, CD; de Bock, GH; Dieben, SWM; Jansen, FW

    2003-01-01

    Objective To assess the diagnostic accuracy of saline contrast hysterosonography in the evaluation of the uterine cavity in women complaining of abnormal uterine bleeding. Design A systematic review and meta-analysis of diagnostic studies that compared saline contrast hysterosonography to a gold sta

  17. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding

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    Prasanna Byna

    2015-11-01

    Full Text Available Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women's health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD. Methods: In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients. Results: Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4% were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42% women, 6 (31.57% had polymenorrhagia, 5 (26.31% had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women was heavy menstrual bleeding in 5 (41.6% women, 3 (25% had oligomennorhoea, 4 (33.3% had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57% had oligomenorrhoea, 3 (42.8% had heavy menstrual bleeding, 2 (28.57% had polymenorrhagia. In a total of 55 patients with AUB, 11 (20% had structural abnormalities in uterus and ovaries. 5 (9% had adenomyosis, 3 (5.4% had ovarian cysts, 3 (5.4% had fibroids. Conclusions: It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery. [Int J Res Med Sci 2015; 3(11.000: 3250-3253

  18. Endometrial Cancer: Hidden Pathology in a Patient with Abnormal Uterine Bleeding and Known Leiomyoma.

    Science.gov (United States)

    Sri, Trisha; Steren, Albert J; Stratton, Pamela

    2015-01-01

    Uterine leiomyomas and endometrial pathology are both associated with abnormal uterine bleeding. We report a case in which a nulliparous woman with heavy uterine bleeding and leiomyomas had undergone two prior hysteroscopic myomectomies for benign leiomyomas. She was evaluated, but was ineligible for a clinical trial of a novel Magnetic Resonance guided High Intensity Focused Ultrasound (MRgx200B;HIFU) device. The 8 cm, prolapsed submucosal leiomyoma hindered endometrial sampling and was inaccessible to HIFU treatment. Preoperatively, neither endometrial sampling nor saline sonohysterography was technically feasible. She underwent hysterectomy, and on histological examination of specimen, stage 1A grade 1 endometrial carcinoma was found on the endometrial side of the prolapsing fibroid. Endometrial pathology is an important consideration in the evaluation of abnormal uterine bleeding, even in women with large prolapsing leiomyoma.

  19. TRANSVAGINAL SONOGRAPHY COMBINED WITH SALINE CONTRAST SONOHYSTEROGRAPHY IN EVALUATING THE UTERINE CAVITY IN PREMENOPAUSAL PATIENTS WITH ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    K. G. M. Premleel

    2016-06-01

    Full Text Available OBJECTIVES To evaluate whether saline contrast sonohysterography (SCSH improved the diagnostic accuracy of transvaginal sonography (TVS for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding. PATIENTS AND METHODS The uterine cavity was evaluated with TVS and SCSH in 60 premenopausal patients with abnormal uterine bleeding. All 58 patients underwent operative hysteroscopy or hysterectomy within 4 months which provided a detailed description of the uterine cavity and was used as the true value for exclusion of polyps and submucous myomas. RESULT Out of 60 patients, 45 had uterine abnormalities on TVS and SCSH and rest of the patients who appeared normal but had other abnormalities such as ovarian haemorrhagic cyst. Out of the 45 patients, 9 patients had submucous myomas and 9 were diagnosed as endometrial polyp. The findings were confirmed using hysterectomy/hysteroscopy/endometrial sampling. CONCLUSION The use of TVS without saline contrast left nine submucosal fibroids and five in nine of the polyps undiagnosed in referred patients with complaints of abnormal bleeding. It also helps in reducing the rate of more invasive procedures such as hysteroscopy. However, studies carried out for longer duration and large study population are required to validate our findings

  20. 左炔诺孕酮宫内节育器治疗围绝经期功能性子宫出血50例临床分析%Levonorgestrel IUD treatment of dysfunctional uterine bleeding of perimenopausal period in 50 cases

    Institute of Scientific and Technical Information of China (English)

    徐艳; 李淑清; 周巧梅

    2009-01-01

    Objective To explore the role of levonorgestrel intrauterine device in the treatment of peri-menopausal dysfunctional uterine bleeding, to find theoretical basis for effective and rational treatment of peri-menopausal dysfunctional uterine bleeding and reduce the rate of hysterectomy. Methods Fifty patients received levonorgestrel intrauterine device (treatment group) and another 50 cases were given oral Fukang tablets (control group). The rate of hysterectomy, assessment of menstrual volume and endometrial thickness were observed between the two groups. Results In treatment group, 1 (2%) patient was performed hysterectomy, 2 (4%) had the assessment of menstrual volume score greater than 100, while in control group, 8 (16%) were performed operations, and 12 (24%) had the assessment of menstrual volume score greater than 100. The assessment of menstrual volume scores were 131.0±51.2, 53.0±21.9, 36.7±19.7, 17.9±6.8, respectively, and endometrialt thickness reduced from (13.2±4.3) mm to (8.5±1.9)mm, (7.2±1.5)mm,(6.2±1.1)ram before or 3, 6 and 12 months after the use of the device. Conclusion The use of levonorgestrel intrauterine device can reduce the volume of menstruation and the hysterectomy rate caused by dysfunctional uterine bleeding.%目的:探讨左炔诺孕酮宫内节育器治疗围绝经期功能性子宫出血的疗效,为寻找有效、合理治疗围绝经期功能性子宫出血提供理论依据并减少子宫切除率.方法:治疗组50例患者放置左炔诺孕酮宫内节育器,对照组为口服妇康片(炔诺酮)50例患者,观察2组子宫切除率、月经量评分、子宫内膜厚度.结果:治疗组50例中1例手术(2%)、月经量评分>100分2例(4%);对照组50例中8例手术(16%)、月经量评分>100分12例(24%).治疗组子宫切除率和出血量均低于对照组;放置左炔诺孕酮宫内节育器前及放置后3,6,12个月月经量评分分别为131.0±51.2,53.0±21.9,36.7±19.7,17.9±6.8;子宫内膜由(13.2±4.3)mm

  1. Clinical effect of different doses of mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding%不同剂量米非司酮治疗围绝经期功能失调性子宫出血临床观察

    Institute of Scientific and Technical Information of China (English)

    郭淑萍

    2014-01-01

    Objective To analyze the effect and safety of different doses of mifepristone treating perimenopa-usal dysfunctional uterine bleeding.Methods 80 patients with perimenopausal dysfunctional uterine bleeding were collected.According to the medicine of 5,10mg,25mg mg doses,80 cases were divided into the low dose group (n=26),middle dose group (n=26) and high dose group (n=28).The treatment results,endometrial thickness change, sex hormone level change and the adverse reaction were observed after 3 months.Results In terms of treatment effect,the effective rate in the middle dose group (92.3%) and high dose group (82.1%) were better than that of the low dose group(61.5%)(F=3.98,P<0.05);The inhibitory effect of endometrium in the middle dose group and high dose group were superior to the low dose group( F=4.34,P<0.05);All three groups of sex hormone level was significantly lower in the body;Middle and high dose group of the adverse reactions of treatment process was more,the adverse reaction happening far higher than that of the low dose and dose group (F=3.97,P<0.05). Conclusion 10mg mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding has good effect, less adverse reactions,which is worthy of clinical application.%目的:分析不同剂量米非司酮治疗围绝经期功能失调性子宫出血的疗效和安全性。方法收集围绝经期功能失调性子宫出血的患者80例,根据米非司酮用量5 mg、10 mg及25 mg分别分为低剂量组26例、中剂量组26例及高剂量组28例,分别观察治疗3个月后的临床效果、子宫内膜厚度变化、性激素水平变化及不良反应发生情况。结果经治疗后,中剂量组(有效率92.3%)和高剂量组(有效率82.1%)的治疗效果优于低剂量组(有效率61.5%),差异有统计学意义(F=3.98,P<0.05);中剂量组及高剂量组抑制子宫内膜作用优于低剂量组(F=4.34,P<0.05);三组都对

  2. Clinical efficacy on levonorgestrel intrauterine system in treating dysfunctional uterine bleeding during peri-menopausal period%左炔诺孕酮宫内缓释系统治疗围绝经期功血的临床观察

    Institute of Scientific and Technical Information of China (English)

    何丽霞; 陈正勤

    2016-01-01

    目的:观察围绝经期功能失调性子宫出血(功血)患者宫腔内放置左炔诺孕酮宫内缓释系统(商品名:曼月乐)的临床疗效。方法:选取曼月乐治疗围绝经期功血患者72例,比较放置曼月乐前后患者月经情况、子宫内膜厚度及血红蛋白、血脂、性激素水平变化。结果:放置曼月乐后月经量减少,子宫内膜变薄,血红蛋白升高,结果均有明显差异(P <0.05),而血脂及性激素水平无明显改变,差异无统计学意义(P >0.05)。结论:曼月乐治疗围绝经期功血减少经量和纠正贫血效果确切,不影响血脂代谢和卵巢功能。%Objective To investigate the clinical efficacy on dysfunctional uterine bleeding during peri -menopausal period of levonorgestrel intrauterine system.Method Seventy -two cases of patients who were diagnosed dysfunctional uterine bleeding during peri -menopausal period were placed with mirenas during menstrual period.The menstrual conditions,endometrium width, hemoglobin,blood lipid,sex hormone level changes of these cases were measured before and after the insertion of mirena.Results After the insertion of mirena the menstrual quantity decreases,thinning of the endometrium,hemoglobin was increased.These were statistically significant(P 0.05).Conclusion Levonorgestrel intrauterine system can efficiently reduce the amount of blood and correct a-nemia but does not affect blood lipid metabolism and ovarian function.

  3. Recurrent venous thromboembolism and abnormal uterine bleeding with anticoagulant and hormone therapy use.

    Science.gov (United States)

    Martinelli, Ida; Lensing, Anthonie W A; Middeldorp, Saskia; Levi, Marcel; Beyer-Westendorf, Jan; van Bellen, Bonno; Bounameaux, Henri; Brighton, Timothy A; Cohen, Alexander T; Trajanovic, Mila; Gebel, Martin; Lam, Phuong; Wells, Philip S; Prins, Martin H

    2016-03-17

    Women receiving vitamin K antagonists (VKAs) require adequate contraception because of the potential for fetal complications. It is unknown whether the use of hormonal therapy, especially those containing estrogens, is associated with recurrent venous thromboembolism (VTE) during anticoagulation. Despite the absence of data, World Health Organization guidelines state that use of estrogen-containing contraceptives confers an "unacceptable health risk" during established anticoagulation for VTE. We compared the incidences of recurrent VTE and abnormal uterine bleeding with and without concomitant hormonal therapy in women aged abnormal uterine bleeding. In total, 1888 women were included. VTE incidence densities on and off hormonal therapy were 3.7%/year and 4.7%/year (adjusted HR, 0.56; 95% confidence interval [CI], 0.23-1.39), respectively, and were 3.7%/year and 3.8%/year, respectively, for estrogen-containing and progestin-only therapy. The adjusted HR for all abnormal uterine bleeding (on vs off hormonal therapy) was 1.02 (95% CI, 0.66-1.57). Abnormal uterine bleeding occurred more frequently with rivaroxaban than with enoxaparin/VKA (HR, 2.13; 95% CI, 1.57-2.89). Hormonal therapy was not associated with an increased risk of recurrent VTE in women receiving therapeutic anticoagulation. The observed increased risk of abnormal uterine bleeding with rivaroxaban needs further exploration.

  4. [Application of TB type thermal balloon endometrial ablation for the treatment of abnormal uterine bleeding].

    Science.gov (United States)

    Wang, W; Zhai, Y; Zhang, Z H; Li, Y; Zhang, Z Y

    2016-11-08

    Objective: To investigate the clinical efficacy, safety and promotion value of TB type thermal balloon endometrial ablation in the treatment of abnormal uterine bleeding. Methods: Fourty three patients who had received TB type endometrial ablation system for treatment of abnormal uterine bleeding from January, 2015 to January, 2016 in theDepartment of gynecology, Beijing Chaoyang Hospital were enrolled in this study. The intra-operative and post-operative complications and improvement of abnormal uterine bleeding and dysmenorrhea were observed. Results: There were nointra-operative complication occurred, such as uterine perforation, massive hemorrhage or surrounding organ damage. At 6 months after operation, 32 patients developed amenorrhea, 6 developed menstrual spotting, 3 developed menstruation with a small volume and 1 had a normal menstruation. No menstruation with an increased volume occurred. The occurrence of amenorrhea was 76.19% and the response rate was 97.62%.At 6 months after operation, 1 case had no response, 2 cases had partial response and 11 cases had complete response among the 14 cases of pre-operative dysmenorrhea; only 3 cases still had anemia among the 23 cases of pre-operative anemia. Compared with before treatment, patients with dysmenorrhea and anemia both significantly reduced with a statistically significant difference(P<0.01). Conclusion: TB type thermal balloon endometrial ablation has a significant efficacy with high safety for the treatment of abnormal uterine bleeding, which could have clinical promotion practice.

  5. Cesarean scar defects: an underrecognized cause of abnormal uterine bleeding and other gynecologic complications.

    Science.gov (United States)

    Tower, Amanda M; Frishman, Gary N

    2013-01-01

    The gynecologic sequelae due to deficient uterine scar healing after cesarean section are only recently being identified and described. These include conditions such as abnormal bleeding, pelvic pain, infertility, and cesarean scar ectopic pregnancy, as well as a potentially higher risk of complications and difficulties during gynecologic procedures such as uterine evacuation, hysterectomy, endometrial ablation, and insertion of an intrauterine device. The proposed mechanism of abnormal uterine bleeding is a pouch or "isthmocele" in the lower uterine segment that causes delayed menstrual bleeding. The prevalence of symptomatic or clinically relevant cesarean scar defects (CSDs) ranges from 19.4% to 88%. Possible risk factors for CSD include number of cesarean sections, uterine position, labor before cesarean section, and surgical technique used to close the uterine incision. There are no accepted guidelines for the diagnostic criteria of CSD. We propose that a CSD be defined on transvaginal ultrasound or saline infusion sonohysterography as a triangular hypoechoic defect in the myometrium at the site of the previous hysterotomy. We also propose a classification system to aid in standardized classification for future research. Surgical techniques for repair of CSD include laparoscopic excision, resectoscopic treatment, vaginal revision, and endometrial ablation.

  6. Ambulatory hysteroscopy and its role in the management of abnormal uterine bleeding.

    Science.gov (United States)

    Cooper, Natalie A M; Robinson, Lynne L L; Clark, T Justin

    2015-10-01

    Hysteroscopy is now an ambulatory procedure, having moved from a conventional day-case operating theatre environment to the outpatient clinic setting. Outpatient hysteroscopy can be used as a diagnostic test and as a therapeutic modality for women presenting with abnormal uterine bleeding. In many cases women can be diagnosed and treated efficiently during a single hospital appointment. This article reviews the development of ambulatory hysteroscopy and how it should optimally be performed and implemented. The contemporary role of this technology for investigating and treating women with abnormal uterine bleeding is then discussed.

  7. Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study

    OpenAIRE

    2013-01-01

    Background: Abnormal uterine bleeding is the Common presenting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri-menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non-organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology.

  8. Diagnostic Features and Therapeutic Consequences of Hysteroscopy in Women with Abnormal Uterine Bleeding and Abortion

    Directory of Open Access Journals (Sweden)

    Sedigheh A. Fard

    2012-01-01

    Full Text Available Problem statement: Hysteroscopy is a procedure in which the endometrial cavity is observable and subject of manipulation via transcervical route. Hysteroscopy is a minimally invasive process in diagnosis and treatment of many intrauterine and endocervical conditions. Polypectomy, myomectomy and endometrial ablation could be easily manageable by this procedure. According to safety and high efficiency of hysteroscopy, this method is changing to a widespread procedure in dealing with many gynecologic and obstetrical conditions. This study aimed at evaluating the diagnostic and therapeutical efficiency of hysteroscopy in managing of common conditions including abnormal uterine bleeding and abortion. Approach: In a descriptive cross-sectional setting, 243 women underwent hysteroscopy were evaluated in two groups: with uterine bleeding 236 cases and with recurrent abortions 7 cases. This study was conducted in Tabriz Alzahra Educational Center during a 15-month period. The main causes of the complaints were determined in each group. Six months after treatment, the overall success rate was recorded. Results: Hysteroscopy was the sole diagnostic procedure in 16.5 and 14.3% of the patients in groups with abnormal uterine bleeding and abortion, respectively. In the group with abnormal uterine bleeding, curettage, myomectomy, polypectomy, hysterectomy, laparoscopy and laparotomy were the main diagnostic-therapeutical approaches along with the hysteroscopy in descending order. In the group with recurrent abortion, laparoscopy, curettage and myomectomy were the main diagnostic-therapeutical approaches along with the hysteroscopy in descending. There was not any major complication. The diagnostic-therapeutical measures accompanying with the laparoscopy were successful in 73.5% of the bleeding group in follow-up period. Conclusion: Based on our results, hysteroscopy is a safe, accurate and highly-efficient procedure in managing women with abnormal uterine

  9. 异常子宫出血临床与病理特点分析%Clinical and Pathological Features of Abnormal Uterine Bleeding Analysis

    Institute of Scientific and Technical Information of China (English)

    宋清玲; 薛莎

    2015-01-01

    Objective: To analyze abnormal uterine bleeding clinical and pathological features.Methods:A retrospective gynecological hospital in January 2011 to January 2013 admitted 400 patients with abnormal uterine bleeding clinical data,summarize the pathological type of abnormal uterine bleeding and pathological diagnosis of women at different stages.Results:Abnormal uterine bleeding is mainly divided into dysfunctional uterine bleeding,bleeding with normal menstrual cycle organic endometrial three categories,of which the latter is the most,and accounting for 60.25% of all patients.Dysfunctional uterine bleeding and endometrial hyperplasia is simple to most,accounting for 71.08% of dysfunctional uterine bleeding;organic disease during pregnancy bleeding to most,accounting for 46.05% organic uterine bleeding;normal menstrual cycle film with atypical endometrial hyperplasia most,accounting for 71.37 percent of the normal menstrual cycle endometrial.Conclusion:The diagnosis and treatment of patients with abnormal uterine bleeding,in conjunction with the patient's medical history and laboratory examinations,timely diagnostic curettage and pathological examination as soon as possible to make a definitive diagnosis and targeted treatment options.%目的:分析异常子宫出血的临床与病理特点。方法:回顾我院妇科2011年1月~2013年1月收治的400例异常子宫出血患者的临床资料,总结不同阶段的女性的异常子宫出血的病理类型以及病理诊断结果。结果:异常子宫出血中主要分为功能性子宫出血、器质性子宫出血与正常月经周期内膜三类,其中以后者为最多,占全部患者的60.25%。功能性子宫出血中以单纯性内膜增生为最多,占功能性子宫出血的71.08%;器质性子宫出血中以妊娠期疾病为最多,占器质性子宫出血的46.05%;正常月经周期内膜中以子宫内膜不典型增生为最多,占正常月经周期内膜的71.37%

  10. Practice points in gynecardiology: Abnormal uterine bleeding in premenopausal women taking oral anticoagulant or antiplatelet therapy

    NARCIS (Netherlands)

    Maas, A.H.E.M.; Euler, M.; Bongers, M.Y.; Rolden, H.J.A.; Grutters, J.P.C.; Ulrich, L.; Schenck-Gustafsson, K.

    2015-01-01

    A growing number of premenopausal women are currently using antithrombotic and/or (dual) antiplatelet therapy for various cardiovascular indications. These may induce or exacerbate abnormal uterine bleeding and more awareness and knowledge among prescribers is required. Heavy and irregular menstrual

  11. Role of thyroid function tests in women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Mangala Gowri

    2014-02-01

    Conclusions: As there is high incidence of thyroid diseases in our area, women with abnormal uterine bleeding are to be screened. This would also avoid unnecessary hormonal treatment and surgery in these patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 54-57

  12. Granulocytes and vascularization regulate uterine bleeding and tissue remodeling in a mouse menstruation model.

    Directory of Open Access Journals (Sweden)

    Astrid Menning

    Full Text Available Menstruation-associated disorders negatively interfere with the quality of life of many women. However, mechanisms underlying pathogenesis of menstrual disorders remain poorly investigated up to date. Among others, this is based on a lack of appropriate pre-clinical animal models. We here employ a mouse menstruation model induced by priming mice with gonadal hormones and application of a physical stimulus into the uterus followed by progesterone removal. As in women, these events are accompanied by menstrual-like bleeding and tissue remodeling processes, i.e. disintegration of decidualized endometrium, as well as subsequent repair. We demonstrate that the onset of bleeding coincides with strong upregulation of inflammatory mediators and massive granulocyte influx into the uterus. Uterine granulocytes play a central role in regulating local tissue remodeling since depletion of these cells results in dysregulated expression of matrix modifying enzymes. As described here for the first time, uterine blood loss can be quantified by help of tampon-like cotton pads. Using this novel technique, we reveal that blood loss is strongly reduced upon inhibition of endometrial vascularization and thus, is a key regulator of menstrual bleeding. Taken together, we here identify angiogenesis and infiltrating granulocytes as critical determinants of uterine bleeding and tissue remodeling in a mouse menstruation model. Importantly, our study provides a technical and scientific basis allowing quantification of uterine blood loss in mice and thus, assessment of therapeutic intervention, proving great potential for future use in basic research and drug discovery.

  13. Postpartum Uterine Bleeding from the Inferior Mesenteric Artery: Case Report and Review of the Literature.

    Science.gov (United States)

    Shin, Sun Mi; Yi, Kyong Wook; Chung, Hwan Hoon

    2015-01-01

    Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. The common causes of primary PPH include uterine atony, abnormal placentation, retained placenta, and birth canal injury. The inferior mesenteric artery (IMA) arises from the aorta and is the main artery to supply the descending and sigmoid colon, as well as the rectum. We present a case of immediate, severe uterine bleeding after a normal vaginal delivery; angiography determined that hemorrhage originated from the IMA, and there were no anastomoses between the IMA and other pelvic arteries. The patient was successfully managed by selective embolization of a distal branch of the IMA. Our case report presents a new and interesting variation of pelvic vascular anatomy; moreover, it is the first report to present a case of postpartum uterine bleeding originating from the IMA.

  14. The prevalence of hyperprolactinemia and galactorrhea in patients with abnormal uterine bleeding.

    Science.gov (United States)

    Eftekhari, Nahid; Mirzaei, Fatemeh; Karimi, Mehdi

    2008-05-01

    Abnormal uterine bleeding is one of the most common gynecological problems in women aged 15-45 years. The relationship of hyperprolactinemia with reproductive disorders, amenorrhea and irregular menstrual cycles has been known. The aim of the present study was to determine the frequency of hyperprolactinemia and galactorrhea in 15-45-year-old females with abnormal uterine bleeding. This analytic descriptive study was carried out on 100 women referred to a gynecology clinic for vaginal bleeding without any organic disorder. Consecutive sampling was performed. Among the cases 61% had hyperprolactinemia and galactorrhea was reported in 48% of these patients. There was a significant association between hyperprolactinemia and galactorrhea (p = 0.003); 46% of patients with galactorrhea and 75% of patients without galactorrhea had a high level of prolactin. Galactorrhea and hyperprolactinemia had no significant association with the type of abnormal uterine bleeding. Among patients with undiagnosed vaginal bleeding, hyperprolactinemia was present in more than 50% of them and in 46% it was associated with galactorrhea. Hyperprolactinemia that presents a gynecological problem may or may not be accompanied by galactorrhea, and galactorrhea cannot be a certain index for hyperprolactinemia.

  15. Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding

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    Đorđević Biljana

    2008-01-01

    Full Text Available Background/Aim. The prevalence of endometrial polyps (EPs in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma, patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204 and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7. Results. In 211 (21.94% patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94% EPs, 29 (13.74% EPs with hyperplasia without atypia, 5 (2.37% EPs with atypical hyperplasia, and 2 (0.95% EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A, patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B were older (p < 0.05, and more commonly postmenopausal (p < 0.05 and with hypertension (p < 0.05, all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

  16. Comparison of the Efficacy and Safety of Levonorgestrel Intrauterine System and Mifepristone in the Treatment of Perimenopausal Dysfunctional Uterine Bleeding%左炔诺孕酮宫内节育系统与米非司酮治疗围绝经期功能失调性子宫出血的疗效和安全性比较

    Institute of Scientific and Technical Information of China (English)

    姜欣; 曾银花

    2016-01-01

    目的:比较左炔诺孕酮宫内节育系统与米非司酮治疗围绝经期功能失调性子宫出血的疗效和安全性。方法:200例围绝经期功能失调性子宫出血患者随机分为观察组(100例)和对照组(100例)。观察组患者放置左炔诺孕酮宫内节育系统(含左炔诺孕酮52 mg),对照组患者口服米非司酮胶囊10 mg/d。两组疗程均为3个月。观察两组患者的临床疗效和治疗前后子宫内膜厚度、月经量[根据图示应用出血评分法(PBAC)评估]、血红蛋白水平及不良反应发生情况。结果:治疗后,观察组患者总有效率显著高于对照组,不良反应发生率显著低于对照组,差异均有统计学意义(P<0.01)。治疗前,两组患者子宫内膜厚度、PBAC评分、血红蛋白水平比较差异无统计学意义(P>0.05);治疗后,两组患者子宫内膜厚度、PBAC评分显著低于同组治疗前,且观察组低于对照组,而血红蛋白水平显著高于同组治疗前,且观察组高于对照组,差异均有统计学意义(P<0.01或P<0.05)。结论:左炔诺孕酮宫内节育系统治疗围绝经期功能失调性子宫出血的疗效和安全性显著优于米非司酮。%OBJECTIVE:To compare the efficacy and safety of levonorgestrel intrauterine system and mifepristone in the treat-ment of perimenopausal dysfunctional uterine bleeding. METHODS:200 patients with perimenopausal dysfunctional uterine bleed-ing were randomly divided into observation group (100 cases) and control group (100 cases). Patients in the observation group placed levonorgestrel intrauterine system (containing levonorgestrel 52 mg),patients in control group received Mifepristone cap-sule 10 mg/d,oral,the treatment course for 2 groups were 3 months. Clinical efficacy,endometrial thickness,menstruation(PBAC score),hemoglobin level before and after treatment and incidence of adverse reaction in 2 groups were observed

  17. Practice points in gynecardiology: Abnormal uterine bleeding in premenopausal women taking oral anticoagulant or antiplatelet therapy.

    Science.gov (United States)

    Maas, Angela H E M; Euler, Mia von; Bongers, Marlies Y; Rolden, Herbert J A; Grutters, Janneke P C; Ulrich, Lian; Schenck-Gustafsson, Karin

    2015-12-01

    A growing number of premenopausal women are currently using antithrombotic and/or (dual) antiplatelet therapy for various cardiovascular indications. These may induce or exacerbate abnormal uterine bleeding and more awareness and knowledge among prescribers is required. Heavy and irregular menstrual bleeding is common in women in their forties and may have a variety of underlying causes that require different treatment options. Thus using anticoagulants in premenopausal women demands specific expertise and close collaboration between cardiovascular physicians and gynecologists. In this article we summarize the scope of the problem and provide practical recommendations for the care for young women taking anticoagulants and/or (dual) antiplatelet therapy. We also recommend that more safety data on uterine bleeding with novel anticoagulants in premenopausal women should be obtained.

  18. A 19 year old with heavy vaginal bleeding; unlikely diagnosis of uterine carcinsarcoma

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    Andrew L. Atkinson

    2013-04-01

    Full Text Available Uterine carcinosarcoma is a rare malignancy that has a high recurrence rate after treatment with very poor long term prognosis. Women are diagnosed usually over the age of 50, with most cases occurring between the sixth and seventh decade of life. We present a rare case of uterine carcinosarcoma diagnosed a nineteen year old after having a dilation and curettage for heavy vaginal bleeding. The patient went on to have a total abdominal hysterectomy with transposition of the ovaries as well as adjuvant treatment with chemotherapy. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 221-223

  19. Abnormal uterine bleeding in pre-menopausal women.

    Science.gov (United States)

    Singh, Sukhbir; Best, Carolyn; Dunn, Sheila; Leyland, Nicholas; Wolfman, Wendy Lynn; Leyland, Nicholas; Wolfman, Wendy; Allaire, Catherine; Awadalla, Alaa; Best, Carolyn; Dunn, Sheila; Heywood, Mark; Lemyre, Madeleine; Marcoux, Violaine; Menard, Chantal; Potestio, Frank; Rittenberg, David; Singh, Sukhbir

    2013-05-01

    qui y sont formulées peuvent être adaptées par les professionnels de la santé qui offrent leurs services aux femmes qui présentent de tels saignements. Conclusions : Les saignements utérins anormaux constituent un trouble courant et parfois débilitant qui affecte les femmes en âge de procréer. La mise en œuvre d’une standardisation de la terminologie connexe, d’une approche systématique en matière de diagnostic et d’exploration, et d’une approche par étapes pour ce qui est de l’intervention s’avère nécessaire. Toutes les interventions thérapeutiques ont pour objectif absolu de débuter le traitement au moyen de modalités thérapeutiques médicales, pour ensuite avoir recours aux modalités chirurgicales les moins effractives possibles, le tout en vue de permettre à la patiente d’obtenir des résultats satisfaisants. Données : Des recherches ont été menées en mars 2011 dans les bases de données MEDLINE et Cochrane afin d’en tirer les articles publiés en anglais, au moyen d’un vocabulaire contrôlé (p. ex. « uterine hemorrhage », « menorrhagia ») et de mots clés appropriés (p. ex. « menorrhagia », « heavy menstrual bleeding », « abnormal uterine bleeding »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles publiés en anglais entre janvier 1999 et mars 2011. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en février 2013. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales

  20. Influence of Gongxuening combined with mifepristone intervention on serum sex hormone levels of patients with perimenopausal dysfunctional uterine bleeding%宫血宁胶囊联合米非司酮对围绝经期功能失调性子宫出血患者血清性激素水平的影响

    Institute of Scientific and Technical Information of China (English)

    何华; 余小蓉; 张正琼; 朱晓兰

    2015-01-01

    目的:探讨宫血宁胶囊联合米非司酮对围绝经期功能失调性子宫出血患者血清性激素的影响。方法:92例围绝经期功能失调性子宫出血患者,随机分为两组,各46例。对照组给予炔诺酮治疗,观察组给予宫血宁胶囊联合米非司酮治疗。结果:观察组总有效率为95.65%高于对照组总有效率76.09%,差异具有统计学意义(P <0.01)。观察组复发率为2.17%少于对照组的复发率17.39%,差异具有统计学意义(P <0.05)。治疗后,观察组患者的 FSH(22.05±5.31)U /L、LH(21.46±3.35)U /L、E2(118.27±30.42) pmol/L 都低于对照组患者 FSH(54.84±7.89)U /L、LH(38.53±6.68)U /L 、E2(332.48±72.94)pmol/L,差异具有统计学意义(P <0.01)。治疗后,观察组患者 HGB 水平(107.54±10.21)g/L 高于对照组患者 HGB水平(96.42±10.46)g/L,差异具有统计学意义(P <0.01)。治疗后,观察组患者子宫内膜厚度(4.26±0.84)mm 低于对照组患者子宫内膜厚度(5.52±1.13)mm,差异具有统计学意义(P <0.01)。观察组患者控制出血时间(21.63±6.89)h、完全止血时间(56.92±14.17)h 都少于对照组患者控制出血时间(32.18±7.72)h、完全止血时间(67.48±23.67)h,差异具有统计学意义(P <0.05)。结论:宫血宁胶囊联合米非司酮治疗围绝经期功能失调性子宫出血疗效显著,能改善患者血清性激素水平,及时有效控制出血,改善子宫内膜厚度。%Objectives:To investigate the effect of Gongxuening capsule combined with mifepristone inter-vention on the serum sex hormone levels of patients with perimenopausal dysfunctional uterine bleeding.Methods:92 patients with perimenopausal dysfunctional uterine bleeding,were randomly divided into two groups,46 cases in each.Control group was given norethisterone treatment while observation group was given

  1. HYSTEROSCOPIC EVALUATION OF WOMEN IN REPRODUCTIVE AGE GROUP WITH ABNORMAL UTERINE BLEEDING

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    E. Vanaja Reddy

    2016-10-01

    Full Text Available BACKGROUND Abnormal uterine bleeding is the most common complaint in gynaecology and an important source of morbidity. This study evaluates the usefulness of hysteroscopy in the diagnosis of abnormal uterine bleeding in comparison to dilatation and curettage in reproductive age group. MATERIALS AND METHODS Between September 2011 to July 2013, women with AUB attending Gynaec OP were subjected to hysteroscopy and subsequent dilatation and curettage. Data was collected and analysed. RESULTS AUB was more common in 30-34 yrs. The most common presenting complaint was menorrhagia. Normal hysteroscopic view was seen in 50% cases. Abnormalities seen were endometrial hyperplasia, polyps, submucous myoma synechiae and rue. Both hysteroscopy and curettage gave specificity of 70%, but the ability to diagnose focal lesion (sensitivity was more with hysteroscopy in comparison to curettage 70 vis. 36. 43 patients had the same tissue diagnosis in both hysteroscopy and curettage. Hysteroscopy revealed more information than curettage in 42% and curettage had more information in 15% cases, 100% accuracy was seen in case of myoma, IUCD, adhesions and polyps with hysteroscopy. CONCLUSION This study confirms the conclusion of many others that hysteroscopy is superior to dilatation and curettage in evaluating patients with abnormal uterine bleeding.

  2. Evaluation of abnormal uterine bleeding: role of diagnostic hysteroscopy and its correlation with histopathology

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    Rebecca Edwin

    2014-08-01

    Full Text Available Background: The objective was to assess the accuracy of diagnostic hysteroscopy in evaluation of abnormal uterine bleeding and to correlate hysteroscopic findings with histopathology reports. Methods: A prospective study was carried out at our institute from January 2010 to December 2013. Ninety cases were included in this study. Patients' age varied from 20 to 60. Those women with the history of abnormal uterine bleeding were admitted. In all cases diagnostic hysteroscopic examination and dilatation and curettage were carried out. Endometrium was sent for histopathology and correlation of hysteroscopic findings with histopathology reports was studied. Results: Various findings on hysteroscopy are as following: proliferative endometrium 36.66%, secretary endometrium 17.77% endometrial hyperplasia 24.44%, atrophic endometrium 5.55%, endometrial polyp 8.88%, submucous fibroid 4.44%, and endometrial carcinoma 2.22%. Conclusions: Hysteroscopy is an eye in uterus and it provides more accurate diagnosis than dilatation and curettage alone in patients with abnormal uterine bleeding. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1082-1086

  3. Dysfunctional Uterine Bleeding: Questions to Discuss with Your Doctor

    Science.gov (United States)

    ... Breast Health & Disease Exercise & Fitness Healthy Eating Menopause Osteoporosis Pregnancy Screening Tests for Women Women's Sexual Health Children's ... Breast Health & Disease Exercise & Fitness Healthy Eating Menopause Osteoporosis Pregnancy Screening Tests for Women Women's Sexual Health Featured ...

  4. The role of Histopathology, Endometrium Thickness and Obstetric History in Abnormal Uterine Bleeding

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    Turkan Cengiz

    2016-09-01

    Full Text Available Aim: To evaluate the clinical manifestations of abnormal uterine bleeding (AUB, ultrasonography findings and compare with histopathological results.Material and Method: A total of 404 women with AUB were classified as; Group I: 18-39 years, Group II: 40-50 years, Group III: >50 years old. Age, parity, bleeding pattern, menstrual history, laboratory results, ultrasonography and histopathological findings were evaluated. Results: Almost half presented with AUB were in the premenopausal group [196 (48.51%], followed by 150(37.13% postmenopausal group and 58(14.36% reproductive age group. The most common bleeding pattern was menometrorrhagia followed by metrorrhagia. Endometrial pathologies were observed in 306 (75.74% and normal menstrual pattern in 98 (24.26% participants of AUB. Endometrium cancer was seen in 7 (1.7% women. In the reproductive period most common pathology was hormonal imbalance pattern. Endometrial polyp was the dominant pathology in premenopausal and postmenopausal age groups. All malignancy cases were in the postmenopausal age group. Malignancy was in 4(19.04% women who gave birth < 3 and in 1(4.76% who had %u22653 children. Four women with vaginal delivery had malignancy whereas no malignancy was seen in women with only cesarean history. Among 109 women who had endometrial thickness 4mm, 30 (10.17% had endometrial hyperplasia, 6(2.03% had endometrium cancer. Discussion: Transvaginal ultrasonography can be used as diagnostic method to evaluate endometrial thickness and differentiate uterine pathologies. However in the case of recurrent uterine bleeding, endometrial sampling should be performed disregarding ultrasonography findings.

  5. Abnormal uterine bleeding after ovarian vein embolotherapy for pelvic congestion syndrome:Case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Mostafa A. Borahay; Gokhan S. Kilic; Mary C. Haver

    2012-01-01

    Ovarian vein embolotherapy is a relatively new treatment for pelvic congestion syndrome that is claimed to be safe and effective.A36-year-old woman underwent ovarian(without internal iliac) vein embolotherapy for pelvic congestion syndrome.Her pain was improved following the procedure.Within three months of the procedure, she started experiencing distressing abnormal uterine bleeding.Specifically, she developed profuse bleeding after intercourse.After thorough evaluation and counseling, a total abdominal hysterectomy was eventually performed.The use of ovarian vein embolization for treatment of pelvic congestion syndrome may be associated with abnormal uterine bleeding.

  6. Efficacy of Prophylactic Uterine Artery Embolization before Obstetrical Procedures with High Risk for Massive Bleeding

    Science.gov (United States)

    Ko, Heung Kyu; Ko, Gi Young; Gwon, Dong Il; Kim, Jin Hyung; Han, Kichang; Lee, Shin-Wha

    2017-01-01

    Objective To evaluate the safety and efficacy of prophylactic uterine artery embolization (UAE) before obstetrical procedures with high risk for massive bleeding. Materials and Methods A retrospective review of 29 female patients who underwent prophylactic UAE from June 2009 to February 2014 was performed. Indications for prophylactic UAE were as follows: dilatation and curettage (D&C) associated with ectopic pregnancy (cesarean scar pregnancy, n = 9; cervical pregnancy, n = 6), termination of pregnancy with abnormal placentation (placenta previa, n = 8), D&C for retained placenta with vascularity (n = 5), and D&C for suspected gestational trophoblastic disease (n = 1). Their medical records were reviewed to evaluate the safety and efficacy of UAE. Results All women received successful bilateral prophylactic UAE followed by D&C with preservation of the uterus. In all patients, UAE followed by obstetrical procedure prevented significant vaginal bleeding on gynecologic examination. There was no major complication related to UAE. Vaginal spotting continued for 3 months in three cases. Although oligomenorrhea continued for six months in one patient, normal menstruation resumed in all patients afterwards. During follow-up, four had subsequent successful natural pregnancies. Spontaneous abortion occurred in one of them during the first trimester. Conclusion Prophylactic UAE before an obstetrical procedure in patients with high risk of bleeding or symptomatic bleeding may be a safe and effective way to manage or prevent serious bleeding, especially for women who wish to preserve their fertility. PMID:28246515

  7. Efficacy of prophylactic uterine artery embolization before obstetrical procedures with high risk for massive bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Heung Kyu; Shin, Ji Hoon; Ko, Gi Young; Gwon, Dong Il; Kim, Jin Hyung; Han, Ki Chang; Lee, Shin Wha [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    To evaluate the safety and efficacy of prophylactic uterine artery embolization (UAE) before obstetrical procedures with high risk for massive bleeding. A retrospective review of 29 female patients who underwent prophylactic UAE from June 2009 to February 2014 was performed. Indications for prophylactic UAE were as follows: dilatation and curettage (D and C) associated with ectopic pregnancy (cesarean scar pregnancy, n = 9; cervical pregnancy, n = 6), termination of pregnancy with abnormal placentation (placenta previa, n = 8), D and C for retained placenta with vascularity (n = 5), and D and C for suspected gestational trophoblastic disease (n = 1). Their medical records were reviewed to evaluate the safety and efficacy of UAE. All women received successful bilateral prophylactic UAE followed by D and C with preservation of the uterus. In all patients, UAE followed by obstetrical procedure prevented significant vaginal bleeding on gynecologic examination. There was no major complication related to UAE. Vaginal spotting continued for 3 months in three cases. Although oligomenorrhea continued for six months in one patient, normal menstruation resumed in all patients afterwards. During follow-up, four had subsequent successful natural pregnancies. Spontaneous abortion occurred in one of them during the first trimester. Prophylactic UAE before an obstetrical procedure in patients with high risk of bleeding or symptomatic bleeding may be a safe and effective way to manage or prevent serious bleeding, especially for women who wish to preserve their fertility.

  8. Is Previous Tubal Ligation a Risk Factor for Hysterectomy because of Abnormal Uterine Bleeding?

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    Sanam Moradan

    2012-07-01

    Full Text Available Objectives: Post tubal ligation syndrome (PTLS is a term used to describe a variety of post tubal ligation side effects or symptoms. These include increased menstrual bleeding and hysterectomy. Whether or not post tubal syndrome is a real entity, it has been a subject of controversy in the medical literature for decades. Numerous studies have reported conflicting conclusions about these symptoms. In this study the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among non-sterilized female population of the same age.Methods: This study was carried out on 160 women, 38-52 years, who underwent hysterectomy in Amir University Hospital, Semnan, Iran, from September 2008 to September 2011. After gathering of data from medical records, in this study, the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among nonsterilized female population for the same age.Results: The mean age of the study group was 44/4±5/7 and the mean age of the control group was 45/2±5/3, (p=0.424.The mean parity of the study group was 3/8±1/8 and the mean parity of the control group was 3/5±1/4, (p=0.220. So, in regard to age and parity, two groups were matched. Hysterectomies were performed for 160 cases and abnormal uterine bleeding was the cause of hysterectomy in 67 cases. Among 67 cases, 19 cases (37.3% had previous tubal sterilization + hysterectomy (study group and 48 cases (44% were not undergoing tubal sterilization but had hysterectomy for abnormal bleeding causes (control group. Statistical analyses showed that there were not significant differences between two groups, (RR=0.85; 95% CI: 0.56-1.28; p=0.418.Conclusion: The result of this study showed that previous tubal sterilization is not a risk factor for undergoing hysterectomy because of abnormal uterine bleeding.

  9. Endometrial ablation in the management of abnormal uterine bleeding.

    Science.gov (United States)

    Laberge, Philippe; Leyland, Nicholas; Murji, Ally; Fortin, Claude; Martyn, Paul; Vilos, George; Leyland, Nicholas; Wolfman, Wendy; Allaire, Catherine; Awadalla, Alaa; Dunn, Sheila; Heywood, Mark; Lemyre, Madeleine; Marcoux, Violaine; Potestio, Frank; Rittenberg, David; Singh, Sukhbir; Yeung, Grace

    2015-04-01

    Contexte : Les saignements utérins anormaux (SUA) sont directement à l’origine d’un fardeau de santé considérable que doivent porter les femmes, leur famille et la société en général. Jusqu’à 30 % des femmes chercheront à obtenir l’aide d’un médecin pour contrer ce problème au cours de leurs années de fertilité. Objectif : Fournir des lignes directrices factuelles à jour quant aux techniques et aux technologies utilisées aux fins de l’ablation de l’endomètre (AE), soit une intervention à effraction minimale permettant la prise en charge des SUA d’origine bénigne. Méthodes : Les membres du comité sur la directive clinique ont été sélectionnés en fonction de leurs spécialisations respectives en vue de représenter une gamme d’expériences pratiques et universitaires : le milieu de pratique au Canada, le type de pratique, la sous-spécialité et les antécédents généraux en gynécologie ont donc été pris en considération. Le comité a analysé les données pertinentes issues de la littérature médicale anglophone (y compris les lignes directrices publiées), en plus d’évaluer les issues chirurgicales et les issues qu’ont connues les patientes à la suite de l’utilisation de diverses techniques d’AE. Les recommandations ont été formulées par consensus. Données : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans MEDLINE et The Cochrane Library en 2013 et en 2014 au moyen d’un vocabulaire contrôlé et de mots clés appropriés (p. ex. « endometrial ablation », « hysteroscopy », « menorrhagia », « heavy menstrual bleeding », « AUB », « hysterectomy »). Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs publiés en anglais entre janvier 2000 et novembre 2014. Les recherches ont été mises à jour de façon r

  10. 宫腔镜在诊治异常子宫出血中的作用%The Role of Hysteroscopy in the Diagnosis and Treatment of Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    李杰

    2013-01-01

    Objective:To investigate the cause of uterine bleeding and the diagnostic value of hysteroscopy.Method:Hysteroscopy examination were retrospectively analyzed the clinical data of 20 patients with uterine bleeding.Result:12 cases were cervical polyp and 3 cases were dysfunctional uterine bleeding and one was submucosal uterine fibroids. Endoscopic diagnosis and biopsy was 100%.Conclusion:The combination of hysteroscopy and histological examination could improve the accuracy of diagnostic for uterine bleeding.%  目的:探讨子宫出血的病因以及宫腔镜的诊断价值。方法:回顾性分析行宫腔镜检查的20例子宫出血患者的临床资料。结果:20例患者出血病因中,子宫内膜息肉12例,子宫颈管息肉4例,功能性子宫出血3例,子宫黏膜下肌瘤1例。镜下诊断与病理活检的符合率为100%。结论:宫腔镜检查与组织学检查结合可提高诊断准确性。

  11. Abnormal uterine bleeding: a study of menstrual patterns and histopathological patterns in perimenopausal females

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    Mahima Jain

    2015-02-01

    Full Text Available Background: In gynecology out-patient department there is a large group of patients especially in perimenopausal age group who present with various menstrual disorders. These can be as such caused due to various etiologies, which need to be investigated as line of management is thereupon decided. This study is undertaken to know the various abnormal uterine bleeding in perimenopausal women, and their histopathological pattern. Methods: This study is done at PDU medical college hospital, Rajkot, Gujarat which is a tertiary care centre. A retrospective analysis of 268 cases clinically presenting with abnormal uterine bleeding is done. They are further posted for dilatation and curettage after thorough investigation to rule out other pathologies. The endometrial samplings from the D and C material are collected and sent for histopathological assessment. The data is recorded and further analysed. Women between 40-55 years age group are included in this study. Women with diagnosed pelvic pathology, endocrinal cause and bleeding tendencies are excluded from the study. Results: In our study almost all menstrual disorders are found, commonest being menorrhagia in 42.16%. Other patterns reported are metrorrhagia in 3.35%, oligomenorrhea in 14.80%, polymenorrhea and polymenorrhagia in 5.22% and 5.59% cases. Post-menopausal bleeding is found in one case. The histopathological diagnoses reported in this study are proliferative and secretory phase in 26.49% and 19.77% respectively. Other endometrial hyperplasias reported are Swiss cheese in 1.86%, simple cystic hyperplasia in 12.31%, complex hyperplasia with or without atypia in 7% and 4.10% respectively. Malignancy is found in 2 cases. Conclusions: From this study it is well established that endometrial sampling from D and C material still remains the gold standard in diagnosis of various endometrial pathologies in low resource set-up. Thereby the further line of management can also be decided for a

  12. Experience of office hysteroscopy for diagnostics of abnormal uterine bleeding causes in puberty girls

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    Bezhanishvili Е.М.

    2016-09-01

    Full Text Available Objective: to prove the role of office hysteroscopy as an important additional method in diagnostics of puberty abnormal uterine bleeding (AUB. Material and methods. The study involved 68 patients with AUB. The average age was 13.4 years (10-17 years. The main complaint of patients concerned bleeding from genital tract during 10-45 days (on an average 28.4 days. Patients were divided into 3 groups according to the type of AUB determined based on the level of serum estradiol, physical and sexual development, internal genitalia ultrasound data: 35 hypo estrogenic girls, 24 girls with normal estrogenic and 9 girls with hyper estrogenic type of AUB. All of the girls took the office hysteroscopy. Results. When performing hysteroscopy it was revealed that there were a clear relationship between the degree of estrogenic saturation and visual picture obtained in the course of the study. Conclusion. Hysteroscopy enables maximum visualization of uterine cavity, which allows to verify the diagnosis, to reduce the "over diagnosis" rate of organic pathology, perform a differentiated approach to treatment of diseases, based on determination of estradiol level in serum and data obtained in the study.

  13. Abnormal excessive per vagina (PV) bleeding on Esmya-selective progesterone receptor modulator (SPRM) in a symptomatic patient with uterine fibroid.

    Science.gov (United States)

    Matytsina-Quinlan, Lyubov; Matytsina, Laura

    2015-05-14

    A woman in her late 40s presented with excessive per vagina (PV) bleeding and uterine fibroid. She reported excessive PV bleeding after starting Esmya; she was brought in by ambulance to the emergency department with profuse bleeding. Abnormal uterine bleeding (AUB) developed after selective progesterone receptor modulator (SPRM) administration in this symptomatic patient with uterine fibroid. The drug was withheld and surgical treatment considered. Progressive deterioration of PV bleeding after receiving SPRM led to an urgent laparoscopic total hysterectomy, which had to be postponed due to severe anaemia. Surgery took place regardless because the excessive bleeding continued. Histology revealed a 6 cm submucosal uterine fibroid (SMUF) and adenomyosis. Physicians prescribing SPRMs to stop PV bleeding should be aware of potential AUB, which could lead to urgent hysterectomy. The mechanism of action of SPRMs is not clearly understood. Awareness of the side effects of Esmya, such as AUB, must be kept in mind when administering SPRMs.

  14. The FIGO systems for nomenclature and classification of causes of abnormal uterine bleeding in the reproductive years: who needs them?

    Science.gov (United States)

    Munro, Malcolm G; Critchley, Hilary O D; Fraser, Ian S

    2012-10-01

    In November 2010, the International Federation of Gynecology and Obstetrics formally accepted a new classification system for causes of abnormal uterine bleeding in the reproductive years. The system, based on the acronym PALM-COEIN (polyps, adenomyosis, leiomyoma, malignancy and hyperplasia-coagulopathy, ovulatory disorders, endometrial causes, iatrogenic, not classified) was developed in response to concerns about the design and interpretation of basic science and clinical investigation that relates to the problem of abnormal uterine bleeding. A system of nomenclature for the description of normal uterine bleeding and the various symptoms that comprise abnormal bleeding has also been included. This article describes the rationale, the structured methods that involved stakeholders worldwide, and the suggested use of the International Federation of Gynecology and Obstetrics system for research, education, and clinical care. Investigators in the field are encouraged to use the system in the design of their abnormal uterine bleeding-related research because it is an approach that should improve our understanding and management of this often perplexing clinical condition.

  15. An international response to questions about terminologies, investigation, and management of abnormal uterine bleeding: use of an electronic audience response system.

    Science.gov (United States)

    Munro, Malcolm G; Broder, Michael; Critchley, Hilary O D; Matteson, Kristen; Haththotuwa, Rohana; Fraser, Ian S

    2011-09-01

    More than 600 registrants attended a two-hour interactive symposium on abnormal uterine bleeding (AUB) at the Federation of Gynecology and Obstetrics World Congress in Cape Town, October 2009. Nearly 250 of these participants answered multiple questions through an electronic audience responder system. The audience heard five structured presentations on clinically important and controversial aspects of AUB, including terminologies and definitions, classification of causes, mechanisms of AUB in the absence of structural lesions of the reproductive tract, the potential for a structured menstrual history, and management of heavy menstrual bleeding (HMB) in low-resource settings. Numerous demographic details were collected, and a total of 30 questions to the audience were interspersed through each of the presentations. The audience demonstrated great variation in the way the terms AUB, menorrhagia, and dysfunctional uterine bleeding (DUB) are used, and considerable majorities agreed that the terms menorrhagia and DUB should be abolished. AUB should be the overarching term to describe all symptomatic departures from normal menstruation or the menstrual cycle. HMB is a suitable replacement term for menorrhagia. DUB can be replaced by the three clinical entities comprising "nonstructural" causes of AUB. There was a high consistency across demographic subgroups in answers to most questions. Acute and chronic AUB were defined, and aspects of a classification system for causes of AUB and of a structured menstrual history were explored. Issues related to investigation and hormonal treatment of HMB in low-resource settings were explored by registrants from developing countries.

  16. Molecular and cellular causes of abnormal uterine bleeding of endometrial origin.

    Science.gov (United States)

    Critchley, Hilary O D; Maybin, Jacqueline A

    2011-09-01

    Women today may reasonably anticipate in the order of some 400 menstrual cycles over their reproductive lifespan. The endometrium is thus subject to repeat cycles of shedding and repair and notably healing of the endometrium post menses is "scarless". The local molecular and cellular mechanisms involved in post menstrual resolution of the inflammatory events associated with menstruation and endometrial repair remain to be fully determined. Menstrual complaints are common. It is highly likely that unrestrained local inflammatory events and/ or deficient repair processes within the endometrium contribute to the women's experience of heavy menstrual bleeding (HMB). The management of women with HMB may need to utilize therapeutic approaches that optimize endometrial repair processes, post menses. These approaches may be necessary in addition to current therapies that hitherto have focused on limiting the local inflammation associated with menstruation. Research endeavors thus need to focus upon the molecular and cellular causes of problematic uterine bleeding. Herein the events associated with pre-menstrual progesterone withdrawal, limitation of blood loss, the expression of vasoactive mediators and factors that may modulate vascular morphology are described. Such lines of enquiry and knowledge will be essential if novel targets for treatment of menstrual bleeding complaints, such as HMB, are to be identified.

  17. Influence and curative effect of mifepristone and desogestrel and ethinylestradiol tablets on endometrial thickness of patients with dysfunctional uterine bleeding during peri -menopausal period%米非司酮与去氧孕烯炔雌醇片对围绝经期功能性子宫出血患者子宫内膜厚度的影响及疗效观察

    Institute of Scientific and Technical Information of China (English)

    季红珍; 黄红燕; 应翩

    2014-01-01

    目的:观察米非司酮与去氧孕烯炔雌醇片对围绝经期功能性子宫出血患者子宫内膜厚度的影响及疗效。方法:选取围绝经期功能性子宫出血患者70例,随机分为观察组和对照组。观察组患者在刮宫术后5d开始口服米非司酮连用3个月。对照组患者在刮宫术后5d开始口服去氧孕烯炔雌醇片连用3个月。观察两组患者治疗前后子宫内膜厚度的变化,并比较其临床疗效及安全性。结果:治疗3个月后,两组患者子宫内膜厚度均较前明显变薄(P<0.05或P<0.01),且观察组较对照组变薄更明显(P<0.05);治疗后随访6个月,两组患者的临床总有效率比较差异无统计学意义(χ2=0.27,P>0.05)。治疗中对照组和观察组分别发生6例和5例不良反应,症状均较轻,两组不良反应发生率比较无明显统计学差异(χ2=0.11, P>0.05)。结论:米非司酮与去氧孕烯炔雌醇片治疗围绝经期功能性子宫出血患者均具有较好疗效及安全性,且前者对子宫内膜增生抑制更明显,适用于年龄较大妇女;而后者恢复正常月经周期率高,适用于较年轻有避孕要求的妇女。%To observe the influence and curative effect of Mifepristone and Desogestrel and Ethinylestradiol Tablets on endometrial thickness of patients with dysfunctional uterine bleeding during peri-meno-pausal period.Methods:70 patients with dysfunctional uterine bleeding during peri-menopausal period were se-lected and divided into observation group and control group randomly.The patients in observation group were given Mifepristone orally 5 days after the uterine curettage for 3 months,while the patients in control group were given Desogestrel and Ethinylestradiol Tablets orally 5 days after the uterine curettage for 3 months.The changes of endo-metrial thickness of patients in two groups after the medical treatment were observed and clinical curative

  18. Efficacy and satisfaction rate comparing endometrial ablation by rollerball electrocoagulation to uterine balloon thermal ablation in a randomised controlled trial.

    NARCIS (Netherlands)

    Zon-Rabelink, I.A.A. van; Vleugels, M.P.; Merkus, J.M.W.M.; Graaf, R.M. de

    2004-01-01

    OBJECTIVE: To compare two methods of endometrial ablation, hysteroscopic rollerball electrocoagulation (RBE) and non-hysteroscopic uterine balloon thermal ablation (Thermachoice trade mark ), regarding efficacy for reducing dysfunctional uterine bleeding and patients satisfaction rate. METHODS: A ra

  19. Abnormal uterine bleeding in midlife: The role of levonorgestrel intrauterine system

    Directory of Open Access Journals (Sweden)

    Osama Shawki

    2013-01-01

    Full Text Available Abnormal uterine bleeding is a common gynecological complaint affecting 10-30% of women in midlife and constitute about one-third of all outpatient gynecological visits. It adversely affects the quality of woman′s life and can lead to psychological, social, medical, and sexual problems and thus necessitating appropriate and adequate management. Different treatment modalities for such problems are available, yet the levonorgestrel intrauterine system (LNG-IUS has recently provided a good treatment option effective in treating such complaints and at the same time, having a reliable contraceptive effect which is desired by such age group. For women in their reproductive years, the LNG-IUS has become one of the most acceptable medical treatments for menorrhagia, reducing referrals to specialists, and decreasing the recourse to operative treatments. It is easy to insert, has a sustained effect, cost-effective, and well tolerated besides providing reliable contraception.

  20. Clinical efficacy of levonorgestrel and norethisterone for the treatment of chronic abnormal uterine bleeding.

    Science.gov (United States)

    Ashraf, Muhammad Nadeem; Habib-Ur-Rehman, Agha; Shehzad, Zahid; AlSharari, Shakir DakheelAllah; Murtaza, Ghulam

    2017-09-01

    To compare the clinical efficacy of levonorgestrel intrauterine system with oral norethisterone for the treatment of idiopathic chronic abnormal uterine bleeding. This cross-sectional study was conducted at Bahawal Victoria Hospital, Jubilee Female Hospital, Civil Hospital and private clinics of consultant gynaecologists in Bahawalpur, Pakistan, from March to August 2014, and comprised patients presenting with abnormal uterine bleeding. The patients were equally and randomly divided into two groups, i.e. intrauterine levonorgestrel administered (group A) and norethisterone administered (group B). Mean age, duration of the disease and parity were determined using a predesigned questionnaire. The primary outcomes of the treatments, i.e. reduction in menstrual blood loss assessed by the pictorial blood assessment chart score, were recorded before the initiation of therapy, at 3 months and at 6months of the study. SPSS 16 was used for data analysis. There were 76 subjects; 38(50%) in each group. In group A, the mean age and mean duration of the disease was 34.16±6.327 years and 6.18±2.415 years compared to 34.21±3.595 years and 6.21±2.418 years in group B. The reduction in menstrual blood loss did not differ significantly between the groups after 3 months (p= 0.321). However, levonorgestrel intrauterine system was found more effective in reducing menstrual blood loss in 36(94.73%) patients, compared to norethisterone-treated patients 28(73.68%) after 6 months of the treatment (p=0.041). The response of both the treatments was found independent of patient's age, parity and chronicity of the disease. The levonorgestrel intrauterine system was better than norethisterone with marked clinical benefit of profound reduction in menstrual blood loss.

  1. Study on Relevance of Endothelin to Abnormal Uterine Bleeding Associated with Long-Term Subdermal Implants Use

    Institute of Scientific and Technical Information of China (English)

    王清; 韩丽晖; 范慧民; 董源芬

    2001-01-01

    Objective To investigate the relationship between estradiol, progesterone and endothelin (ET) and abnormal uterine bleeding after using sub-dermal contraceptive implant Materials & methods A prospective self-control clinical trial was conducted in 29 women in the self-control group. Blood samples were obtained on four occasions across the different phases of menstrual cycle before and after using implant. A blood sample was taken for a single determination in another 59 women in the already-use implant group. Plasma of estradiol, progesterone and endothelin were determined by using radioimmunoassays (RIA) in both groups.Results The level of estradiol and progesterone had no significant differences in women before and after using implant in self-control group. The level of estradiol,progesterone had no differences between women with normal and abnormal menstrual cycle in both groups. The levels of plasma endothelin (ET) in women with abnormal bleeding pattern were higher than women with normal bleeding pattern, but difference was not significant. Women with abnormal bleeding pattern had significantly higher ET level than that in women with normal bleeding pattern before using implants,especially in early-proliferative phase and mid-proliferative phase. the level of plasma endothelin was significantly higher in women with disturbed bleeding pattern than that in normal women in the already-use group.Conclusion High serum concentrations of ET are likely to be correlated with abnormal uterine bleeding in long-term subdermal contraceptive implants users.

  2. Arterial hemorrhage from cesarean scar: a rare cause of recurring massive uterine bleeding and successful surgical management.

    Science.gov (United States)

    Wang, Chun-Feng; Hu, Min

    2015-02-01

    Abnormal uterine bleeding and other gynecologic complications associated with a previous cesarean section scar are only recently being identified and described. Herein we report a rare case of a woman with recurring massive uterine bleeding after 2 cesarean sections. Curettage and hormone therapy were unsuccessfully used in an attempt to control the bleeding. After she was transferred to our hospital, she had another episode of vaginal bleeding that was successfully managed with oxytocin and hemostatic. Diagnostic hysteroscopy performed under anesthesia revealed an abnormal transected artery in the cesarean section scar with a thrombus visible. In the treatment at the beginning of laparoscopic management, we adopted temporary bilateral uterine artery occlusion with titanium clips to prevent massive hemorrhage. Secondly, with the aid of hysteroscopy, the bleeding site was opened, and then the cesarean scar was wedge resected and stitched interruptedly with 1-0 absorbable sutures. The postoperative recovery was uneventful. It would seem that the worldwide use of cesarean section delivery may contribute to the risk of gynecologic disturbances including some unrecognized and complex conditions as seen in this case.

  3. CYTO - HISTO CORRELATION OF ATYPICAL GLANDULAR CELLS OF ENDOMETRIAL ORIGIN ON CERVICAL CYTOLOGY IN ABNORMAL UTERINE BLEEDING CASES

    Directory of Open Access Journals (Sweden)

    Lopa Mudra

    2015-02-01

    Full Text Available BACKGROUND: An association has been reported with presence of endometrial cells on cervical smears and clinically significant uterine lesions. Hence for early detection of endometrial pathology , t he 2001 Bethesda system has suggested the mandatory reporting of presence of any atypical endometrial cells regardless of age and menstrual status and out of phase normal looking endometrial cells in women aged 40 years or more. OBJECTIVES: To assess the association between atypical glandular cells of endometrial origin in cervical cytology and histopathological findings in abnormal uterine bleeding cases . SETTINGS AND DESIGN : The study was conducted at JSS hospital , Mysore in the department of pathology. This was a descriptive type of study. The sample was collected fro m patients attending the gynecology OPD with the complaints of abnormal uterine bleeding in JSS hospital . MATERIALS AND METHODS : Smears for cervical cytology are collected using either pap smear or manual liquid based smear from 82 patients in the age grou p of 20 - 75 years with complaints of abnormal bleeding history. The results of cervical cytology were compared and confirmed with the endometrial pathology. RESULTS : Out of 82 abnormal uterine bleeding cases 14 showed atypical endometrial cells. On follow u p of these cases , the results indicated an association between atypical endometrial cells in cervical cytology with endometrial carcinoma in 8 cases (60% , 1 case with complex hyperplasia with atypia (10% . CONCLUSION : Presence of atypical endometrial cell s in all women with abnormal uterine bleeding has considerable clinical implications & further diagnostic evaluation by endometrial sampling is of utmost importance.

  4. Comparative effectiveness and impact on health-related quality of life of hysterectomy vs. levonorgestrel intra-uterine system for abnormal uterine bleeding.

    Science.gov (United States)

    Cozza, G; Pinto, A; Giovanale, V; Bianchi, P; Guarino, A; Marziani, R; Frega, A; Caserta, D

    2017-05-01

    To compare hysterectomy and levonorgestrel intra-uterine system (LNG-IUS) for the treatment of abnormal uterine bleeding (AUB) and iron deficiency anemia. Retrospective study evaluating quality of life, sexual function, satisfaction and blood hemoglobin concentration improvement in 60 pre-menopausal women treated with hysterectomy or LNG-IUS. All analysis was performed with statistical software SPSS 21.0 (SPSS Inc., Chicago, IL, USA). Despite superior control of bleeding and dysmenorrhea observed after hysterectomy, LNG-IUS showed similar impact on blood hemoglobin levels, quality of life, satisfaction and sexual function resulting more cost-effective. In the absence of contraindications, LNG-IUS should always be the first therapeutic choice for chronic AUB. Surgical treatment must be considered as an "extrema ratio".

  5. The need for investigations to elucidate causes and effects of abnormal uterine bleeding.

    Science.gov (United States)

    Munro, Malcolm G; Heikinheimo, Oskari; Haththotuwa, Rohana; Tank, Jaydeep D; Fraser, Ian S

    2011-09-01

    This article describes a modern perspective on the basic investigations for abnormal uterine bleeding (AUB) in low-resource settings compared with a much more detailed approach for high-resource settings, bearing in mind issues of effectiveness and cost effectiveness. AUB includes any one or more of several symptoms, and it should be evaluated for the characteristics of the woman's specific bleeding pattern, her "complaint" and the presence of other symptoms (especially pain), the impact on several aspects of body functioning and lifestyle, and the underlying cause(s), especially cancer. Ideally, the evaluation is comprehensive, considering each of the potential etiological domains defined by the International Federation of Gynecology and Obstetrics PALM-COEIN system for the classification of causes. However, the detail of the questions and the extent of investigations will be significantly influenced by the technologies available and the time allotted for a consultation. In general, investigations should be performed only if they will make a material difference to the management approaches that can be offered. This should be an important consideration when a range of costly high-technology tests is accessible or when certain tests only have limited availability.

  6. Diagnostic value of saline contrast sonohysterography comparing with hysteroscopy for detecting endometrial abnormalities in women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Farzaneh Goharzad

    2011-01-01

    Full Text Available Background: Abnormal uterine bleeding is a common presentation of uterine abnormalities among premenopausal and postmenopausal women.Objective: To evaluate and compare the diagnostic accuracy of saline contrast sonohysterography and hysteroscopy for detecting the cause of abnormal uterine bleeding.Materials and Methods: A total of 65 women with abnormal uterine bleeding were enrolled in this study. A prior saline contrast sonohysetrography followed by a hysteroscopy was performed in all cases. Sensitivity, specificity, positive and negative predictive value and test accuracy were calculated.Results: As the most common abnormality, SCSH showed hyperplasia in 19 patients while hysteroscopy diagnosed polyp in 15 cases. A sensitivity of 73.3%, 71.4% and 90.9% were reported for polyp, hyperplasia and submucous myoma respectively whereas the specificity was calculated 96% for polyps, 82.3% for hyperplasia and 90.7% for submucous myoma.Conclusion: Comparing with hysteroscopy, sonohysterography showed a high sensitivity and specificity for detecting submucous myoma but not for endometrial polyp and endometrial hyperplasia

  7. Comparison of two modalities: a novel technique, 'chromohysteroscopy', and blind endometrial sampling for the evaluation of abnormal uterine bleeding.

    Science.gov (United States)

    Alay, Asli; Usta, Taner A; Ozay, Pinar; Karadugan, Ozgur; Ates, Ugur

    2014-05-01

    The objective of this study was to compare classical blind endometrial tissue sampling with hysteroscopic biopsy sampling following methylene blue dyeing in premenopausal and postmenopausal patients with abnormal uterine bleeding. A prospective case-control study was carried out in the Office Hysteroscopy Unit. Fifty-four patients with complaints of abnormal uterine bleeding were evaluated. Data of 38 patients were included in the statistical analysis. Three groups were compared by examining samples obtained through hysteroscopic biopsy before and after methylene blue dyeing, and classical blind endometrial tissue sampling. First, uterine cavity was evaluated with office hysteroscopy. Methylene blue dye was administered through the hysteroscopic inlet. Tissue samples were obtained from stained and non-stained areas. Blind endometrial sampling was performed in the same patients immediately after the hysteroscopy procedure. The results of hysteroscopic biopsy from methylene blue stained and non-stained areas and blind biopsy were compared. No statistically significant differences were determined in the comparison of biopsy samples obtained from methylene-blue stained, non-stained areas and blind biopsy (P > 0.05). We suggest that chromohysteroscopy is not superior to endometrial sampling in cases of abnormal uterine bleeding. Further studies with greater sample sizes should be performed to assess the validity of routine use of endometrial dyeing. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  8. LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM AS AN ALTERNATIVE THERAPY IN ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    Kunjamma Roy

    2017-05-01

    Full Text Available BACKGROUND Abnormal uterine bleeding is one of the most frequent reasons for gynaecological consultation, occurring in approximately 30% of women of reproductive age. Menorrhagia by definition implies a menstrual blood loss equal to or greater than 80 mL. Many women seek consultation for bleeding episodes of less than this amount because of the stress associated with it. Most frequently used medications are combinations of prostaglandin synthetase inhibitors and antifibrinolytic drugs, nonsteroidal antiinflammatory drugs, oral progesterone like Norethisterone or medroxyprogesterone acetate and combined oral contraceptives. The usual treatment for women with menorrhagia not desiring further pregnancies and those not responding to medical managements is either hysterectomy or endometrial ablation. Endometrial ablation less commonly performed due to low success rate. Levonorgestrel intrauterine system (LNG-IUS is a new modality in the treatment of AUB. The objective of this study is to evaluate the use of Levonorgestrel intrauterine system as a treatment for women with menorrhagia. MATERIALS AND METHODS This is a prospective interventional comparative study conducted on women with abnormal uterine bleeding. The duration of study was from March 2012 to October 2013. The respondents include those outpatients attending Gynaecology Department of Government Medical College, Kottayam with menorrhagia. The samples size was 50 of which 25 were in experimental groups and remaining 25 in control group. Experimental group were given LNG IUS for menorrhagia and the remaining 25 patients were given oral progestins for heavy menstrual bleeding. In order to make a comparison of the impact of the two different kinds of interventions, the Hb level as well as the amount of blood loss were systematically estimated at frequent intervals. Accordingly, these measurements were carried for the said both groups at the commencement of research study and thereafter at an

  9. Comparative Study of Ormeloxifene and Medroxyprogesterone Acetate in Abnormal Uterine Bleeding.

    Science.gov (United States)

    Godha, Zeepee; Mohsin, Zehra; Hakim, Seema; Wasim, Saeeda

    2016-10-01

    The purpose of this study was to compare the effects of ormeloxifene with medroxyprogesterone acetate in patients with abnormal uterine bleeding. 440 Patients were divided into two groups. In group A, ormeloxifene was given at the dosage of 60 mg twice a week for 3 months followed by 60 mg once a week for 1 month. In group B, medroxyprogesterone acetate was given at the dosage of 10 mg twice a day from day 5 to day 25 of the menstrual cycle. At follow-ups, patients were assessed for PBAC score, endometrial thickness by USG, hemoglobin level, and the side effects of drug therapy. There were 240 patients in group A and 200 in group B. Reduction in median PBAC score was 79.4 % in group A and 75 % in group B after 4 months of treatment. The mean duration of bleeding reduced to 4.8 from 9 in group A and 5 from 8.7 in group B. Mean hemoglobin was increased from 8.6 to 9.8 g % in group A and from 8.7 to 9.9 g % in group B; endometrial thickness was reduced from 7.7 mm to 6.8 mm in group A and from 7.4 mm to 6.9 mm in group B. We conclude from this study that ormeloxifene should be considered the first choice in the management of AUB, especially in the perimenopausal age group where amenorrhea is acceptable.

  10. 功能失调性子宫出血的非激素类药物止血及支持治疗%The hemostasis and supporting therapy by the non-sexual hormone in the treatment of dysfunctional uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    乔杰; 李蓉

    2006-01-01

    功能失调性子官出血(dysfunctional uterine bleeding,DUB)其病理基础是中枢-下丘脑-垂体-卵巢轴神经内分泌调控失常,也可以是卵巢或子宫局部调控机制异常所致。DUB可发生于月经初潮至绝经期前的任何年龄阶段,但以青春期和绝经过渡期发病率较高,约50%发生在绝经过渡期,20%发生在青春期。根据病因分为无排卵型DUB和排卵型DUB两类,以无排卵型为主。基于DUB的定义,诊断本病时需除外妊娠、医源性因素、全身性疾病和生殖道的器质性疾病。

  11. Scientific evaluation of medicinal plants used for the treatment of abnormal uterine bleeding by Avicenna.

    Science.gov (United States)

    Mobli, Masumeh; Qaraaty, Marzieh; Amin, Gholamreza; Haririan, Ismaeil; Hajimahmoodi, Mannan; Rahimi, Roja

    2015-07-01

    Abnormal uterine bleeding (AUB) is one of the prevalent gynecological disorders that cause considerable morbidity and management of that plays an important role in protecting women's health. This review focuses on medicinal plants mentioned by Avicenna, a great Iranian philosopher and physician (A.D. 980-1037), in his book Canon for treatment of AUB. Medicinal plants mentioned in Canon for treatment of AUB were elicited and searched in electronic databases including PubMed, Scopus, Google Scholar and Cochrane library to find studies that confirmed their efficacy. Data were collected for the years 1980-2014. The findings included 23 plants belonging to 18 families. Scientific findings have revealed that these plants control AUB through four mechanisms of action including inhibition of inflammatory process, inhibition of prostaglandins production, antiproliferative activity on human cervical cancer cells (HeLa), and estrogenic activity. All of the plants exhibited anti-inflammatory activity in vitro and/or in vivo. Cuscuta chinensis and Portulaca oleracea exhibited estrogenic activity. Boswellia carteri, Lens culinaris, Myrtus communis, Polygonum aviculare, Pistacia lentiscus, and Punica granatum have revealed inhibitory activity on biosynthesis of prostaglandins. Some of the mentioned plants including: Ceratonia siliqua, Cuscuta chinensis, Cuscuta epithymum, Cydonia oblonga, Paeonia sp., Portulaca oleracea, Solanum nigrum, Rumex acetosa and Onopordum acanthium have shown antiproliferative activity on HeLa cells. Investigation of traditional Iranian medicine literatures can lead to the identification of effective natural medicines for the management of AUB; however, conclusive confirmation of the efficacy and safety of these treatments needs more evaluations.

  12. Uterine dysfunction in biglycan and decorin deficient mice leads to dystocia during parturition.

    Directory of Open Access Journals (Sweden)

    Zhiping Wu

    Full Text Available Cesarean birth rates are rising. Uterine dysfunction, the exact mechanism of which is unknown, is a common indication for Cesarean delivery. Biglycan and decorin are two small leucine-rich proteoglycans expressed in the extracellular matrix of reproductive tissues and muscle. Mice deficient in biglycan display a mild muscular dystrophy, and, along with mice deficient in decorin, are models of Ehlers-Danlos Syndrome, a connective tissue anomaly associated with uterine rupture. As a variant of Ehlers-Danlos Syndrome is caused by a genetic mutation resulting in abnormal biglycan and decorin secretion, we hypothesized that biglycan and decorin play a role in uterine function. Thus, we assessed wild-type, biglycan, decorin and double knockout pregnancies for timing of birth and uterine function. Uteri were harvested at embryonic days 12, 15 and 18. Nonpregnant uterine samples of the same genotypes were assessed for tissue failure rate and spontaneous and oxytocin-induced contractility. We discovered that biglycan/decorin mixed double-knockout dams displayed dystocia, were at increased risk of delayed labor onset, and showed increased tissue failure in a predominantly decorin-dependent manner. In vitro spontaneous uterine contractile amplitude and oxytocin-induced contractile force were decreased in all biglycan and decorin knockout genotypes compared to wild-type. Notably, we found no significant compensation between biglycan and decorin using quantitative real time PCR or immunohistochemistry. We conclude that the biglycan/decorin mixed double knockout mouse is a model of dystocia and delayed labor onset. Moreover, decorin is necessary for uterine function in a dose-dependent manner, while biglycan exhibits partial compensatory mechanisms in vivo. Thus, this model is poised for use as a model for testing novel targets for preventive or therapeutic manipulation of uterine dysfunction.

  13. 前列腺素E2、环加氧酶2在功能失调性子宫出血和子宫内膜癌患者血浆中的表达及意义%The Expression and Significance of Prostaglandin-E2 and Cyclooxygenase-2 in the Plasma of Patients with Dysfunctional Uterine Bleeding or Endometrial Carcinoma

    Institute of Scientific and Technical Information of China (English)

    赵江红; 胡远飞; 何荣霞; 杨慧; 王海燕; 丁燕

    2015-01-01

    目的:探讨前列腺素E2(PGE2)与环加氧酶2(COX-2)在功能失调性子宫出血(DUB)和子宫内膜癌( EC)患者血浆中的表达及意义。方法选取2011年9月至2012年6月兰州大学第二医院妇产科及甘肃省肿瘤医院妇瘤科就诊的围绝经期DUB患者40例及EC患者20例为研究对象。选取本院同期体检的20例健康妇女志愿者作为正常对照组。采用酶联免疫吸附测定(ELISA)法测定各组外周血浆中PGE2及COX-2的表达。结果 DUB组和EC组最近阴道流血天数和出血量均较正常对照组高,差异有统计学意义( P<0.01);DUB 组外周循环中 COX-2较正常对照组明显升高, EC组患者外周循环中的COX-2及PGE2较正常对照组明显升高(P<0.01)。结论在 DUB 及EC的发展过程中,外周循环中PGE2及COX-2不影响DUB的发展,而外周PGE2及COX-2对EC发展的影响有待进一步深入研究。%Objective To study the expression and clinical significance of prostaglandin-E2 ( PGE2 ) and cyclooxygenase-2(COX-2)in the plasma of patients with dysfunctional uterine bleeding(DUB) or endometrial carcinoma( EC) .Methods We recruited 20 normal women as control group,40 DUB group patients and 20 EC patients as trial group in Department of Gynecology and Obstetrics of Lanzhou University Second Affil-iated Hospital and Gansu Province Tumor Hospital from Sep.2011 to Jun.2012.Then the level of PGE2 and COX-2 in peripheral plasma of the patients were detected by enzyme-linked immunoadsordent assay ( ELISA) .Results Recent days of vaginal bleeding and bleeding volume of DUB group and EC group were higher than normal control group,the difference was statistically significant(P <0.01).Peripheral blood COX-2 of DUB group was significantly higher than the normal control,COX-2 and PGE2 of group EC were significantly increased than the control group(P <0.01).Conclusion Circulating PGE2 and COX-2 do influence the development of DUB

  14. Analysis of 100 cases of abnormal uterine bleeding and submucosal myoma by hysteroscopy%宫腔镜治疗异常子宫出血及黏膜下肌瘤100例分析

    Institute of Scientific and Technical Information of China (English)

    谭娟; 梁明霞

    2015-01-01

    Objective: To investigate the clinical effect of hysteroscopy in the treatment of abnormal uterine bleeding and submucosal myoma.Methods:100 cases of abnormal uterine bleeding patients with abnormal uterine bleeding were treated by hysteroscopy and the effect of treatment was analyzed.Results: 60 cases of dysfunctional uterine bleeding, including 50 cases of endometrial hyperplasia, 8 cases of endometrial polyps, submucous myoma of uterus in 32 cases. Dysfunctional uterine bleeding in patients with endometrial hyperplasia excised tissue weight for (6.85 + 1.32) g, endometrial polyp is (28.65 + 516 g) and uter-ine submucous myoma (9.65 + 1.68) g. Postoperative follow-up of patients with dysfunctional uterine bleeding rate was 93.33%. The amount of the rest of the disease patients were significantly reduced or normal, the menstrual cycle shortened or normal, the efficiency was 100%.Conclusion:Hysteroscopy for a uterine bleeding and submucosal fibroids clinical curative effect, small trau-ma, postoperative quick recovery, and pathological examination combined science to improve the accuracy of diagnosis, which is worthy of clinical popularization and application.%目的:探讨宫腔镜治疗异常子宫出血及黏膜下肌瘤的临床疗效。方法通过对我院收治的100例异常子宫出血患者行宫腔镜电切术,分析其治疗效果。结果功血60例,其中50例为子宫内膜增生,子宫内膜息肉为8例,子宫黏膜下肌瘤为32例。功血中子宫内膜增生患者切除组织重量为(6.85±1.32)g,子宫内膜息肉为(28.65±5.16)g,子宫黏膜下肌瘤(9.65±1.68)g。术后随访功血患者的有效率为93.33%。其余类型疾病的患者术后经量均明显减少或正常,月经周期缩短或者正常,有效率为100%。结论宫腔镜用于一场子宫出血及黏膜下肌瘤临床疗效确定,创伤小,术后恢复快,与病理检查相结合科提高诊断的准确性,值得临床推广与应用。

  15. THE CHANGES OF COMPLEMENT C3, IMMUNOGLOBULINS AND HISTAMINE CONCENTRATIONS IN THE MENSTRUAL BLOOD OF IUD USERS WITH ABNORMAL UTERINE BLEEDING

    Institute of Scientific and Technical Information of China (English)

    ZHANGPeng-Cheng; FANRui-Qin; GAOYu

    1989-01-01

    Abnormal uterine bleeding aRer insertion of IUD was caused by various factors. In order to explore the mechanism of bleeding, the changcs of complement C3, IgG, IgA, IgM and histamine concentration in the menstrual blood of IUD users were analyzed. Participants

  16. Off ice Hysteroscopy in Patients with Abnormal Uterine Bleeding and Normal Transvaginal Sonography

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    Mojgan Barati

    2008-01-01

    Full Text Available Background: Abnormal uterine bleeding (AUB is one of the most common clinical problemsin gynecology. Transvaginal sonography (TVS and hysteroscopy are two diagnostic methods forpatients with AUB. For most of the patients with AUB, diagnostic hysteroscopy can be done inclinic with minimal discomfort and much lower expense than operative room.Materials and Methods: In our clinical trial study, from March 21, 2005 to March 20, 2007,patients with AUB in Ahwaz Imam Khomayni hospital, after history and physical examinationsunderwent TVS. Of those, 147 patients with normal TVS entered the study and were considered foroutpatient hysteroscopy. Patients with endometrial cavity lesion were scheduled for operation room,and those with empty endometrial cavity aspiration biopsy were done outpatiently. Specimens weresent to pathologist for examination.Results: All the patients were divided into three groups: group 1 or minority was under 30 yearsold (7 women, group 2 was 30-40 years, and group 3 or majority was over 40 years old (96women. 115 patients (78.2% had normal and 32 patients (21.8% had abnormal hysteroscopicresults. 116 patients (78.8% had normal and 31 patients (21.2% had abnormal pathologic results;moreover, cervical canal polyp was the most common lesion hysteroscopically and pathologicallyin all groups.Conclusion: Of 147 patients (100% with AUB and normal TVS, 32 patients (21.8% wereabnormal hysteroscopically. Cervical canal polyps may be missed by transvaginal sonography, butcan be diagnosed by hysteroscopy. In patients with AUB and normal TVS, hysteroscopy can beused as the second step.

  17. Menstrual cycle distribution of uterine natural killer cells is altered in heavy menstrual bleeding.

    Science.gov (United States)

    Biswas Shivhare, Sourima; Bulmer, Judith N; Innes, Barbara A; Hapangama, Dharani K; Lash, Gendie E

    2015-11-01

    Heavy menstrual bleeding (HMB) affects 30% of women of reproductive age and significantly interferes with quality of life. Altered endometrial vascular maturation has been reported in HMB and recurrent miscarriage, the latter associated with increased uterine natural killer (uNK) cell numbers. This study compared endometrial leukocyte populations in controls and women with HMB. Formalin-fixed paraffin-embedded endometrial biopsies from controls (without endometrial pathology) and HMB were immunostained for CD14 (macrophages), CD56 (uNK cells), CD83 (dendritic cells), FOXP3 (regulatory T cells/Tregs), CD3 and CD8 (T cells). Leukocyte numbers were analysed as a percentage of total stromal cells in five randomly selected fields of view in the stratum functionalis of each sample. In control women across the menstrual cycle, 2-8% of total stromal cells were CD3(+) cells, 2-4% were CD8(+) T cells and 6-8% were CD14(+) macrophages. Compared with controls, CD3(+) cells were reduced during the mid-secretory phase (4%, P<0.01) and increased in the late secretory phase (12%, P=0.01) in HMB. CD83(+) dendritic cells and FOXP3(+) Tregs were scarce throughout the menstrual cycle in both groups. In controls, 2% of stromal cells in proliferative endometrium were CD56(+) uNK cells, increasing to 17% during the late secretory phase. In HMB, CD56(+) uNK cells were increased in the proliferative (5%, P<0.01) and early secretory (4%, P<0.02) phases, but reduced (10%, P<0.01) in the late secretory phase. This study demonstrates dysregulation of uNK cells in HMB, the functional consequence of which may have an impact on endometrial vascular development and/or endometrial preparation for menstruation.

  18. Correlation between Endometrial Endothelin and Irregular Uterine Bleeding after Implant Insertion

    Institute of Scientific and Technical Information of China (English)

    韩丽晖; 董源芬; 王清; 龚泉; 谢琤; 范慧民

    2002-01-01

    Objective To investigate endometrial endothelin type Ⅰ (ET-Ⅰ) level during menstru-al cycle and its change after implant insertionfrom 27 healthy women using radio-immunity technology. ET-Ⅰ level in proliferationperiod and secretion period were measured and compared. ET-Ⅰ level before and 3 to 7months after implant insertion were also compared. The side effect of long term use ofimplant was also study by measuring the ET-Ⅰ level among women 24 to 36 monthsafter implant insertion.Results ET-Ⅰ level in proliferation period was 2. 76± 1.25 pg/mg, which was sig-nificantly(P< 0. 05) lower than that in secretion period (3. 90±1.30 pg/mg). ET-Ⅰlevel in 14 women, from whom samples before and 3 to 7 months after implant insertionwere obtained, were3.38±1. 17 pg/mg and 10. 86± 3. 93 pg/mg respectively, withsignificant statistical difference (P< 0. 001). At different periods of implant inser-tion, the average ET-Ⅰ level was 10. 86± 3. 93 pg/mg within 2 to 3 years after im-plant insertion, significantly higher than that of women have implant insertion formore than 24 to 36 months year.Conclusion ET-Ⅰ level changes periodically. ET-Ⅰ level 3 to 7 months after implantinsertion was significantly higher than that before insertion, and drops as time goes.The increase of ET-Ⅰ level is possibly related to irregular uterine bleeding after the useof implant.

  19. COMPARATIVE STUDY BETWEEN THE OUT COME OF ONLY DILATATION & CURETTAGE AND THE OUTCOME OF ORMELOXIF ENE AFTER DILATATION AND CURETTAGE IN DYSFUNCTIONAL UTE RINE BLEEDING

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    Parveen Rajora

    2013-02-01

    Full Text Available INTRODUCTION: Even a single drop of blood is a boon for anemic wom en. Menstruation sets in approximately between the age of 12 and 14 years and persists throughout the reproductive period of life with an av erage rhythm of 28 days and duration of flow between 4-6 days. A normal menstrual blood los s is 50-80ml and does not exceed 100ml. 1 Menstrual dysfunction is a cause of inconvenience, discomfort and disruption of a healthy lifestyle and affects many millions of wome n in both the developed and developing world. Abnormal uterine bleeding is one of the most common problem that challenge the Gynecologists. A correct diagnosis is essential bec ause of the consequences of bleeding and the implications of the treatment.

  20. STUDY OF ADOLESCENT ABNORMAL UTERINE BLEEDING (AUB AND ITS OUTCOME - IN TERTIARY CENTRE K.I.M.S. KARAD

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    Manisha M

    2015-08-01

    Full Text Available BACKGROUND/AIMS: Menstruation is a normal part of adolescence, but for girls with excessive uterine bleeding, it can be associated with significant morbidity . Menstrual disorders and abnormal uterine bleeding (AUB are among the most frequent gynaecological complaints of adolescents . AUB has been defined in the past by a variety of terms and there have been inconsistencies and lack of categorization of various potential causes of AUB. To have standard nomenclature internationally, palm coein Classification of AUB was introduced in 2011 by FIGO Menstrual disorder group for non - pregnant, reproductive age women. In the present study we ai med to evaluate cases of adolescent AUB by investigations and palm coein approach. METHOD S : The study was conducted prospectively on all adolescent girls attending OPD at Krishna institute of medical sciences Karad, Menstrual complaints were classified according to palm coein approach after a thorough history taking, examination and investigation s. RESULTS: Prevalence of menstrual disorders in adolescents was 64.5%, of which 86.90% were attributed to AUB. Palm coein approach was applied to AUB cases. Ovulatory disorders (AUB - 0 formed a major chunk of adolescent AUB (96.90%, of which 60.60% were due to immaturity of Hypothalamic Pituitary Ovarian axis, 27.87% due to polycystic ovarian syn drome and 8.48% due to Thyroid disorders. Contribution of coagulopathy to AUB was 2.42%. Polyps and leiomyoma were seen in 1.2% and 0.6% of cases respectively. A ll cases were classified when palm coein was applied. CONCLUSION: AUB in adolescents can also be classified by palm coein to standardize nomenclature and abandonment of terms like menorrhagia, metrorrhagia and dysfunc tional uterine bleeding and treated it successfully.

  1. [Diagnostic evaluation of endouterine manual aspiration for the detection of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding].

    Science.gov (United States)

    Suarez Rincón, A E; Arévalo Lagunas, I; Cerpa Batres, M G; Díaz Rodríguez, M C

    2000-01-01

    The objective was to determinate the diagnostic value of manual vacuum aspiration with Karman cannula (MVA) for the detection of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding. Fifty patients with abnormal uterine bleeding were evaluated with MVA prior to dilatation and curettage (D&C). The needing of cervical dilatation was noted. A matched analysis of the histological reports with Wilcoxon contrast test was performed. In order to calculate the diagnostic value, the histological examination of the tissue recollected by D&C was defined as gold-standard. Sensitivity, specificity, pre-test probability (prevalence), post-test probabilities (predictive values) and likelihood-ratios were calculated. No significant difference between either histological reports in matched analysis and the insufficient samples proportion was detected. Cervical dilatation was performed more frequently to D&C (p = 0.0002). The pre-test probability (prevalence) of endometrial hyperplasia/cancer was 20%. Two cases of hyperplasia were not detected by MVA (negative false 20%). The endometrial biopsy for MVA showed a sensitivity of 71% and specificity 93%. The post-test probabilities for an abnormal and normal biopsy (positive and negative predictive values) were 62.5% and 95.2%, respectively. The corresponding likelihood-ratios were 10.23 and 0.3, respectively. The endometrial biopsy for MVA has a high diagnostic value, similar to D&C, in the detection of endometrial hyperplasia/cancer in patients with abnormal uterine bleeding with the advantage to be an office procedure without either risks and costs of D&C.

  2. 异常子宫出血药物治疗进展%Progress in Medical Treatment of Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    胡燕军(综述); 朱依敏; 黄荷凤(审校)

    2013-01-01

    国际妇产科联盟月经疾病组(FMDG)提出异常子宫出血(abnormal uterine bleeding,AUB)是涵盖月经紊乱的术语,应摒弃月经过多和功能失调性子宫出血(dysfunctional uferine bleading,DUB)称谓。月经量过多术语推荐用严重出血(heavy menstrual bleeding,HMB)替代月经过多。FMDG把AUB按照病因的首字母分为9个系统,即PALM-COEIN。其中COEIN为非器质性因素引起的AUB,首选为药物治疗,包括抗纤溶制剂、非甾体类抗炎药(NSAIDs)、避孕药、孕激素和左炔诺孕酮宫内缓释系统(LNG-IUS)等。LNG-IUS是最有效的治疗特发性HMB的方法之一,可以长期有效地控制月经量。去氨加压素(desmopressin,DDAVP)在治疗凝血功能障碍患者HMB时有效。二甲双胍可调节多囊卵巢综合征(PCOS)妇女月经,并对子宫内膜增生性疾病孕激素抵抗的患者有治疗作用。另外,四相口服避孕药、氨甲环酸的新制剂、丹那唑的阴道制剂和阴道避孕环等是治疗HMB的可供选择新方法。%FIGO Menstrual Disorders Group (FMDG) put forward that the abnormal uterine bleeding(AUB) was a suitable overarching term for the symptom of disturbed menstrual bleeding,and that the terms’menorrhagia’ and ’disfunctional uterine bleeding (DUB)’ should be discarded . The heavy menstrual bleeding (HMB) should be used to replace the term of menorrhagia for the symptom of excess menstrual bleeding. FMDG classified the AUB according to the causes using the PALM-COEIN system. Medical management should be the initial treatment for AUB of COEIN causes, including multi-dose regimens of combined oral contraceptives or oral progestins,NSAIDs,tranexamic acid and the levonorgestrel-releasing intrauterine system (LNG-IUS). LNG-IUS is the most effective medical treatment for idiopathic HMB. Desmopressin is effective in management of HMB in women with bleeding disorders. Metformin is applied to regulate

  3. Status of carcinoma cervix and high risk HPV 16 DNA in women with postmenopausal uterine bleeding (PMB

    Directory of Open Access Journals (Sweden)

    Veena Kashyap

    2014-09-01

    Full Text Available Postmenopausal bleeding (PMB is a discharge that occurs following the firm diagnosis of menopause, which is at least six months from the end of women’s menstrual cycle but not to be confused with infrequent or irregular periods occurring around the time of menopause. It is a common problem representing 5% of all gynecology outpatient attendances which are to eliminate endometrial cancer as the cause of bleed and PMB should be reported urgently to the gynecologist. Uterine bleeding in postmenopausal women is highly indicative clinically of malignancy originating from cervix or endometrium and Human papilloma virus (HPV is one of the causative agent for carcinoma cervix. Incidence of carcinoma cervix increases with the age in mature women, however, incidence of human papillomavirus (HPV infection reduces as menopause sets in. The presence of the virus could be used as an early indication of disease potential. Because the Pap test can only detect clinical evidence of cervical disease, molecular-based diagnostic tools are being used more frequently to detect the virus before abnormal cell growth can be observed. This study was aimed to determine the status of cervical cancer and HPV 16 DNA positivity in relation to postmenopausal bleeding.

  4. 围绝经期异常子宫出血200例的临床与病理分析%Clinical and pathological analysis of 200 cases of perimenopausal abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    马辉平; 吕淑兰; 周扬

    2013-01-01

    目的 探讨围绝经期异常子宫出血的发病原因及病理变化.方法 对200例39~55岁围绝经期异常子宫出血患者的临床及病理资料进行回顾性分析,总结不同年龄组病理类型分布特点,分析各种病理类型的临床相关因素.结果 200例患者中,功能失调性子宫出血占74.5%,其中39~45岁占56.2%;子宫内膜不典型增生占7.5%,其中51~55岁占40%;子宫内膜癌占5.0%,其中51~55岁占60.0%;其他良性病变占13%.患者的年龄、出血时间、高危因素与子宫内膜病理分型存在关联性(χ2值分别为37.32、2 118.45、10.04,均P<0.01).结论 功能失调性子宫出血是围绝经期39~50岁年龄阶段异常子宫出血的主要原因,但51~55岁年龄阶段在子宫内膜不典型增生及子宫内膜癌发病比例较高.存在高危因素的围绝经期异常子宫出血妇女其发生子宫内膜癌的危险性明显高于无高危因素的患者,随着年龄增大、出血时间延长,子宫内膜癌发病危险性增加.%Objective To explore the causes and pathological changes of perimenopausal abnormal uterine bleeding. Methods Retrospective analysis was conducted to analyze the clinical and pathological data of 200 cases aged 39-55 years old with perimenopausal abnormal uterine bleeding. Distribution characteristics of pathological types of different age group were summarized and clinical related factors of each pathological type were analyzed. Results In 200 patients, patients with dysfunctional uterine bleeding occupied 74. 5% , among whom 56. 2% were patients aged 39-45 years old. Patients with endometrial atypical hyperplasia occupied 7. 5% , and those aged 51-55 years old accounted for 40%. Patients with endometrial carcinoma accounted 5. 0% , among whom 60. 0% were aged 51-55 years old. Other benign lesions accounted for 13%. Age, bleeding time and risk factors were correlated with endometrial pathological type(χ2 value was 37.32, 2 118.45 and 10. 04, respectively, all P

  5. Diagnostic Value of Endometrial Sampling with Pipelle Suction Curettage for Identifying Endometrial Lesions in Patients with Abnormal Uterine Bleeding

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    F Behnamfar

    2004-06-01

    Full Text Available Background: While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C with pipelle suction curettage. Methods: This study was quasiexperimental on 200 pre and postmenopausal patients with abnormal uterine bleeding who refered to Shabihkhani hospital in Kashan, Iran. Endometrial sampling was performed in all patients with two methods namely pipelle and D&C. A pathologist examined the samples each having a predetermined code. Results: The mean age of subjects was 46.2 ±6.2 years, minimum age was 35 years and the maximum was 70 years. The various pathological lab findings were proliferative endometrium, secretory endometrium, athrophic, decidua, cystic and adenomatous hyperplasia. The reports were the same in two methods except for 2 cases where they were different: secretory endometrium with D&C but cystic hyperplasia in pipelle method. Conclusions: The result of our study shows the comparability of obtaining endometrial sample by pipelle with D&C. Due to comfort and convenience of patients in pipelle methode especially in the office setting which does not need anesthesia, pipelle method can easily be employed instead of D&C. Keywords: Pipelle Suction Curette, Dilatation and Curettage, Premenopause, Postmenopause.

  6. Different Bleeding Patterns with the Use of Levonorgestrel Intrauterine System: Are They Associated with Changes in Uterine Artery Blood Flow?

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    Carlo Bastianelli

    2014-01-01

    Full Text Available Objective. Evaluate if different bleeding patterns associated with the use of the levonorgestrel intrauterine system (LNG-IUS are associated with different uterine and endometrial vascularization patterns, as evidenced by ultrasound power Doppler analysis. Methodology. A longitudinal study, with each subject acting as its own control was conducted between January 2010 and December 2012. Healthy volunteers with a history of heavy but cyclic and regular menstrual cycles were enrolled in the study. Ultrasonographic examination was performed before and after six months of LNG-IUS placement: uterine volume, endometrial thickness, and subendometrial and myometrial Doppler blood flow patterns have been evaluated. Results. A total of 32 women were enrolled out of 186 initially screened. At six months of follow-up, all subjects showed a reduction in menstrual blood loss; for analysis, they were retrospectively divided into 3 groups: normal cycling women (Group I, amenorrheic women (Group II, and women with prolonged bleedings (Group III. Intergroup analysis documented a statistically significant difference in endometrial thickness among the three groups; in addition, mean pulsatility index (PI and resistance index (RI in the spiral arteries were significantly lower in Group I and Group III compared to Group II. This difference persisted also when comparing—within subjects of Group III—mean PI and RI mean values before and after insertion. Conclusions. The LNG-IUS not only altered endometrial thickness, but—in women with prolonged bleedings—also significantly changed uterine artery blood flow. Further studies are needed to confirm these results and enable gynecologists to properly counsel women, improving initial continuation rates.

  7. Uterine Arteriovenous Malformation with Sudden Heavy Vaginal Hemmorhage

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    Marianne Haughey

    2013-09-01

    Full Text Available Dysfunctional uterine bleeding (DUB is a common presentation in the emergency department and has a wide differential. Most presentations of DUB are in hemodynamically stable patients and can be evaluated as an outpatient. Uterine arteriovenous malformation (AVM is one presentation that can result in a life-threatening medical emergency with unexpected sudden and massive vaginal bleeding. We describe a case of a 24-year-old female with sudden heavy vaginal bleeding requiring a blood transfusion, ultrasound evidence of uterine AVM, and a treatment method of expectant management using an intrauterine device in an attempt to preserve fertility. [West J Emerg Med. 2013;14(5:411-414.

  8. Comparison of Sexual Dysfunction Using the Female Sexual Function Index following Surgical Treatments for Uterine Fibroids

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    Allison Ryann Louie

    2012-01-01

    Full Text Available Uterine fibroids are a common problem in women. Statistics showing 20–50% of fibroids produce symptoms and consequently patients seek surgical intervention to improve their quality of life. Treatments for fibroids are typically successful in controlling the fibroid disease, yet sexual function following invasive surgical treatments for fibroids can be jeopardized. The Sexual Function Index (FSFI is a valid instrument producing quantifiable reproducible results. In this paper three case reports are evaluated by the FSFI and compared between the following treatment groups: hysterectomy, myomectomy, and uterine embolization. Our goal is to illustrate how each of these treatment outcomes can result in sexual dysfunction and therefore decreased quality of life. Effects of invasive fibroid treatments on sexual functioning would be helpful in guiding patient’s ultimate decisions regarding treatment.

  9. Dysfunction of neutrophils in patients with peptic ulcers, complicated with bleeding

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    Sulayeva O.N.

    2011-01-01

    Full Text Available To analyze a role of leukocytes dysfunction in the pathogenesis of ulcer bleeding the oxygen dependent metabolism, phagocytic activity and cytochemical indices of neutrophils were estimated in 100 patients with gatric and duodenal ulcers bleeding with effective hemostasis (group 1, n = 77 and rebleeding (group 2, n = 23. It was shown that peptic ulcer bleeding in patients of group 1 was associated with moderate increase of spontaneous production of active oxygen radicals, restriction of induced NADPH oxidase activity, decrease of acid phosphatase and myeloperoxidase activity but enhancement of phagocytic index. Sharp increase of spontaneous NBT-reaction with lost of oxidize functional reserve in neutrophils with significant inhibition of ability to phagocytosis and decreased of lysosomal enzymes activity were risk factors for rebleeding in patients of group 2.

  10. Skeletal muscle metastasis from uterine leiomyosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, J.M.; Brennan, D.D.; Taylor, D.H.; Eustace, S.J. [Cappagh National Orthopaedic Hospital, Department of Radiology, Dublin (Ireland); Holloway, D.P.; O' Keane, J.C. [Cappagh National Orthopaedic Hospital, Department of Pathology, Dublin (Ireland); Hurson, B. [Cappagh National Orthopaedic Hospital, Department of Orthopaedics, Dublin (Ireland)

    2004-11-01

    A case of a 68-year-old woman who presented with a rapidly enlarging painful right thigh mass is presented. She had a known diagnosis of uterine leiomyosarcoma following a hysterectomy for dysfunctional uterine bleeding. She subsequently developed a single hepatic metastatic deposit that responded well to radiofrequency ablation. Whole-body MRI and MRA revealed a vascular mass in the sartorius muscle and a smaller adjacent mass in the gracilis muscle, proven to represent metastatic leiomyosarcoma of uterine origin. To our knowledge, metastatic uterine leiomyosarcoma to the skeletal muscle has not been described previously in the English medical literature. (orig.)

  11. Skeletal muscle metastasis from uterine leiomyosarcoma.

    Science.gov (United States)

    O'Brien, J M; Brennan, D D; Taylor, D H; Holloway, D P; Hurson, B; O'Keane, J C; Eustace, S J

    2004-11-01

    A case of a 68-year-old woman who presented with a rapidly enlarging painful right thigh mass is presented. She had a known diagnosis of uterine leiomyosarcoma following a hysterectomy for dysfunctional uterine bleeding. She subsequently developed a single hepatic metastatic deposit that responded well to radiofrequency ablation. Whole-body MRI and MRA revealed a vascular mass in the sartorius muscle and a smaller adjacent mass in the gracilis muscle, proven to represent metastatic leiomyosarcoma of uterine origin. To our knowledge, metastatic uterine leiomyosarcoma to the skeletal muscle has not been described previously in the English medical literature.

  12. Is Previous Tubal Ligation a Risk Factor for Hysterectomy because of Abnormal Uterine Bleeding?

    OpenAIRE

    Sanam Moradan; Raheb Gorbani

    2012-01-01

    Objectives: Post tubal ligation syndrome (PTLS) is a term used to describe a variety of post tubal ligation side effects or symptoms. These include increased menstrual bleeding and hysterectomy. Whether or not post tubal syndrome is a real entity, it has been a subject of controversy in the medical literature for decades. Numerous studies have reported conflicting conclusions about these symptoms. In this study the incidence of hysterectomy for bleeding disorders among sterilized women was co...

  13. 围绝经期子宫肌瘤及子宫腺肌病所致异常出血%Perimenopausal abnormal bleeding caused by uterine fibroids and uterine adenomyosis

    Institute of Scientific and Technical Information of China (English)

    汪利群; 黄欧平

    2012-01-01

    Uterine fibroids and adenomyosis is the most common benign gynecological diseases, they are one important reason for abnormal uterine bleeding in perimenopausal period. This article summarizes the e-tiology, diagnosis and treatment of abnormal uterine bleeding caused by fibroids and adenomyosis in perimenopausal women,which should lead to attention.%子宫肌瘤与子宫腺肌病是妇科最常见的良性肿瘤,是导致围绝经期子宫异常出血的重要原因之一.该文概述了子宫肌瘤与子宫腺肌病导致围绝经期异常子宫出血病因、诊断及治疗,以期引起关注.

  14. A COMPARATIVE STUDY OF CLINICAL EXAMINATION, ULTRASOUND FINDINGS, DIAGNOSTIC HYSTEROSCOPY WITH HISTOPATHOLOGICAL EXAMINATION REPORT OF ENDOMETRIUM IN PATIENTS WITH ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    Sathenahalli Devegowda Prathibha

    2016-08-01

    Full Text Available BACKGROUND AND OBJECTIVES Abnormal Uterine Bleeding (AUB is a very frequent gynaecological complaint and occurs across the entire age spectrum, approximately 75000 hysterectomies are carried out each year with 30% of these for menstrual problems alone. These menstrual aberrations occur more commonly at extremes of reproductive life. The introduction of hysteroscopy has opened a new dimension in evaluation of patient with AUB replacing the blind technique of Dilatation and Curettage. The present study was undertaken to know the accuracy of various tests with Histopathology. MATERIALS AND METHODS The present prospective study was carried out on 100 patients from reproductive, perimenopausal and postmenopausal age group with abnormal uterine bleeding in Dr. B. R. Ambedkar Medical College and Hospital. RESULTS In the present study, in relation to histopathological examination, clinical findings and hysteroscopy had better accuracy (72% as compared to ultrasound findings (41% in diagnosis of abnormal uterine bleeding. CONCLUSION Hysteroscopy guided biopsy and histopathology complements each other in the evaluation of patient with abnormal uterine bleeding for accurate diagnosis and further treatment.

  15. 宫腔镜检查在异常子宫出血中的应用价值%Application analysis of hysteroscopy in abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    尚强

    2011-01-01

    Objective To explore hysteroscopy for abnormal uterine bleeding in clinical applications. Methods February 2008 - May 2010 in our hospital diagnosis of abnormal uterine bleeding by hysteroscopy 240 cases were retrospectively analyzed. Results The hysteroscopy and histopathological examination diagnostic rate is higher than 90%, consistent with those reported. Conclusions Hysteroscopy easy to operate, safe, effective, abnormal uterine bleeding diagnosis show a great advantage,has become an effective method for diagnosis of abnormal uterine bleeding.%目的 探讨宫腔镜检查对子宫异常出血的临床应用价值.方法 对2008年2月-2010年5月利用宫腔镜检查诊断异常子官出血240例患者资料进行回顾性分析.结果 官腔镜检查与病理组织学检查的诊断符合率高于90%,与文献报道一致.结论 官腔镜检查操作方便、安全、有效、在异常子宫出血中显示出了巨大的优越性,目前已成为诊断异常子官出血的有效方法.

  16. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years

    DEFF Research Database (Denmark)

    Dreisler, E; Stampe Sorensen, S; Ibsen, P H;

    2009-01-01

    OBJECTIVE: To estimate the prevalence of endometrial polyps and to investigate associated abnormal uterine bleeding in a Danish population aged 20-74 years. METHODS: This was a study of a random selection of women from the Danish Civil Registration System: 1660 women were invited of whom 686 were...... was performed in 619 women (two failures of TVS and 60 failures of SCSH, in two women SCSH was contraindicated (endometrial cancer), in two women hysteroscopy was contraindicated, and one polyp was lost before histology). World Health Organization histopathological criteria were used for diagnosing true...... diagnosed in 4.2% (26/622; 95% CI, 2.6-5.8%) and intramural myomas in 11.1% (76/684; 95% CI, 8.8-13.5%) of women. Polyps were diagnosed in 2% of oral-contraceptive and 25% of hormone-therapy users. CONCLUSIONS: The overall prevalence of endometrial polyps was 7.8% and the prevalence increased with age...

  17. Placenta previa with early opening of the uterine isthmus is associated with high risk of bleeding during pregnancy, and massive haemorrhage during caesarean delivery.

    Science.gov (United States)

    Goto, M; Hasegawa, J; Arakaki, T; Takita, H; Oba, T; Nakamura, M; Sekizawa, A

    2016-06-01

    To demonstrate the relationship between the timing of opening of the uterine isthmus and bleeding during pregnancy and caesarean section in patients with placenta previa. A prospective observational study was conducted at a single perinatal centre. All patients with placenta previa, diagnosed between 20 and 22 weeks of gestation, who were followed up at the study hospital and underwent caesarean section were enrolled. The condition of the uterine isthmus was examined every 2 weeks. The timing (in gestational weeks) of complete opening of the uterine isthmus was determined. Patients were divided into two groups: patients in whom the uterine isthmus opened before 25 weeks of gestation (EO-previa), and patients in whom the uterine isthmus opened after 25 weeks of gestation (LO-previa). The frequency of bleeding during pregnancy and the amount of intra-operative bleeding were compared between the two groups. Forty-four cases of EO-previa and 55 cases of LO-previa were analysed. Complete placenta previa at delivery was observed more frequently in the EO-previa group than in the LO-previa group (88.6% vs 47.3%, pprevia group (48%) than in the LO-previa group (25%) (p=0.021). The frequency of massive haemorrage (>2500ml) during caesarean section was higher in the EO-previa group than in the LO-previa group (25% vs 9%, p=0.033). Placenta previa was associated with a high risk of bleeding leading to emergency caesarean section during pregnancy, and massive haemorrhage during caesarean section in patients in whom the uterine isthmus opened before 25 weeks of gestation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Abnormal expression of MMP-9 and imbalance of MMP-9/TIMP-1 is associated with prolonged uterine bleeding after a medical abortion with mifepristone and misoprostol.

    Science.gov (United States)

    Li, Li; Zhou, Zanhua; Huang, Lili

    2009-01-01

    To investigate the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitory of metalloproteinase-1 (TIMP-1) in women who had undergone a medical abortion and explore their possible role in the mechanism of prolonged uterine bleeding after a mifepristone-misoprostol abortion. Cross-sectional study. Tertiary referral university hospital. Forty women were recruited following a medical abortion with mifepristone and misoprostol, 20 with duration of bleeding >14 days and 20 with duration of bleeding 14 days after a medical abortion (bleeding group), whereas each sample of women with duration of bleeding after a medical abortion (control group) showed normal endometrial changes. Immunohistochemistry and semi-quantitative scoring showed a significantly decreased expression level of MMP-9 in the bleeding group, compared with the control group. There was no significant difference of TIMP-1 expression between the bleeding group and the control group. The MMP-9/TIMP-1 ratio value was significantly lower in the bleeding group than in the control group. This study documents that prolonged bleeding after a medical abortion with mifepristone and misoprostol is associated with retained products of conception with inflammatory cell infiltration, abnormal expression of MMP-9 and imbalance of MMP-9/TIMP-1.

  19. Curative effects of two new endometrial ablation procedures using radiofrequency thermocoagulation for the treatment of severe abnormal uterine bleeding.

    Science.gov (United States)

    Yin, Geping; Li, Juan; Zhu, Tongyu; Chen, Ming

    2013-07-01

    Severe Abnormal Uterine Bleeding (SAUB) is a common gynecological disorder. The clinical characteristics include disordered menstrual cycle and massive bleeding that can cause anemia or secondary infection. Current treatment mainly relies on drug therapy or surgical removal of the uterus, each having its significant disadvantages. How to preserve the uterus, reduce the pain from surgery, and achieve better treatment effects have been well known but remaining as unresolved issues. This study aims at evaluating two types of radiofrequency (RF) thermocoagulation procedures for the treatment of SAUB: the RF-A procedure group included 25 SAUB patients ≥45 years of age treated for amenorrhea; the RF-B procedure group included 51 patients at bleeding. Post-treatment ratings of menstrual satisfaction and pre-/post-treatment menstrual scores-pictorial blood loss assessment chart (PBAC)-and hemoglobin levels were collected; and the mean length of follow-up was 72 months. Also, 38 SAUB patients treated with standard drug regimens served as a control group. The results of the study showed that following RF treatment, the average long-term patient menstrual satisfaction was greater than 92 %. In both the RF groups, PBAC scores and hemoglobin levels were significantly improved from baseline (p < .05). Compared with the control group, PBAC scores and hemoglobin levels were also significantly better for the RF groups at 6-24-month post-operation. Patients experienced no hysterectomy in association with the RF procedures. In conclusion, this pilot study suggests that the novel RF procedures are both safe and effective in treating patients with SAUB. Further investigation is necessary to evaluate their application in broader clinical indication.

  20. Diagnosis and treatment of the abnormal uterine bleeding by hysteroscopy%宫腔镜对异常子宫出血的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    刘彦

    2009-01-01

    Objective To explore the effect of hysterescopy on the diagnosis and treatment of abnormal uterine bleeding. Methods Hysteroscopy was used in 120 cases of abnormal uterine bleeding, 98 cases with abnormal uterine cavity lesions were found. According to the different diseases, different treatments were unde~aken. Results The use of hysteroscopy could make a clear diagnosis to variety of intrauterine abnormalities, and could treat many diseases at the same time directly. Conclusion Using hysteroscopy to diagnose and treat abnormal uterine bleeding is a reliable method.%目的 探讨宫腔镜在诊断及治疗异常子宫出血中的作用.方法 对120例异常子宫出血患者行官腔镜检查,发现98例宫腔异常病变,根据病变的不同,采取不同的治疗措施.结果 应用宫腔镜能够对各种宫腔异常情况做出明确诊断,同时亦可对多种疾病进行直接治疗.结论 宫腔镜诊断异常子宫出血是一种可靠的方法.

  1. The Th1/Th2/Th17/Treg paradigm induced by stachydrine hydrochloride reduces uterine bleeding in RU486-induced abortion mice.

    Science.gov (United States)

    Li, Xia; Wang, Bin; Li, Yuzhu; Wang, Li; Zhao, Xiangzhong; Zhou, Xianbin; Guo, Yuqi; Jiang, Guosheng; Yao, Chengfang

    2013-01-09

    The Th1/Th2/Th17/Treg paradigm plays an important role in achieving maternal-fetal immunotolerance and participates in RU486-induced abortion. Excessive uterine bleeding is the most common side effect of RU486-induced abortion; however, its etiopathogenesis has not been fully understood. Therefore, elucidating the correlation between the Th1/Th2/Th17/Treg paradigm and the volume of uterine bleeding may offer novel therapeutic target for reducing uterine bleeding in RU486-induced abortion. Leonurus sibiricus has been used in clinics to reduce postpartum hemorrhage with low toxicity and high efficiency; however, the effective constituents and therapeutic mechanism have not been described. Stachydrine hydrochloride is the main constituent of L. sibiricus, therefore L. sibiricus is regarded as a candidate for reducing uterine bleeding in RU486-induced abortion mice by regulating the Th1/Th2/Th17/Treg paradigm. The purpose of this study was to determine the Th1/Th2/Th17/Treg paradigm in uterine bleeding of RU486-induced abortion mice and to elucidate the immunopharmacologic effects of stachydrine hydrochloride on inducing the Th1/Th2/Th17/Treg paradigm in reducing the uterine bleeding volume in RU486-induced abortion mice. To investigate the Th1/Th2/Th17/Treg paradigm in uterine bleeding during RU486-induced abortion mice, pregnant BALB/c mice were treated with high- and low-dose RU486 (1.5mg/kg and 0.9 mg/kg, respectively), and the serum progesterone (P(4)) protein level, uterine bleeding volume, and proportions of Th1/Th2/Th17/Treg cells in mice at the maternal-fetal interface were detected by ELISA assay, alkaline hematin photometric assay, and flow cytometry, respectively. To determine the regulatory effect of stachydrine hydrochloride on the Th1/Th2/Th17/Treg paradigm in vitro, splenocytes of non-pregnant mice were separated and treated with P(4,) RU486, and/or stachydrine hydrochloride (10(-5)M, 10(-4)M, and 10(-3)M, respectively). The proportions of Th1/Th2/Th17

  2. Clinical study of uterine balloon therapy for abnormal uterine bleeding%子宫热球仪治疗异常子宫出血的临床研究

    Institute of Scientific and Technical Information of China (English)

    周虹; 钟玲; 池余刚

    2009-01-01

    目的:探讨热球子宫内膜去除术(Thermal balloon endometrial ablation,TBEA)治疗异常子宫出血的可行性、安全性及有效性.方法:选择我院2005~2006年间采用热球子宫内膜治疗仪治疗异常子宫出血的70例患者,分析术中、术后并发症并随访2年,观察其治疗后月经情况的改变.结果:70例患者术后1月随访有效率达97.14%,2年后总有效率仍达85.71%,治疗前后效果差异具有统计学意义(P<0.01).其中5例患者因月经量明显增多行全子宫切除术,所有患者术中术后均未出现明显并发症.结论:子宫热球仪治疗异常子宫出血具有良好临床疗效,且安全、简单,值得临床推广.%Objective :To investigate the effect of uterine thermal balloon therapy in treating abnormal uterine bleeding. Methods: The uterine thermal balloon therapy system was made in Gynecar.70 patients receiving uterine thermal balloon therapy for treatment of abnormal uterine bleeding from 2005 to 2006 were retrospectively analyzed. Results: All the patients were followed up for 2 years. The rate of hemostasis was 85.71 %. No complications were found inlraoperatively and postoperatively. Conclusion: Uterine thermal ballon therapy to treat patients who have abnormal uterine bleeding is simple,safe and effective,which provides a new treatment method for abnormal uterine bleeding.

  3. 异常子宫出血宫腔镜检查679例分析%Analysis of 679 abnormal uterine bleeding of women examined by hysteroscopy

    Institute of Scientific and Technical Information of China (English)

    姚招琴; 方芙蓉

    2008-01-01

    Objective To study the applicability of hysteroseopy for abnormal uterine bleeding of women and to analyze the etiology.Methods 679 cases of women with abnormal uterine bleeding were examined by hysteroscopy,whose situations were showed first under bimanual or trimanual examinations,then trams abdominal or traps vaginal B-ultrasonograpy.Results The postive rate of uterie abnormality was 98.6% detected by hysteroscopy and biopsy.Endometrial hyperplasia and endometrialpolyp were the main cause of abnormal uterine bleeding,which occupied 56.7%,then were myoma and endometritis.Women of child-bearing age were the largdy group that in volved.Conclusion Hysteorscopic examination was useful for abnormality uterine bleeding of women.We can underatand the relationship with abnormal uterine bleeding and intra-uterine disease,and the distribution of the different diseases in different age to enhance accurate diagnosis.%目的 探讨女性异常子宫出血病因及宫腔镜的应用价值.方法 对679例女性异常子宫出血患者经妇科检查后结合B超、病理诊断和官腔镜检查明确出血病因.结果 宫腔镜检查联合B超及活检病理诊断宫内病变的阳性检出率为98.6%.其中子宫内膜异常增生、子宫内膜息肉是异常子宫出血的主要病因,占56.7%.其次为子宫肌瘤(包括宫颈肌瘤)、子宫内膜炎.发病年龄以育龄妇女为主.结论 宫腔镜是检查女性异常子宫出血的重要方法 之一,可了解宫腔病变与子宫出血的关系,能明显提高临床诊断准确率,并能明确各病种在不同年龄段的分布情况.

  4. Application of hysteroscope in diagnosis and treatment of abnormal uterine bleeding%官腔镜在异常子宫出血诊疗中的应用

    Institute of Scientific and Technical Information of China (English)

    叶凤如; 黄玉玲

    2012-01-01

    目的:探讨官腔镜在异常子宫出血诊治中的应用价值.方法:回顾分析2009~2010年对204例异常子宫出血患者行官腔镜检查的临床资料.结果:官腔镜检查204例异常子宫出血的病因有:子宫内膜息肉57例,宫颈管息肉13例,子宫黏膜下肌瘤4例,妊娠物残留17例,子宫内膜炎5例,子宫内膜癌1例,官腔粘连14例,节育器崁顿或移位13例,官腔正常80例.结论:官腔镜检查能及时查找病因并对因治疗,缩短诊疗时间,提高治愈率.%Objective; To explore the application value of hysteroscope in diagnosis and treatment of abnormal uterine bleeding. Methods; The clinical data of 204 patients with abnormal uterine bleeding who received hysteroscopy from 2009 to 2010 were analyzed retrospectively. Results; The causes of 204 patients with abnormal uterine bleeding included endometrial polyp (57 patients), cervical polyp (13 patients) , submucous uterine myoma (4 patients) , residual pregnancy tissue (17 patients), endometritis (5 patients) , endometrial cancer (one patient) , intrauterine adhesion (14 patients) , and IUD incarceration or displacement (13 patients); 80 patients were found with normal uterine cavity. Conclusion; Hysteroscopy can find out the etiologies and take etiological treatment, shorten the time of diagnosis and treatment, and improve curative rate.

  5. 子宫异常出血子宫内膜病理研究%Study of the endometrial pathology in patients with abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    雷亚平; 胡雪涛

    2015-01-01

    Objective:To investigate the histopathology of endometrium in patients with abnormal uterine bleeding and distribution of various types of endometrium in different age patients. Methods:The data of the histopathology of endometrium in 294 cases with abnormal uterine bleeding were retrospectively analyzed. Results:The difference of the histopathology distribution of endometrium in different age patients with abnormal uterine bleeding was no statistical significance(P > 0. 05). The differences of the types of endometrial hyperplasia and polyp in different age patients were not statistical significance(P>0. 05). Conclusions:The endometrial lesion in patient with abnormal uterine bleeding is not related to their age.%目的:探讨子宫异常出血患者的子宫内膜组织病理学及不同年龄阶段各种子宫内膜类型的分布情况. 方法:分析294例异常子宫出血患者诊刮子宫内膜的组织病理学资料. 结果:不同年龄阶段子宫异常出血患者子宫内膜病理组织学类型差异无统计学意义(P>0. 05),不同年龄阶段子宫内膜增生类型及息肉类型差异亦均无统计学意义(P>0. 05). 结论:子宫异常出血的子宫内膜病变与年龄阶段不具有明显相关性.

  6. Clinical Analysis on Endoscopic Diagnosis and Treatment of Abnormal Uterine Bleeding%宫腔镜诊治异常子宫出血临床分析

    Institute of Scientific and Technical Information of China (English)

    刘岚

    2015-01-01

    Objective: To investigate the effect of clinical application of hysteroscopy in the diagnosis and treatment of abnormal uterine bleeding.Method: The clinical data of 86 cases in our hospital in 2014 the use of hysteroscopy in the diagnosis and treatment of abnormal uterine bleeding were retrospectively analyzed, and compared with pathological examination.Result: Hysteroscopy in 86 cases of abnormal uterine bleeding, 80 cases of positive detection, according to resection, 83 cases of which biopsy, diagnostic curettage and electric, scraping and excised tissue all sent pathology the examination, the diagnostic accordance rate was 92.8% and the pathological diagnosis of microscopic. Conclusion: Hysteroscopy in diagnosis of abnormal uterine bleeding with high accuracy rate, and has double functions of treatment.%目的:探讨宫腔镜诊治异常子宫出血的临床应用效果。方法:对本院2014年利用宫腔镜诊治异常子宫出血的86例患者的临床资料进行回顾性分析,并与病理检查做对比。结果:86例异常子宫出血患者经宫腔镜检查,检出阳性80例,根据情况对其中的83例取活检、行诊断性刮宫术及电切术,刮出及切除组织全部送病理检查,镜下诊断与病理诊断符合率92.8%。结论:宫腔镜对异常子宫出血的诊断准确率高,并且兼有治疗的双重作用。

  7. Management of abnormal uterine bleeding by northern, rural and isolated primary care physicians: PART II: What do we need?

    Directory of Open Access Journals (Sweden)

    Vigod Simone N

    2002-11-01

    Full Text Available Abstract Background Abnormal uterine bleeding (AUB is a common problem that affects one in five women during the pre-menopausal years. It is frequently managed by family physicians, especially in northern, rural and isolated areas where severe shortages of gynecologists exist. Methods We surveyed 194 family physicians in northern, rural and isolated areas of Ontario, Canada to determine their educational and resource needs for the management of AUB, with a specific focus on the relevance and feasibility of using clinical practice guidelines (CPGs. Results Most physicians surveyed did not use CPGs for the management of AUB because they did not know that such guidelines existed. The majority were interested in further education on the management of AUB through mailed CPGs and locally held training courses. A major theme among respondents was the need for more timely and effective gynecological referrals. Conclusion A one-page diagnostic and treatment algorithm for AUB would be easy to use and would place minimal restrictions on physician autonomy. As the majority of physicians had Internet access, we recommend emailing and web posting in addition to mailing this algorithm. Local, hands-on courses including options for endometrial biopsy training would also be helpful for northern, rural and isolated physicians, many of whom cannot readily take time away from their practices.

  8. Uterine Leukocyte Function and Dysfunction: A Hypothesis on the Impact of Endometriosis.

    Science.gov (United States)

    Parkin, Kirstin L; Fazleabas, Asgerally T

    2016-03-01

    Endometriosis is a chronic inflammatory disease characterized by the growth of endometrial glands and stroma outside of the uterus. The disease affects approximately 10-15% of women of reproductive age and presents with clinical symptoms of pelvic pain and infertility. Changes in the leukocyte populations within the ectopic tissue and eutopic endometrium have been reported, and data suggest these alterations contribute to the pathology and symptoms of the disease. In this review, we discussed differences when comparing uterine NK cells and regulatory T cells within the eutopic endometrium between patients with endometriosis and healthy patients, and how these differences relate to implantation failure and/or decreased clearance of menstrual tissue in patients with the disease. The data demonstrate a critical need to examine endometrium and menstrual tissue in patients with endometriosis excluded from studies examining unknown causes of infertility and heavy menstrual bleeding. The information gathered from excluded patients will further enhance our understanding of how the immune system contributes to the pathophysiology of endometriosis and help to identify biomarkers for patients at higher risk for developing endometriosis-associated infertility.

  9. Role of serum copper and ceruloplasmin level in patients with dysfunctional uterine bleeding

    Directory of Open Access Journals (Sweden)

    Ketki P. Khandhadiya

    2014-04-01

    Conclusions: This study has concluded that serum copper and ceruloplasmin could be a sensitive indicator of angiogenesis in endometrium leading to DUB in females. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 330-334

  10. Serum Angiopoietin-2 and β-hCG as Predictors of Prolonged Uterine Bleeding after Medical Abortion in the First Trimester

    Science.gov (United States)

    Wang, Maofeng; Chen, Junqing; Ying, Jun; Yu, Jiong; Huang, Bifei; Ren, Zhaoxiang; Wang, Xianyu; Guo, Qiaoqiao; Wang, Yunlai; Qiu, Liuyi; Yu, Hongsheng; Wan, Rugen

    2013-01-01

    Objective The combination of mifepristone and misoprostol is an established method for induction of early first trimester abortion, but there is no consensus about the best evaluation of treatment outcome. We evaluate serum Angiopoietin-2(Ang-2) and β human chorionic gonadotropin (β-hCG) in women who had undergone a medical abortion as markers of prolonged uterine bleeding (PUB). Methods Prospective trial involving 2843 women attending an gynecology outpatient clinic who following a medical abortion with mifepristone and misoprostol, the study cohort was divided into women with duration of uterine bleeding >14 days (PUB) and women with duration of uterine bleeding ≤14 days (normal uterine bleeding, NUB). Serum determinations of Ang-2 levels by ELISA and β-hCG levels by electrochemiluminiscence immunoassay. Receiver Operating Characteristics (ROC) analyses were calculated and plotted for the diagnostic accuracy of serum β-hCG and Ang-2 concentration to discriminate PUB and NUB. Results Baseline characteristics for both groups were similar, Only duration of bleeding showed a significant difference between the PUB group and NUB group. Ang-2 serum levels moderately correlated with serum β-hCG levels with statistically significant correlation coefficients of 0.536. Serum β-hCG and Ang-2 levels on day 7 and on day 14 after medical abortion were signifcantly higher in PUB group than in NUB group. Plotted as ROC curves, β-hCG area under curve (AUC) was 0.65 (95% CI, 0.53–0.76) on day 7, rising to AUC = 0.83 (95% CI, 0.75–0.92) on day 14. Using Ang-2 on day 7 and day 14 as predictive parameter resulted in an analogous AUC (AUC = 0.61 on day 7, AUC = 0.78 on day 14). Conclusions Both parameters are clinically useful as a diagnostic test in predicting PUB after medical abortion, and can be helpful in uncertain clinical situations, but should be considered as supplementary to a general clinical evaluation. PMID:23696855

  11. Serum angiopoietin-2 and β-hCG as predictors of prolonged uterine bleeding after medical abortion in the first trimester.

    Directory of Open Access Journals (Sweden)

    Maofeng Wang

    Full Text Available OBJECTIVE: The combination of mifepristone and misoprostol is an established method for induction of early first trimester abortion, but there is no consensus about the best evaluation of treatment outcome. We evaluate serum Angiopoietin-2 (Ang-2 and β human chorionic gonadotropin (β-hCG in women who had undergone a medical abortion as markers of prolonged uterine bleeding (PUB. METHODS: Prospective trial involving 2843 women attending an gynecology outpatient clinic who following a medical abortion with mifepristone and misoprostol, the study cohort was divided into women with duration of uterine bleeding >14 days (PUB and women with duration of uterine bleeding ≤14 days (normal uterine bleeding, NUB. Serum determinations of Ang-2 levels by ELISA and β-hCG levels by electrochemiluminiscence immunoassay. Receiver Operating Characteristics (ROC analyses were calculated and plotted for the diagnostic accuracy of serum β-hCG and Ang-2 concentration to discriminate PUB and NUB. RESULTS: Baseline characteristics for both groups were similar, Only duration of bleeding showed a significant difference between the PUB group and NUB group. Ang-2 serum levels moderately correlated with serum β-hCG levels with statistically significant correlation coefficients of 0.536. Serum β-hCG and Ang-2 levels on day 7 and on day 14 after medical abortion were signifcantly higher in PUB group than in NUB group. Plotted as ROC curves, β-hCG area under curve (AUC was 0.65 (95% CI, 0.53-0.76 on day 7, rising to AUC = 0.83 (95% CI, 0.75-0.92 on day 14. Using Ang-2 on day 7 and day 14 as predictive parameter resulted in an analogous AUC (AUC = 0.61 on day 7, AUC = 0.78 on day 14. CONCLUSIONS: Both parameters are clinically useful as a diagnostic test in predicting PUB after medical abortion, and can be helpful in uncertain clinical situations, but should be considered as supplementary to a general clinical evaluation.

  12. Role of transvaginal sonography and hysteroscopy in abnormal uterine bleeding: does the diagnostic yield increase by combining transvaginal sonography, hysteroscopy and biopsy?

    Directory of Open Access Journals (Sweden)

    Nivedita Krishnamoorthy

    2014-08-01

    Methods: This was a descriptive cross sectional study between January 2013 to June2014 in Sri Manakula Vinayagar medical college and hospital. After obtaining ethics committee approval, 100 consecutive patients with abnormal uterine bleeding between the age group of 35 and 55 years, who consented to participate in the study, were subjected to transvaginal sonography followed by diagnostic hysteroscopy combined with a directed biopsy. TVS and hysteroscopy was performed by two different investigators. The endometrial curettings and any intracavitary lesion were subjected to histopathological examination. Results tabulated and analysed using MS EXCEL and cross tabulation using Epi-info. Sensitivity, specificity, PPV, NPV for each pathology by TVS and hysteroscopy with HPE as the gold standard was calculated. Also the pathology causing abnormal uterine bleeding was computed by taking into account the endometrial characteristics and the associated lesions diagnosed by TVS, hysteroscopy and histopathological examination report. Results: 61 patients had only single lesions in the form of normal endometrium, atrophic endometrium, endometrial hyperplasia, endometrial polyp, malignancy and IU synechiae whereas 39 patients had lesions like intramural fibroids, adenomyosis, submucus myoma and polyps associated with different types of endometrium. The diagnostic accuracy of TVS and hysteroscopy were comparable for normal endometrium whereas hysteroscopy was found to be more accurate for endometrial polyps, endometrial hyperplasia and atrophic endometrium. Conclusions: The combination of transvaginal sonography, hysteroscopy and directed biopsy was found to increase the diagnostic yield in patients with abnormal uterine bleeding. As the diagnostic accuracy increased by combining the three modalities, an effective and appropriate management can be planned. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 919-923

  13. 宫腔镜检查异常子宫出血596例分析%Analysis of 596 Cases of Hysteroscopy on Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    刘青云; 徐成康

    2013-01-01

    目的:观察宫腔镜对异常子宫出血的诊断符合率。方法对596例异常子宫出血患者采用宫腔镜检查,并与B超和病理结果进行对比分析。结果宫腔镜对宫内膜、宫颈管息肉等多种疾病与病理结果比较,其诊断符合率在95.5%以上,多种疾病甚至达100.0%,显著优于B超检查结果,P<0.01。结论宫腔镜在直视状态下对异常子宫出血的病因诊断有较高的诊断符合率,是一种安全有效的检查与治疗方法。%Objective to observe the coincidence rate of hysteroscopy in diagnosis of abnormal uterine bleeding.Methods 596 patients with abnormal uterine bleeding by hysteroscopy, and the results were compared with B ultrasound and pathology. The results of hysteroscopy in endometrial and endocervical polyp and other diseases and pathologicalResults the diagnostic accordance rate in more than 95.5% kinds of diseases, even up to 100%, significantly better than the results of ultrasonic examination,P < 0.01.Conclusion hysteroscopy diagnosis coincidence rate higher for the diagnosis of abnormal uterine bleeding in the open state, is a safe and effective examination and treatment methods.

  14. 性激素在围绝经期异常子宫出血中的作用机制%Mechanism of action of sex hormones in perimenopausal abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    薛薇; 孙爱军

    2012-01-01

    围绝经期异常子宫出血(abnormal uterine bleeding,AUB)病因众多,主要包括子宫与宫腔局部因素,全身出凝血功能的异常与生殖内分泌轴的功能异常.性激素在三大因素中分别起到不同作用,涉及到的疾病包括功能性AUB、子宫内膜增生引起的AUB、应用性激素类药物引起的AUB等,上述疾病与性激素的量、时间、比例有关,根据性激素的作用机制可大致分为雌激素撤退性出血、雌激素突破性出血、孕激素突破性出血三类.%Abnormal uterine bleeding in perimenopa-usal women is mainly associated with uterine and u-terine cavity abnormalities, impaired coagulation function and disturbances of the hypothalamus-pitui-tary-ovary axis. Sex hormones play different roles in all causes. Disturbances of their level, action duration , and proportion may lead to functional AUB, AUB caused by endometrial hyperplasia, AUB caused by sex hormone drugs. The bleeding patterns mainly include estrogen withdrawal bleeding, estrogen breakthrough bleeding, and progesterone breakthrough bleeding.

  15. Abnormal Uterine Bleeding FAQ

    Science.gov (United States)

    ... can have many causes. They include the following: • Pregnancy • Miscarriage • Ectopic pregnancy • Adenomyosis • Use of some birth control methods, such ... the uterus at the top of the vagina. Ectopic Pregnancy: A pregnancy in which the fertilized egg begins ...

  16. Papel da Histerossonografia no Estudo da Cavidade Uterina em Pacientes com Sangramento Uterino Anormal Role of Sonohysterography in the Evaluation of the Uterine Cavity in Patients with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    Angélica Lemos Debs Diniz

    2000-06-01

    Full Text Available Objetivo: determinar o papel da histerossonografia na avaliação das anormalidades da cavidade uterina, em pacientes com sangramento uterino anormal, selecionadas previamente pela ultra-sonografia transvaginal. Métodos: foram selecionadas 48 pacientes na menacme e pós-menopausa, portadoras de sangramento uterino anormal e anormalidades da cavidade uterina, diagnosticadas inicialmente pela ultra-sonografia transvaginal. Todas as pacientes se submeteram à histerossonografia e, posteriormente, aos métodos "padrão ouro", a histeroscopia e/ou histerectomia. As histerossonografias foram avaliadas por dois diferentes médicos e os diagnósticos confrontados. Resultados: a histerossonografia mostrou ter alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina. Na presença de pólipo a sensibilidade e a especificidade do método foram, respectivamente, de 100 e 97%, seguido do mioma submucoso cuja sensibilidade e especificidade foram, respectivamente, de 83 e 100%. Já na hiperplasia endometrial e no endométrio normal a sensibilidade e especificidade foram de 100%. Diagnosticamos 33 casos de pólipos, 13 casos de miomas submucosos, quatro casos de hiperplasia endometrial e três casos normais na análise dos métodos "padrão ouro". Houve alta correlação entre os diagnósticos dados pelos dois examinadores. Conclusões: a histerossonografia mostrou ser um exame reprodutível, com alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina em pacientes com sangramento uterino anormal.Purpose: to determine the role of sonohysterography in the evaluation of abnormalities in the uterine cavity in patients presenting abnormal uterine bleeding, who had previously been selected by transvaginal ultrasonography. Methods: forty-eight patients presenting abnormal uterine bleeding and changes in the uterine cavity seen by transvaginal ultrasonography were selected, and they were in

  17. Argon Plasma Coagulation Therapy Versus Topical Formalin for Intractable Rectal Bleeding and Anorectal Dysfunction After Radiation Therapy for Prostate Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yeoh, Eric, E-mail: eric.yeoh@health.sa.gov.au [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia); School of Medicine, University of Adelaide, Adelaide (Australia); Tam, William; Schoeman, Mark [School of Medicine, University of Adelaide, Adelaide (Australia); Department of Gastroenterology, Royal Adelaide Hospital, Adelaide (Australia); Moore, James; Thomas, Michelle [School of Medicine, University of Adelaide, Adelaide (Australia); Department of Colorectal Surgery, Royal Adelaide Hospital, Adelaide (Australia); Botten, Rochelle; Di Matteo, Addolorata [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia)

    2013-12-01

    Purpose: To evaluate and compare the effect of argon plasma coagulation (APC) and topical formalin for intractable rectal bleeding and anorectal dysfunction associated with chronic radiation proctitis. Methods and Materials: Thirty men (median age, 72 years; range, 49-87 years) with intractable rectal bleeding (defined as ≥1× per week and/or requiring blood transfusions) after radiation therapy for prostate carcinoma were randomized to treatment with APC (n=17) or topical formalin (n=13). Each patient underwent evaluations of (1) anorectal symptoms (validated questionnaires, including modified Late Effects in Normal Tissues–Subjective, Objective, Management, and Analytic and visual analogue scales for rectal bleeding); (2) anorectal motor and sensory function (manometry and graded rectal balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before and after the treatment endpoint (defined as reduction in rectal bleeding to 1× per month or better, reduction in visual analogue scales to ≤25 mm, and no longer needing blood transfusions). Results: The treatment endpoint was achieved in 94% of the APC group and 100% of the topical formalin group after a median (range) of 2 (1-5) sessions of either treatment. After a follow-up duration of 111 (29-170) months, only 1 patient in each group needed further treatment. Reductions in rectal compliance and volumes of sensory perception occurred after APC, but no effect on anorectal symptoms other than rectal bleeding was observed. There were no differences between APC and topical formalin for anorectal symptoms and function, nor for anal sphincteric morphology. Conclusions: Argon plasma coagulation and topical formalin had comparable efficacy in the durable control of rectal bleeding associated with chronic radiation proctitis but had no beneficial effect on anorectal dysfunction.

  18. 宫腔镜检查对子宫出血的诊断价值%Hysteroscopy in the treatment of 60 patients with abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    周彦

    2013-01-01

    Objective To investigate the clinical diagnosis and treatment value of hysteroscopy on patients with abnormal uterine bleeding.Method 60 patients with abnormal uterine bleeding were taken hypsteropic diagnosis and treatment compared with B ultrasonic and histologic diagnosis.The confirmed cases also taken hysteroscopy surgery.Results Endometrial polyps 23 cases (38.3%),endometrial hyperplasia disease 17 cases (28.3%),submucous myoma of uterus 9 cases (15.0%),uterine cavity adhesion in 7 patients (11.7%),submucosal uterine adenomyoma 2 cases (3.3%),chronic endometritis 1 case (1.7%) and endometrial carcinoma 1 case (1.7%) respectively.The concordance rate of B ultrasonic diagnosis and histologic diagnosis was 40.0%,while rate of hypsteropic diagnosis and histologic diagnosis was 86.7%,the difference was significant (x2 =0.865,P < 0.001).In 60 patients,the cure rate of hysteroscopy surgery was 98.3%.Conclusion Hysteroscopy in gynecological abnormal uterine bleeding diagnosis is specific,while the treatment effect is remarkable,which can be used as a safe and effective method to diagnosis and treatment abnormal uterine bleeding.%目的 探讨宫腔镜在子宫异常出血的检查价值.方法 对60例子宫异常出血的患者采用宫腔镜检查、宫腔镜手术治疗、宫腔镜取组织活检.结果 宫腔镜诊断:子宫内膜息肉23例(38.3%),子宫内膜增生症17例(28.3%),子宫黏膜下肌瘤9例(15.0%),宫腔粘连7例(11.7%),子宫黏膜下腺肌瘤2例(3.3%),慢性子宫内膜炎1例(1.7%)和子宫内膜癌l例(1.7%).宫腔镜诊断与病理诊断一致率为86.7%,显著高于B超诊断与病理诊断一致率40.0%,差异有统计学意义(x2=0.865,P<0.01).60例患者宫腔镜手术治愈率为98.3%.结论 宫腔镜对妇科异常子宫出血诊断特异度高,镜下治疗效果显著,可作为安全有效的异常子宫出血诊疗首选方法.

  19. Physiological implications of arteriovenous anastomoses and venous hemodynamic dysfunction in early gestational uterine circulation : a review

    NARCIS (Netherlands)

    Gyselaers, Wilfried; Peeters, Louis

    2013-01-01

    This review summarizes current information on anatomical and physiological properties of the early gestational uteroplacental circulation, and implications of normal or abnormal functioning of the venous compartment. It is illustrated that these properties serve intra-uterine redistribution of blood

  20. 一次性宫腔组织吸引管在异常子宫出血诊断中的临床价值%Clinical value of disposable uterine cavity tissue suction tube in diagnosing abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    郑妮; 孙奇; 韦静

    2015-01-01

    Objective To explore the clinical value of the disposable uterine cavity tissue suction tube in diagnosing abnormal u‐terine bleeding .Methods Seventy‐five patients ,who needed an endometrial biopsy because of abnormal uterine bleeding ,were se‐lected for this study .An endometrial biopsy was performed by a disposable uterine cavity tissue suction tube before the conventional suction dilatation and curettage (D&C) .The sample satisfactory rate and the diagnose accordance rate of the two methods were compared .Results The sample satisfactory rate of the disposable uterine cavity tissue suction tube and of the D&C was 85 .3%(64/75) and 94 .7% (71/75) respectively .The difference was not statistically significant(P>0 .05) .The diagnose accordance rate of the disposable uterine cavity tissue suction tube and the D&C was 90 .3% (56/62) and 93 .5% (58/62) respectively .The differ‐ence was not statistically significant(P>0 .05) .Conclusion To a certain extent ,endometrial biopsy performed by disposable uter‐ine cavity tissue suction tube can be a substitute for D&C as the initial inspection to assess abnormal uterine bleeding ,for its econo‐my ,efficiency and safety .%目的:探讨一次性宫腔组织吸引管在异常子宫出血诊断中的临床价值。方法选取因异常子宫出血需进行子宫内膜活检的患者75例,在接受常规分段诊刮术前利用一次性宫腔组织吸引管先获取子宫内膜组织。比较两种方法的取材标本满意率和诊断符合率。结果一次性宫腔组织吸引管取材标本满意率为85.3%(64/75),常规分段诊刮术取材标本满意率为94.7%(71/75),差异无统计学意义(P>0.05);一次性宫腔组织吸引管取材诊断符合率为90.3%(56/62),常规分段诊刮术取材诊断符合率为93.5%(58/62),差异无统计学意义(P>0.05)。结论一次性宫腔组织吸引管经济、有效、安全,可在一定程度上

  1. Clinical exploration of diagnosis and treatment of adolescent abnormal uterine bleeding%青春期异常子宫出血诊治临床探讨

    Institute of Scientific and Technical Information of China (English)

    罗奕巾

    2016-01-01

    目的:分析青春期异常子宫出血诊治临床方法和效果。方法随机选取2013年6月~2015年6月于本院就诊的71例青春期异常子宫出血患者作为研究对象,随机分组。雌孕激素组患者予以雌孕激素联合治疗,去氧孕烯炔雌醇组患者予以去氧孕烯炔雌醇片治疗;比较两组患者的临床疗效以及用药副作用、出血初步控制时间和出血完全控制时间。结果去氧孕烯炔雌醇组患者的临床总治疗效率明显高于雌孕激素组,其中雌孕激素组总有效率为96.67%,雌孕激素组总有效率为77.42%,差异有统计学意义(P<0.05)。去氧孕烯炔雌醇组治疗过程用药副作用发生率跟雌孕激素组相似,雌孕激素组发生率为9.68%,去氧孕烯炔雌醇组发生率为10.00%,差异无统计学意义(P>0.05)。去氧孕烯炔雌醇组患者出血初步控制时间和出血完全控制时间明显短于雌孕激素组,差异无统计学意义(P>0.05)。结论去氧孕烯炔雌醇片治疗青春期异常子宫出血的临床效果好,可推广应用。%Objective To analyze the clinical methods and effects of the diagnosis and treatment of adolescent abnormal uterine bleeding. Methods 71 patients with adolescent abnormal uterine bleeding who were admitted to our hospital from June 2013 to June 2015 were randomly selected as research objects and they were randomly allocated to the estrogen and progesterone group and the desogestrel ethinylestradiol group.Patients in the estrogen and progesterone group were received combined treatment of estrogen and progesterone while patients in the desogestrel ethinylestradiol group were received treatment of desogestrel ethinylestradiol tablets.Clinical curative effect,side effects of drugs, bleeding preliminary control time and bleeding complete control time of patients in two groups were compared. Results Clinical total effective rate of the desogestrel ethinylestradiol group was

  2. 宫内节育器与子宫异常出血的关系分析%Analysis of the relationship between intrauterine devices and uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    闫丽华; 孙涛; 宋永昌; 段微

    2011-01-01

    目的 了解与放置宫内节育器有关的子宫异常出血的相关因素.方法 采用病例对照研究方法,比较放置宫内节育器后子宫异常出血的132例患者(研究组)与放置宫内节育器后无异常子宫出血的132例妇女(对照组)的放置时机、类型和子宫内膜炎等情况.结果 研究组中金属宫内节育器比例最高(48.48%),对照组则以活性带铜宫内节育器最多(37.88%),两组使用节育器类型比较有显著性差异(χ2=6.01,P<0.05).研究组中人工流产后立即放置宫内节育器的比例高于对照组,经比较有显著性差异(χ2=12.97,P<0.05).研究组有59.09%患有子宫内膜炎,其中宫内节育器异位合并子宫内膜炎者占53.85%,明显高于宫内节育器异位无子宫内膜炎者的20.37%,经比较有显著性差异(χ2=14.88,P<0.05).结论 宫内节育器类型、放置时机、子宫内膜炎和节育器异位与子宫异常出血有关.%To investigate the relationship between intrauterine device ( IUD ) and abnormal uterine bleeding. Methods Casecontrol study was carried out to compare IUD type, inserting time and endometritis between 132 women with abnormal uterine bleeding after inserting IUD ( study- group ) and 132 cases without abnormal uterine bleeding after inserting IUD ( control group ). Results The proportion of metal IUD in study group was highest ( 48.48% ), while in control group the proportion of copper IUD was highest ( 37.88% ). The IUD types in two groups were significantly different ( X2 = 6.01, P < 0.05 ). The cases who were inserted with IUD immediately after induced abortion were more in study group than those in control group, and the difference was significant (X2= 12.97, P < 0.05 ). In study group 59.09% of cases developed endometritis, and of them 53.85% complicated with dystopia. The rate was higher than that of IUD dystopia without endometritis ( 20.37% ) (X2= 14.88,P < 0.05 ). Conclusion IUD types, insertion time

  3. [Analysis from the French DRG-based information system (PMSI) of conservative surgical treatment for abnormal uterine bleeding in 2008-2010].

    Science.gov (United States)

    Fernandez, H; Villefranque, V; Panel, P

    2015-05-01

    To evaluate the conservative surgical treatment for abnormal uterine bleeding from the Medicalized Information System Program (PMSI). The diagnosis codes were selected from 10th version of the international classification disease. A transversal and longitudinal descriptive analysis was performed from hospital stays, patient's characteristics, medical procedures between 2008-2010. Nineteen thousand six hundred and seventy-nine patients were admitted in hospital (public or private) for treatment of abnormal uterine bleeding. Endometrial ablation increased by 16,7%, 10.2% for first generation technique (G1) and 63.5% for second generation techniques (G2). G2 were used in 15% of indications. The median age was respectively 45.2±6.4 years old versus 45.8±4.9 years old for G2. The median length of hospital stay was 1.6 ±1with 69% of patients in ambulatory care. The likelihood to have a hysterectomy in the 3 years follow-up was higher after G1 than G2 treatments (P=0.0034) for the patients above 40 years old. In longitudinal study, defined only by endometrial hyperplasia, 11,532 patients were included and only 8.2% had been treated by G2. In spite of the international guidelines since 2008, 85% of patients treated with first generation surgical technique. The failure rate defined by a re-ablation or a hysterectomy is higher after G1. This result must be discussed in relationship with cost effective aspects. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Diagnosis and treatment for anovulatory abnormal uterine bleeding%无排卵型异常子宫出血的诊治

    Institute of Scientific and Technical Information of China (English)

    古健

    2014-01-01

    AnOvulatOry abnOrmal uterine bleeding is One tyPe Of abnOrmal uterine bleeding(AUB),alsO AUB -O fOr shOrt. AUB - O can be diagnOsed with medical histOry and labOratOry examinatiOn by excluding Organic factOrs Of systemic Or rePrOductive system. The Objective Of treatment fOr AUB - O includes twO asPects. One is tO inhibit endOmetrial hyPerPlasia,PrOlOnged menstruatiOn and menOrrhagia,which induced by chrOnic anOvulatiOn. The Other is tO PrOmOte the restOratiOn Of nOrmal menstrual functiOn,including nOrmal menstrual cycle and menstrual quantity. TheraPeutic regimen includes hemOstasis,menstruatiOn cycle adjustment and OPeratiOn. EstrOgen / PrOgestin PrOgestins are the mainstay Of treatment fOr AUB - O.%无排卵型异常子宫出血是异常子宫出血(abnOrmal uterine bleeding,AUB)中的一个类型,简称 AUB - O。通过病史及辅助检查排除全身或生殖系统器质性因素可诊断 AUB - O。AUB - O 的治疗目的包括两方面,一是抑制长期无排卵引起的子宫内膜过度增生、月经期延长和经量过多,二是促进正常月经功能恢复,包括正常月经周期和月经量的恢复。具体方案包括止血、调整月经周期及手术治疗。雌、孕激素尤其是孕激素是治疗 AUB - O 的主要药物。

  5. Oral misoprostol in the prevention of uterine bleeding after surgical evacuation of first trimester abortion: a comparative study of three uterotonic agents.

    Science.gov (United States)

    Aramide, T M; Olusegun, A K; Akinfolarin, A C; Oriola, D F

    2014-01-01

    This comparative study was aimed at determining the effectiveness of oral Misoprostol compared with intravenous Ergometrine and intravenous Oxytocin in reducing vaginal bleeding following surgical evacuation for first trimester abortions. This was a single-blind placebo-controlled study in which patients with first trimester uncomplicated abortions were divided into three groups using computer-generated randomization table. The first group was administered oral Misoprostol, the second group had intravenous Ergometrine, and the third group was administered intravenous Oxytocin. The uterotonic agents were administered before the surgical evacuation was carried out. There was statistically significant reduction in blood loss after the evacuation in the Misoprostol group ( P Misoprostol group (2.00 ± 0.86) compared with 4.43 ± 0.92 and 4.64 ± 1.06 days in the Ergometrine and Oxytocin groups, respectively ( P Misoprostol and Ergometrine groups (60.7% and 57.1%, respectively) compared with the Oxytocin group. Oral Misoprostol appeared to demonstrate superior efficacy in reducing uterine bleeding after surgical evacuation, compared to the other commonly used uterotonic agents.

  6. The p160/steroid receptor coactivator family: potent arbiters of uterine physiology and dysfunction.

    Science.gov (United States)

    Szwarc, Maria M; Kommagani, Ramakrishna; Lessey, Bruce A; Lydon, John P

    2014-11-01

    The p160/steroid receptor coactivator (SRC) family comprises three pleiotropic coregulators (SRC-1, SRC-2, and SRC-3; otherwise known as NCOA1, NCOA2, and NCOA3, respectively), which modulate a wide spectrum of physiological responses and clinicopathologies. Such pleiotropy is achieved through their inherent structural complexity, which allows this coregulator class to control both nuclear receptor and non-nuclear receptor signaling. As observed in other physiologic systems, members of the SRC family have recently been shown to play pivotal roles in uterine biology and pathobiology. In the murine uterus, SRC-1 is required to launch a full steroid hormone response, without which endometrial decidualization is markedly attenuated. From "dovetailing" clinical and mouse studies, an isoform of SRC-1 was recently identified which promotes endometriosis by reprogramming endometrial cells to evade apoptosis and to colonize as endometriotic lesions within the peritoneal cavity. The endometrium fails to decidualize without SRC-2, which accounts for the infertility phenotype exhibited by mice devoid of this coregulator. In related studies on human endometrial stromal cells, SRC-2 was shown to act as a molecular "pacemaker" of the glycolytic flux. This finding is significant because acceleration of the glycolytic flux provides the necessary bioenergy and biomolecules for endometrial stromal cells to switch from quiescence to a proliferative phenotype, a critical underpinning in the decidual progression program. Although studies on uterine SRC-3 function are in their early stages, clinical studies provide tantalizing support for the proposal that SRC-3 is causally linked to endometrial hyperplasia as well as with endometrial pathologies in patients diagnosed with polycystic ovary syndrome. This proposal is now driving the development and application of innovative technologies, particularly in the mouse, to further understand the functional role of this elusive uterine

  7. Platelet dysfunction in thrombosis patients treated with vitamin K antagonists and recurrent bleeding.

    Directory of Open Access Journals (Sweden)

    Paola E J van der Meijden

    Full Text Available BACKGROUND: Recurrent bleeding can complicate the treatment of thrombosis patients with vitamin K antagonists (VKA, even at a well-regulated level of anticoagulation. In this proof-of-principle study, we investigated whether alterations in platelet function or von Willebrand factor (vWf contribute to a bleeding phenotype in these patients. METHODS: In this case-control study 33 well-regulated patients without bleeding events (controls and 33 patients with recurrent bleeding (cases were retrospectively included. Thrombin generation and vWf were determined in plasma. Platelet function was assessed by light transmission aggregometry and flow cytometry using a validated panel of agonists. RESULTS: Thrombin generation was similarly reduced in controls and cases, in comparison to normal plasma. Plasma vWf level was above the normal range in 85% of controls and 67% of the cases. vWf activity was similarly increased in all patients in comparison to healthy volunteers. Platelet aggregation was in the normal range for almost all patients irrespective of the type of agonist. However, in response to a low collagen dose, platelets from 21% of controls and 27% of cases showed diminished responses. Agonist-induced secretion of alpha- and dense-granules or integrin αIIbβ3 activation were affected in platelets from neither controls nor cases. CONCLUSION: Recurrent bleeding in well-controlled patients on VKA therapy is not explained by anti-hemostatic changes in platelet or vWf function.

  8. Endometrial biopsy in diagnosis of abnormal uterine bleeding%子宫内膜活检在异常子宫出血中的诊断作用

    Institute of Scientific and Technical Information of China (English)

    邢彦君; 严红莲

    2013-01-01

      目的探讨子宫内膜活检在异常子宫出血中的诊断作用。方法对2010年3月-2013年3月对来本院就诊的192例异常子宫出血患者进行子宫内膜活检。结果对192例患者进行子宫内膜活检,结果显示,排在前3位的依次是子宫内膜增生(44.79%)、子宫内膜炎(14.27%)、与妊娠相关疾病(18.23%),然后是子宫内膜息肉(5.73%)。子宫内膜增生类型中,子宫内膜单纯增生所占比例最高(79.07%),其次为子宫内膜复杂增生(11.63%)及子宫内膜不典型增生(9.30%)。子宫内膜炎类型中,慢性子宫内膜炎占比例最高(89.19%),其次为子宫内膜结核(8.11%)及子宫腔积脓(2.70%)。结论对子宫异常出血患者进行子宫内膜病理学检查与诊断,可以指导临床诊断和治疗。%Objective To explore endometrial biopsy in diagnosis of abnormal uterine bleeding. Methods 192 cases of abnormal uterine bleeding in patients with endometrial biopsy were collected from March 2010 to March 2013 in our hospital. Results 192 patients with endometrial biopsy showed that ranked in the top three were endometrial hyperplasia(44.79%),endometritis (14.27%),and pregnancy related diseases (18.23%), and then the endometrial polyps(5.73%). Endometrial hyperplasia type, simple hyperplasia of endometrium had the highest proportion (79.07%), which followed by endometrial complex hyperplasia(11.63%) and atypical hyperplasia of endometrium (9.30%). The type of endometritis, chronic endometritis accounted for the highest proportion (89.19%), which followed by endometrial tuberculosis (8.11%) and uterine empyema(2.70%). Conclusion For abnormal uterine bleeding in patients with endometrial pathological examination and diagnosis,to guide clinical diagnosis and treatment.

  9. Comparison of Sexual Dysfunction Using the Female Sexual Function Index following Surgical Treatments for Uterine Fibroids

    OpenAIRE

    Allison Ryann Louie; Jennifer Alice Armstrong; Laura Katherine Findeiss; Scott Craig Goodwin

    2012-01-01

    Uterine fibroids are a common problem in women. Statistics showing 20–50% of fibroids produce symptoms and consequently patients seek surgical intervention to improve their quality of life. Treatments for fibroids are typically successful in controlling the fibroid disease, yet sexual function following invasive surgical treatments for fibroids can be jeopardized. The Sexual Function Index (FSFI) is a valid instrument producing quantifiable reproducible results. In this paper three case repor...

  10. PCSD的B超形态学改变与异常子宫出血的相关性分析%Analysis of the morphological changes of PCSD B ultrasound associated with abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    黄日林

    2015-01-01

    目的:探讨剖宫产宫壁瘢痕缺损(PCSD)在B超形态学上的改变与异常子宫出血之间的联系.方法:选取102例剖宫产产妇,对其B超检查资料进行回顾性分析,将产妇分为PCSD组和完整组,观察比较两组产妇的B超检出率以及异常子宫出血情况.结果:PCSD组B超检出率为60.78%(62/102),宫壁瘢痕位置与宫颈内口的距离比完整组短,异常子宫出血概率高于完整组,差异具有统计学意义(P<0.05).结论:PCSD用B超检查检出率高,可检测出异常子宫出血,两者具有相关性.%Objective:To investigate the link between changes and abnormal uterine bleeding of PCSD on B- morphology. Methods:102 cases of cesarean section , a retrospective analysis of their B -ultrasound data , the maternal group and the intact group into PCSD observed two groups of B- positive rate of maternal and abnormal uterine bleeding. Results:PCSD group B-detection rate of 60.78% (62/102), the distance from the uterine wall scar to the cervix is shorter than intact group , abnormal uterine bleeding probability is higher than the intact group, the difference was statistically significant (P < 0.05). Conclusion:PCSD detection rate with the B -ultrasound can detect abnormal uterine bleeding , both relevant.

  11. 崩漏停对药物流产大鼠子宫出血模型的影响%Effect of Benglouting on Uterine Bleeding of Medical Abortion Rats

    Institute of Scientific and Technical Information of China (English)

    吴敏; 叶凤; 干红女; 王梦; 嵇晶; 许云; 程建明

    2016-01-01

    Objective:Uterine bleeding model rats were carried out to study Benglouting on uterine bleeding.Methods:Mifepristone and misoprostol were given to early-pregnancy rats orally to cause vaginal hemorrhage model in rats.The effects of Benglouting were observed by the change of uterine bleeding quantity,plasma coagulation index,serum estradiol and progesterone levels.The weight and histological change of uterus and ovary were observed as well.Results:Benglouting could promote coagulation and reduce uterine bleeding quantity in uterine bleeding model rats.High dose can improve the levels of serum estradiol and progesterone.Pathology examination of uterine and ovarian tissue showed that high dose group gained the best function recovery of ovarian and the highest value of endometrial repair score,but no significant difference between groups.Conclusion:Benglouting can reduce uterine blood loss of medical abortion and is contribute to ovarian and endometrial repair.%目的:采用流产大鼠子宫出血模型研究崩漏停治疗在体子宫出血症状.方法:采用早孕大鼠灌服米非司酮和米索前列醇造成阴道出血模型,观察崩漏停对该模型子宫出血量的影响,同时观察大鼠的血浆凝血指标、血清雌二醇和孕酮水平变化,子宫和卵巢重量及组织学形态变化.结果:崩漏停对药物流产大鼠有促进凝血和减少子宫出血的作用,高剂量可提高血清雌二醇和孕酮水平.子宫和卵巢组织病理学检查,高剂量组的卵巢功能恢复最好,药物流产子宫内膜修复评分值高剂量组最高,但各组间没有明显差异.结论:崩漏停可减少早孕大鼠药物流产模型的子宫出血量,并有助于卵巢和子宫内膜修复.

  12. 宫腔镜在异常子宫出血患者诊治中的应用研究%Application of Hysteroscopy in the Diagnosis and Therapy of Patients with Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    张军莲; 石月圆; 黄玉珍

    2014-01-01

    Objective To investigate the clinical value of hysteroscopy in the diagnosis and treatment of patients in abnormal uterine bleeding. Methods A retrospective analysis of 120 cases of abnormal uterine bleeding hysteroscopy results of patients, and the results were compared with pathology. Results Hysteroscopy combined with pathological examination confirmed the diagnosis of the cause of abnormal uterine bleeding, Benign uterine lesion 78 Including endometrial hyperplasia, uterine endometrial polyps Submucous myoma of uterus, endometritis and normal uterine cavity. Cervical polyp 16 cases, malignant uterine tumor 4cases, intrauterine device (IUD)4 cases, pregnancy residues 10 cases, cesarean scar diverticulum 8 cases. Examination and pathological examination of hysteroscopy coincidence rate 81.6%. Conclusions Pathological examination of hysteroscopy to assist the cause of abnormal uterine bleeding, Overall, precision, accuracy, and has a certain therapeutic effect, is worthy of clinical promotion.%目的:探讨宫腔镜在异常子宫出血患者中的诊断与治疗中的临床价值。方法回顾分析120例异常子宫出血患者的宫腔镜检查结果,并与病理结果进行对照。结果宫腔镜检查联合病理检查确诊引起异常子宫出血的原因中,子宫内膜良性病变78例,包括子宫内膜增殖症、子宫内膜息肉、黏膜下子宫肌瘤、子宫内膜炎和正常宫腔,宫颈管息肉16例,子宫恶性肿瘤4例,宫内节育器4例,妊娠物残留10例,剖宫产瘢痕憩室8例。宫腔镜检查与病理检查符合率81.6%。结论宫腔镜检查协助病理检查异常子宫出血的原因,全面、精细、准确率,并有一定的治疗作用,值得临床推广。

  13. Clinical evaluation of long-term safety and effectiveness of a third-generation thermal uterine balloon therapy system for heavy menstrual bleeding.

    Science.gov (United States)

    Cash, Charles; Garza-Leal, Jose; Donovan, Arthur; Guidry, Cyrus; Romanowski, Christine; Patel, Bababhai

    2012-01-01

    To estimate the incidence of amenorrhea at 36 months after treatment using a third-generation thermal uterine balloon therapy (UBT) system and to compare it with the first-generation UBT system. The secondary objective was to estimate the effect of post-procedure curettage on patient outcomes at 36 months after endometrial ablation. Multicenter controlled study (Canadian Task Force classification I). Thirteen hospitals: 12 in the United States and 1 in Mexico. Two-hundred fifty premenopausal women aged at least 30 years with heavy menstrual bleeding not responsive to previous medical therapy for at least 3 months. After treatment with a third-generation thermal UBT system, patients were randomly assigned to receive post-procedure curettage (PPC) or no PPC. Amenorrhea was estimated at 12 months using individual success defined by a pictorial blood loss assessment chart score of 0, and at 24- and 36-month follow-up by patient response of amenorrhea on a 5-point scale (amenorrhea, spotting, and light, normal, or excessive bleeding). In the intention-to-treat population, at 36 months after ablation, the amenorrhea rate was 26.8% with the third-generation UBT system, and 13.0% with the first-generation UBT system. Results by assigned intervention were 29.8% in the no PPC group vs 23.8% in the PPC group. At extended 36-month follow-up, results were similar to the previously reported results at 1 year using prospectively defined matched-pair analysis, and demonstrated superiority in treating amenorrhea using the third-generation UBT system vs the first-generation UBT system. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

  14. 异常子宫出血子宫内膜病理与B超对比观察%Comparative observation of endometrial pathology and B ultrasound in abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    章达桂; 郑守广; 倪慕兰

    2016-01-01

    Objective:To compare the endometrial pathology and B ultrasound diagnosis result of abnormal uterine bleeding. Methods:120 patients with abnormal uterine bleeding were selected.They were respectively given B ultrasound examination and pathology examination,and the diagnosis results of the two methods were compared.Results:B ultrasound diagnosed 80 cases.The coincidence rate of pathology diagnosis result was 66.67%,and the diagnosis accuracy rate of intrauterine fetal residue was highest. Conclusion:Compared with the results of pathological examination,the coincidence rate of abnormal uterine bleeding by B ultrasound is higher.%目的:比较异常子宫出血子宫内膜病理与B超诊断结果。方法:收治异常子宫出血患者120例,分别给予B超检查和病理检查,比较两种方式的诊断结果。结果:B超检查诊断出80例患者,与病理诊断结果的符合率66.67%,其中宫腔胚胎残留的诊断准确率最高。结论:与病理学检查结果相比较,B超诊断异常子宫出血的符合率较高。

  15. Advances in Impedance Controlled Endometrial Resection System for Abnormal Uterine Bleeding%阻抗控制子宫内膜切除系统治疗异常子宫出血的新进展

    Institute of Scientific and Technical Information of China (English)

    谭慧珍

    2013-01-01

    阻抗控制子宫内膜切除系统属于第二代子宫内膜去除术,在治疗异常子宫出血(AUB)中,通过射频能量切除子宫内膜以达到控制月经过多的目的,具有操作简便、内膜破坏深度一致、手术时间短、安全性高、创伤性小、并发症少和疗效显著的优点,越来越多地受到广大临床医师和患者的认同.该文就阻抗控制子宫内膜切除系统治疗AUB的临床应用进展予以综述.%NovaSure impedance control system has been established as a safe and effective second-generation technique for the treatment of abnormal uterine bleeding by endometrial resection. It resects endometrial and controls abnormal uterine bleeding by RF energy. It has a lot of advantages such as simple intimal,damage consistent depth, shorter operative time,high safety,less traumatic,fewer complications, significant efficacy and so on. It becomes welcomed by more and more clinicians and patients home and abroad. Here is to make a review of the new progress of NovaSure system for abnormal uterine bleeding.

  16. Comparison of Sensitivity & Specificity of Transvaginal Sonography, Saline Infusion Sonohysterography and Hysteroscopy in Evaluation of Women with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    K Shojaie

    2009-10-01

    Full Text Available Introduction: Bleeding disorders are a common problem in daily practice, especially in premenopausal women. In our investigation, we compared the sensitivity and specificity of three different diagnostic methods Trans-vaginal sonography(TVS, saline infusion sonohystrography(SIS and Hysteroscopy. Methods: It was a cross- sectional study with a study population of ninety-nine women suffering fromAUB attending the outpatient clinic of Imam and Razi hospital in Ahvaz- Iran. They were evaluated by three different diagnostic methods and the results were compared. This study started from March 2008 to December 2008. The sensitivity, specificity, positive predictive and negative predictive values were measured in TVS, SIS, and finally these two methods were compared with hysteroscopy (as a gold standard. Results: The sensitivity and specificity of TVS was 74.2% and 49.7%, respectively, while that of SIS was 91.6% and 86%, respectively. The positive predictive value and negative predictive value of TVS was 71.9% and 54.3%, respectively, while that of SIS was 85.9% and 85.75%, respectively. The sensitivity, specificity, the positive predictive and negative predictive values of SIS was more than TVS, and it was similar to hysteroscopy. Conclusion: The findings obtained in the present study indicate that in AUB, sensitivity, specificity, positive and negative predictive value of SIS is more than TVS and therefore can be considered as a first step for diagnosis of AUB.

  17. 阴道超声在绝经期妇女子宫异常出血诊断中的应用分析%Application of Transvaginal Ultrasonography in the Diagnosis of Postmenopausal Women with Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    张敬红

    2014-01-01

    Objective To explore the application of transvaginal ultrasonography in the diagnosis of postmenopausal women with abnormal uterine bleeding. Methods 108 cases of postmenopausal women with abnormal uterine bleeding were given transvaginal ultrasonography, Hysteroscopy and histopathological examination, two methods and histopathological examination of the compliance rate were compared, to evaluate the value of transvaginal ultrasonography in the diagnosis of postmenopausal women with abnormal uterine bleeding. Results The correspondence between pathology and transvaginal ultrasonography in endometrial hyperplasia was 87.0%, the correspondence between pathology and hysteroscopy in endometrial hyperplasia was 89.8%, the difference was not statistically difference(P>0.05). Conclusion Transvaginal ultrasound has an important value in the diagnosis of postmenopausal women with abnormal uterine bleeding, it can be used as the conventional method in the clinical screening of abnormal uterine bleeding.%目的:探讨阴道超声检查在绝经期妇女子宫异常出血诊断中的临床应用价值。方法我院2011年3月至2012年3月共收治108例绝经期子宫异常出血患者,所有患者均行阴道超声、宫腔镜和组织病理学检查,对比前两种检查方法与组织病理学检查结果的符合率,以评价阴道超声检查在子宫异常出血诊断中的价值。结果阴道超声与组织病理学结果总符合率为87.0%,宫腔镜与组织病理学检查结果总符合率为89.8%,两组差异无统计学意义(P>0.05)。结论阴道超声在绝经期妇女子宫异常出血中具有较高的诊断符合率,可作为子宫异常出血临床筛检的常规方法。

  18. 绝经后激素治疗引发子宫异常出血的研究进展%Research progress of uterine abnormal bleeding induced by postmenopausal HT

    Institute of Scientific and Technical Information of China (English)

    盛秋; 李芬

    2012-01-01

    激素治疗可以有效地缓解绝经后相关症状,改善妇女的生活质量,与此同时也可能引发子宫异常出血,而对于这种出血的机制目前尚不十分清楚,可能与激素暴露下内膜和间质的改变及血管活性介质的产物增加等因素有关.该文就此展开综述,为绝经后妇女激素治疗和异常子宫出血的处理提供理论依据.%Hormone therapy ( HT ) can relieve postmenopausal complications effectively and improve life quality of women. Meanwhile, it is likely to induce uterine abnormal bleeding. Yet the mechanism of it is not quite clear. Abnormal bleeding may relate with altered endometrial and matrix and increasing of vasoactive mediator products. The article summarized the relationship between abnormal bleeding and its influencing factors, so as to provide theoretic evidence for HT for postmenopausal women and treatment of uterine abnormal bleeding.

  19. Plasma-mediated vascular dysfunction in the reduced uterine perfusion pressure model of preeclampsia: a microvascular characterization.

    LENUS (Irish Health Repository)

    Walsh, Sarah K

    2012-01-31

    Preeclampsia is associated with widespread maternal vascular dysfunction, which is thought to be mediated by circulating factor(s). The aim of the study was to characterize vascular function in the reduced uterine perfusion pressure (RUPP) rat model of preeclampsia and to investigate the role of plasma factors in mediating any observed changes in vascular reactivity. Mean arterial blood pressure and vascular function were measured in RUPP and control rats. Mesenteric vessels from both virgin and pregnant rats were exposed for 1 hour or overnight to plasma from both RUPP and control rats and their vascular function assessed. RUPP rats were characterized by severe hypertension, restricted fetal growth, and reduced placental weight (P<0.001). Vasorelaxation was impaired in resistance vessels from RUPP compared with control rats (acetylcholine: R(max) 70+\\/-3 versus 92+\\/-1 [NP] and 93+\\/-3% [sham], P<0.01; bradykinin: 40+\\/-2 versus 62+\\/-2 [NP] and 59+\\/-4% [sham], P<0.001). Incubation of vessels from pregnant (but not virgin) animals with RUPP plasma overnight resulted in an attenuation of vasorelaxant responses (acetylcholine: 63+\\/-7 versus 86+\\/-2%, P<0.05; bradykinin: 35+\\/-5 versus 55+\\/-6%, P<0.001). The residual relaxant response in RUPP plasma-treated vessels was not further attenuated after treatment with N(omega)-nitro-l-arginine methyl ester (acetylcholine: 57+\\/-7 versus 63+\\/-7%, ns; bradykinin: 37+\\/-5 versus 35+\\/-5%, ns). The RUPP rat model is characterized by an impaired response to vasodilators which may be attributable to one or more circulating factors. This plasma-mediated endothelial dysfunction appears to be a pregnancy-dependent effect. Furthermore, nitric oxide-mediated vasorelaxation appears to be absent in RUPP plasma-treated vessels.

  20. The diagnostic value of hysteroscopy in the etiology of abnormal uterine bleeding%宫腔镜在异常子宫出血病因中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    佛新艳; 王群英; 孙养玲

    2016-01-01

    Objective:To investigate the diagnostic value of hysteroscopy in the etiology of abnormal uterine bleeding.Methods:120 patients with abnormal uterine bleeding were selected.They were randomly divided into the two groups.Patients in the observation group used hysteroscopy,while patients in the control group used ultrasound combined with uterine curettage.The examination results and pathological diagnosis coincidence rate were analyzed between groups.Results:The total detection rate of the observation group was 86.67% ,which was higher than 56.67% of the control group,and the difference was statistically significant(P<0.05).Conclusion:The hysteroscopy for diagnosing the cause of abnormal uterine bleeding is obviously superior to the traditional diagnostic curettage.%目的:探讨宫腔镜在异常子宫出血病因中的诊断价值。方法:收治异常子宫出血患者120例,随机平分为两组,观察组采用宫腔镜检查,对照组采用B超和诊断性刮宫检查。分析两组检查结果与病理诊断符合率。结果:观察组总检出率86.67%,高于对照组的56.67%,两组比较,差异有统计学意义(P<0.05)。结论:宫腔镜对异常子宫出血的病因诊断明显优于传统诊断性刮宫,安全、高效。

  1. 子宫内膜消融术治疗良性病变所致子宫出血疗效的研究%The study of endometrial ablation in the treatment of benign uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    颜士杰; 韦雯雯; 昝培霞

    2011-01-01

    目的 探讨超声引导下子宫内膜消融术在良性疾病导致的异常子宫出血中的治疗效果.方法 应用自凝刀对114例患者在超声监护下行子宫内膜射频消融术,术后定期随访,观察疗效.结果 自凝刀子宫内膜消融术治疗子宫出血平均(12.32±4.51)min,96例治愈,18例有效,总有效率100%,无严重并发症.结论 超声引导下子宫内膜消融术治疗子宫异常出血是一种安全、疗效好、简单、快速的治疗方法.%Objective To investigate the treatment effect of ultrasound-guided endometrial ablation in treating abnormal uterine bleeding caused by benign disease. Methods 114 cases were treated with uterine endometrium ablation using ultrasound-guided self-clotting cutter radiofrequency. All cases of benign uterine bleeding were under regular follow-up and the treatment efficacy were observed. Results The average operation time was (12. 32± 4. 51) minutes. 96 cases were completely cured and 18 cases improved with the effective rate 100%. Conclusions Ultrasound-guided endometrial ablation is a safe, effective? Simple, rapid method for the treatment of abnormal u-terine bleeding.

  2. Emergence of late-onset placental dysfunction: relationship to the change in uterine artery blood flow resistance between the first and third trimesters.

    Science.gov (United States)

    Llurba, Elisa; Turan, Ozhan; Kasdaglis, Tania; Harman, Chris R; Baschat, Ahmet A

    2013-06-01

    To test if emergence of third-trimester (T3) placental dysfunction is related to the impedance change in uterine artery blood flow resistance between the first trimester (T1) and T3. Mean T1 and T3 uterine artery (mUtA) pulsatility index (PI) was measured in 1098 singletons. Each patient's individual mUtA-PI change was calculated ([(T3 PI - T1 PI/interval in days)] × 100; ΔmUtA-PI). This parameter and T1 and T3 mUtA-PI z-scores were related to placenta-related disease (PRD) and to constitutionally small neonates (CS). Forty-seven (5%) women had PRD and 83 (8.7%) delivered a CS neonate. T1 and T3 mUtA-PI z-scores were higher with PRD (0.418 versus -0.097 and 1.06 versus -0.13, p Change in mUtA-PI (ΔmUtA PI) was similar for patients with PRD. However, the prevalence of PRD doubled with rising ΔmUtA-PI (11.1% versus 5.2%, p = 0.041). T3 uterine artery Doppler performs significantly better in detecting patients at risk for late-onset PRD than T1 or the gestational age change in uterine artery Doppler resistance This suggests that a proportion of late emerging PRD is not amenable to early screening by uterine artery Doppler. Further research is essential to identify the optimal screening strategy for late-onset placental dysfunction. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Progestins Upregulate FKBP51 Expression in Human Endometrial Stromal Cells to Induce Functional Progesterone and Glucocorticoid Withdrawal: Implications for Contraceptive- Associated Abnormal Uterine Bleeding.

    Science.gov (United States)

    Guzeloglu Kayisli, Ozlem; Kayisli, Umit A; Basar, Murat; Semerci, Nihan; Schatz, Frederick; Lockwood, Charles J

    2015-01-01

    Use of long-acting progestin only contraceptives (LAPCs) offers a discrete and highly effective family planning method. Abnormal uterine bleeding (AUB) is the major side effect of, and cause for, discontinuation of LAPCs. The endometria of LAPC-treated women display abnormally enlarged, fragile blood vessels, decreased endometrial blood flow and oxidative stress. To understanding to mechanisms underlying AUB, we propose to identify LAPC-modulated unique gene cluster(s) in human endometrial stromal cells (HESCs). Protein and RNA isolated from cultured HESCs treated 7 days with estradiol (E2) or E2+ medroxyprogesterone acetate (MPA) or E2+ etonogestrel (ETO) or E2+ progesterone (P4) were analyzed by quantitative Real-time (q)-PCR and immunoblotting. HSCORES were determined for immunostained-paired endometria of pre-and 3 months post-Depot MPA (DMPA) treated women and ovariectomized guinea pigs (GPs) treated with placebo or E2 or MPA or E2+MPA for 21 days. In HESCs, whole genome analysis identified a 67 gene group regulated by all three progestins, whereas a 235 gene group was regulated by E2+ETO and E2+MPA, but not E2+P4. Ingenuity pathway analysis identified glucocorticoid receptor (GR) activation as one of upstream regulators of the 235 MPA and ETO-specific genes. Among these, microarray results demonstrated significant enhancement of FKBP51, a repressor of PR/GR transcriptional activity, by both MPA and ETO. q-PCR and immunoblot analysis confirmed the microarray results. In endometria of post-DMPA versus pre-DMPA administered women, FKBP51 expression was significantly increased in endometrial stromal and glandular cells. In GPs, E2+MPA or MPA significantly increased FKBP51 immunoreactivity in endometrial stromal and glandular cells versus placebo- and E2-administered groups. MPA or ETO administration activates GR signaling and increases endometrial FKBP51 expression, which could be one of the mechanisms causing AUB by inhibiting PR and GR-mediated transcription

  4. Progestins Upregulate FKBP51 Expression in Human Endometrial Stromal Cells to Induce Functional Progesterone and Glucocorticoid Withdrawal: Implications for Contraceptive- Associated Abnormal Uterine Bleeding.

    Directory of Open Access Journals (Sweden)

    Ozlem Guzeloglu Kayisli

    Full Text Available Use of long-acting progestin only contraceptives (LAPCs offers a discrete and highly effective family planning method. Abnormal uterine bleeding (AUB is the major side effect of, and cause for, discontinuation of LAPCs. The endometria of LAPC-treated women display abnormally enlarged, fragile blood vessels, decreased endometrial blood flow and oxidative stress. To understanding to mechanisms underlying AUB, we propose to identify LAPC-modulated unique gene cluster(s in human endometrial stromal cells (HESCs. Protein and RNA isolated from cultured HESCs treated 7 days with estradiol (E2 or E2+ medroxyprogesterone acetate (MPA or E2+ etonogestrel (ETO or E2+ progesterone (P4 were analyzed by quantitative Real-time (q-PCR and immunoblotting. HSCORES were determined for immunostained-paired endometria of pre-and 3 months post-Depot MPA (DMPA treated women and ovariectomized guinea pigs (GPs treated with placebo or E2 or MPA or E2+MPA for 21 days. In HESCs, whole genome analysis identified a 67 gene group regulated by all three progestins, whereas a 235 gene group was regulated by E2+ETO and E2+MPA, but not E2+P4. Ingenuity pathway analysis identified glucocorticoid receptor (GR activation as one of upstream regulators of the 235 MPA and ETO-specific genes. Among these, microarray results demonstrated significant enhancement of FKBP51, a repressor of PR/GR transcriptional activity, by both MPA and ETO. q-PCR and immunoblot analysis confirmed the microarray results. In endometria of post-DMPA versus pre-DMPA administered women, FKBP51 expression was significantly increased in endometrial stromal and glandular cells. In GPs, E2+MPA or MPA significantly increased FKBP51 immunoreactivity in endometrial stromal and glandular cells versus placebo- and E2-administered groups. MPA or ETO administration activates GR signaling and increases endometrial FKBP51 expression, which could be one of the mechanisms causing AUB by inhibiting PR and GR

  5. 272例异常子宫出血宫腔镜检查结果分析%Abnormal uterine bleeding diagnosed by hysteroscopy: 272 cases

    Institute of Scientific and Technical Information of China (English)

    杨春梅; 李其香; 牟海波

    2016-01-01

    目的 探讨宫腔镜诊断绝经前后异常子宫流血的临床价值及安全性.方法 回顾性分析2010年1月至2015年1月因异常子宫出血于重庆市长寿区人民医院妇产科行宫腔镜检查的272例患者的临床特点及组织病理学资料.结果 组织病理学诊断子宫内膜息肉75例,其中5例镜下误诊为子宫黏膜下肌瘤,镜下诊断符合率为93.3% (70/75);子宫黏膜下肌瘤50例,符合率为90.9%(50/55);子宫内膜增生症97例,其中7例镜下误诊为不典型增生或癌,符合率92.8% (90/97);不典型增生或子宫内膜癌19例,符合率为73.1%(19/26);萎缩性子宫内膜23例;宫内节育环残留8例.结论 绝经前女性以子宫内膜增生、子宫黏膜下肌瘤、子宫内膜息肉为主,子宫内膜癌及癌前病变少见;而绝经后女性主要以子宫内膜息肉、萎缩性子宫内膜、癌及癌前病变为主.宫腔镜对常见的子宫内膜病变具有良好诊断价值,宜同时配合组织病理学检查.%Objective To evaluate the clinical value and safety of hysteroscopy in diagnosis of abnormal uterine bleeding.Methods The clinical characters and histopathological data of 272 cases of abnormal uterine bleeding were retrospectively analyzed.They received hysteroscopy in our hospital from Jan.2010 to Jan.2015.Results Histopathological diagnosis showed 75 cases were with endometrial polyps,including 5 cases misdiagnosed as submucosal fibroids,and the correct diagnostic rate was 93.3% (70/75).50 cases were with submucosal fibroids,and the diagnostic rate was 90.9% (50/55).97 cases were endometrial hyperplasia,including 7 cases misdiagnosed as atypical hyperplasia or cancer by hysteroscopy,and the correct diagnostic rate was 92.8% (90/97).19 cases were atypical hyperplasia or endometrial carcinoma,and the diagnostic rate was 73.1%(19/26).Atrophic endometrium were 23 cases.8 cases had intrauterine device remained.Conclusions Premenopausal women are more likely to present

  6. Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

    Science.gov (United States)

    Laban, Mohamed; Eisa, Marwa M.

    2016-01-01

    The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P = 0.223; P = 0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB. PMID:28003825

  7. Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding.

    Science.gov (United States)

    Laban, Mohamed; Hussain, Sherif H; Hassanin, Alaa S; Khalaf, Waleed M; Etman, Mohamed K; Elsafty, Mohammed S E; Bahaa Eldin, Ahmed M; Hasanien, Ahmad S; Sakna, Noha A; Taema, Mohammed; Mostafa, Mohammed H; Eisa, Marwa M

    2016-01-01

    The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P = 0.223; P = 0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

  8. Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    Mohamed Laban

    2016-01-01

    Full Text Available The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS, and three-dimensional (3D Virtual Organ Computer-aided AnaLysis™ (VOCAL to detect endometrial polyps (EPs in premenopausal women with abnormal uterine bleeding (AUB. This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33% were diagnosed with EP by 2D TVUS. 50 (45.9% had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223; P=0.06. 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

  9. 宫腔镜检查在诊断异常子宫出血中的临床价值%Clinical value of hysteroscopy in the diagnosis of abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    吴汝芳

    2012-01-01

    Objective: To explore the clinical value of hysteroscopy in the diagnosis of abnormal uterine bleeding. Methods; The clinical data of 287 patients who underwent hysteroscopy because of abnormal uterine bleeding, received treatment under hysteroscope, endo-metrial location and biopsy were analyzed retrospectively. Results; The total coincidence rate of hysteroscopic diagnosis and histopathological diagnosis for 287 patients with abnormal uterine bleeding was 80. 84% , the coincidence rates of hysteroseopic diagnosis and histopathological diagnosis for submucous myoma, endometrial polyps, endometrial hyperplasia, endometrilis, atrophic endometrium, and endometrial cancer were 100. 00% , 96. 83% , 68.42% , 77. 27% , 100.00% , and 100.00% , respectively. CamMon: Hysteroscope can observe the morphologies and structures of uterine cavity and cervical canal clearly, which has the incomparable advantages compared to diagnostic curettage and ultrasonography, hysteroscope is a gold standard for the diagnosis of abnormal uterine bleeding.%目的:探讨宫腔镜检查在诊断异常子宫出血中的临床价值.方法:回顾性分析因异常子宫出血行宫腔镜检查,同时在宫腔镜下进行相应治疗和子宫内膜定位活检的287例患者资料.结果:287例异常子宫出血患者的宫腔镜诊断与病理组织学诊断总符合率为80.84%,其中子宫黏膜下肌瘤100.00%、子宫内膜息肉96.83%、子宫内膜增生68.42%、子宫内膜炎77.27%、萎缩性子宫内膜100.00%、子宫内膜癌100.00%.结论:宫腔镜能直接清晰地观察宫腔内及宫颈管的形态与结构,具有诊断性刮宫和超声检查不可比拟的优点,是诊断异常子宫出血的金标准.

  10. Clinical Analysis of Hysteroscopic Electrotomy Treatment of Abnormal Uterine Bleeding%宫腔镜电切术治疗异常子宫出血的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘云梅; 左溢华; 陶立安

    2015-01-01

    Objective Discussion hysteroscopic electrotomy treatment of abnormal uterine bleeding clinical results.Methods Select our hospital 80 cases of abnormal uterine bleeding were randomly divided into observation group and the control group,the control group underwent hysteroscopy,lesion site,routine curettage treatment,observation group underwent hysteroscopic resection,observe the operation time,complications,postoperative recovery. Results Efficacy of observation group is better than the control group,the recurrence rate is lower than in the control group(P<0.05). Conclusion Hysteroscopic surgery is effective in treating abnormal uterine bleeding,with a smal surgical trauma,conducive to patient recovery, worthy of clinical application of the promotion.%目的:探讨宫腔镜电切术治疗异常子宫出血的临床效果。方法选取我院收治的80例异常子宫出血患者,随机分为观察组和对照组,对照组行宫腔镜检查,明确病变部位,常规刮宫术治疗,观察组行宫腔镜电切术治疗,观察手术时间、并发症情况、术后患者恢复情况。结果观察组疗效明显优于对照组,复发率低于对照组(P<0.05)。结论宫腔镜电切术治疗异常子宫出血的疗效确切,手术创伤小,有利于患者恢复。

  11. Correlation Between Body Reproductive Hormone Level and Abnormal Uterine Bleeding After Drug Abortion%药物流产后机体生殖激素水平与子宫异常出血的相关性

    Institute of Scientific and Technical Information of China (English)

    冉丽萍; 冉爱冬

    2011-01-01

    Objective To explore the correlation between body reproductive hormone level and abnormal uterine bleeding after drug abortion. Methods The patients with uterine bleeding less than 16 days after drug abortion were selected as the normal group, while the patients with uterine bleeding more than 16 days were selected as the abnormal group. Surgical abortion women were served as the control group. The levels of E2, P, FSH, LH, and HCG in the women of three groups were continuously monitored during 10 ~ 22 days after abortion. Results The changes of E2 level in the three groups were generally identical and showed an ascendant trend. P level of the abnormal group was significantly higher than those of the control group and the normal group all the time (P<0.05). FSH levels of the three groups fluctuated repeatedly, and LH levels showed a decreased trend. HCG level in abnormal group was significantly higher than those in the control group and the normal group all the time (P<0.05). Conclusions The abnormal uterine bleeding after drug abortion is related to high levels of P and HCG, but irrelevant to the levels of E2, LH, and FSH.%目的 探讨药物流产后机体生殖激素水平与子宫异常出血的相关性.方法 选取药流后子宫出血小于16d者为正常组,子宫出血大于16 d者为异常组,手术流产妇女为对照组.连续监测三组妇女流产10~22 d的E2、P、FSH、LH、HCG水平.结果 三组E2水平变化基本相同,呈上升趋势;异常组P水平始终显著高于对照组和正常组(P<0.05);三组FSH水平均在反复波动,LH水平呈下降趋势;异常组HCG水平始终显著高于对照组和正常组(P<0.05).结论 药物流产后子宫异常出血与高水平的P和HCG有关,而与E2、LH、FSH无关.

  12. 层粘连蛋白及纤维粘连蛋白与药流后子宫出血关系的研究%Fibronectin and Laminin Expressions in Prolonged Uterine Bleeding after Medical Abortion

    Institute of Scientific and Technical Information of China (English)

    赵艳忠; 翁梨驹; 诸定寿; 吕国蔚

    2001-01-01

    为探讨层粘连蛋白(LM)及纤维粘连蛋白(FN)在米非司酮药物流产(以下简称药流)后子宫持续出血时的表达,对20例米非司酮+米索前列醇药物流产后子宫出血(出血组)的刮出组织及10例人工流产负压吸宫术吸出的组织(对照组),用HE及免疫组织化学方法染色并观察标本。结果:出血组的刮出组织中45%可见滋养细胞或绒毛,90%发现蜕膜组织。2组蜕膜组织的血管及腺上皮基膜、蜕膜细胞周围和一部分蜕膜细胞胞质内都含有较丰富的LM与FN,并且2组间比较,FN与LM含量表达无明显差异(P>0.05)。说明残留蜕膜中含有能分泌大量LM与FN的蜕膜细胞和血管,致使蜕膜组织与子宫壁牢固地结合而不易脱落,影响内膜发育而引起出血。%To investigate the expression of fibronectin(FN) and laminin(LN)in prolonged uterine bleeding after mifepristone induced abortion, 20 specimens from curettage were obtained from 20 women who had prolonged uterine bleeding after termination of early pregnancy by mifepristone and misoprostol. Ten specimens from normal early pregnancy by suction aspiration served as control group. All samples were studied by immunochemical stainning. Trophoblasts or villi were presented in 45% of the cases with prolonged bleeding, and retained decidua cells were shown in 90%. By immunochemical stainning, LM and FN were both significantly expressed around the decidual cells and in the base membrane of blood vessels and glandular epithelium; and also within some of the decidual cells. The expression levels at the three locations had no significant differences between the 2 groups (P>0.05). The result illustrated that the retained decidua cells kept the function of secreting FN and LM, which served as the adhesion molecules to the uterine wall, thus caused prolonged uterine bleeding and postponed the regeneration of endometrium development.

  13. Analysis on 115 cases with abnormal uterine bleeding examinaed by hysteroscope combined with B ultrasound%宫腔镜联合B超检查异常子宫出血115例分析

    Institute of Scientific and Technical Information of China (English)

    张帆

    2011-01-01

    目的:讨论宫腔镜与B超联合检查在诊断异常子宫出血中的临床价值.方法:应用宫腔镜联合B超检查异常子宫出血115例术中行定位取材或直视下活检.结果:B超报告子宫内膜正常者63例,宫腔镜诊断子宫内膜息肉3例,增殖期子宫内膜4例,宫颈管息肉2例,病理报告与宫腔镜诊断相符,B超发现异常情况52例,经宫腔镜检查活检、诊刮的病理报告异常的有35例.宫腔镜诊断子宫内膜息肉、子宫肌瘤、子宫内膜癌的准确性较高分别为100.0%、85.9%、100.0%,宫腔镜诊断子宫内膜增生、子宫内膜萎缩的准确性分别达59.1%、60.0%、宫腔镜诊断异常子宫出血的漏诊率为零,B超检查的漏诊率为8.7%.结论:宫腔镜检查结合B超定位活检、诊刮相结合才能提高对异常子宫出血诊断的准确性,宫腔镜检查对诊断宫腔及宫颈管内疾病有重要价值,若联合B超检查可以使宫腔镜检查更加安全、准确并同时诊断宫腔外的盆腔疾病.%Objective: To explore the clinical values of hysteroscopy and B ultrasonography in diagnsosis of abnormal uterine bleeding. Methods; 115 cases with abnormal uterine bleeding received hysteroscopy and B ultrasonography, and in the course of operation, location and biopsy under direct vision were carried out Results; 63 cases with normal endometrium were reported by B ultrasound; 3 cases with endometrial polyp, 4 cases with endometrium at proliferative phase and 2 cases with endocervial canal polyp were diagnosed by hysteroscopy , the pathological reports were identified with hysteroscopic diagnosis; 52 cases with abnormalities were found by B ultrasound, while 35 cases were defined by biopsy and diagnostic curettage under hysteroscope. The accuracies of hysteroscopy in diagnosis of endometrial polyp, hysteromyoma and endometrial cancer were high (100.0% , 85. 9% and 100. 0% , respectively) , the accuracies of hysteroscopy in diagnosis of endometrial

  14. Uterine artery embolization to treat uterine fibroids

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    Machan, L.; Martin, M. [Univ. of British Columbia Hospital, Dept. of Radiology, Vancouver, BC (Canada)

    2001-06-01

    The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

  15. The GPVI-Fc fusion protein Revacept reduces thrombus formation and improves vascular dysfunction in atherosclerosis without any impact on bleeding times.

    Directory of Open Access Journals (Sweden)

    Martin Ungerer

    Full Text Available AIMS: Glycoprotein VI (GPVI is a key platelet receptor which mediates plaque-induced platelet activation and consecutive atherothrombosis, but GPVI is also involved in platelet-mediated atheroprogression. Therefore, interference in GPVI-mediated platelet activation has the potential to combine short-term and long-term beneficial effects, specificity and safety especially regarding bleeding complications. METHODS AND RESULTS: We investigated the effects of the soluble dimeric GPVI receptor fusion protein, Revacept, an antagonist of collagen-mediated platelet activation, in an animal model of atherosclerosis: twenty week old rabbits, which had been fed on a cholesterol-rich diet for 8 weeks, received Revacept (8 mg/kg or control twice weekly for 4 weeks. Pharmacokinetics indicated a slight accumulation of the drug in the serum after repeated dosing of Revacept for 3 weeks. A significant improvement of endothelial dysfunction after 0.06 and 0.6 µg/min acetylcholine and a significant decrease of vessel wall thickening were found after Revacept treatment. Accordingly, aortic vessel weight was reduced, and plaque sizes, macrophage and T-cell invasion tended to be reduced in histological evaluations. Bleeding time was determined after tail clipping in mice. Revacept alone or in combination with widely used anti-platelet drugs revealed a high safety margin with no prolongation of bleeding times. CONCLUSION: Repeated doses of Revacept led to a significant improvement of endothelial dysfunction and vascular morphology in atherosclerotic rabbits. Furthermore, no influence of Revacept on bleeding time alone or in combinations with various anti-platelet drugs was found in mice. Thus, the inhibition of collagen-mediated platelet interaction with the atherosclerotic endothelium by Revacept exerts beneficial effects on morphology and vascular function in vivo and seems to have a wide therapeutic window without influencing the bleeding time.

  16. 宫腔镜联合B超诊断异常子宫出血124例临床分析%Clinical Analysis of Hysteroscopy plusB Ultrasound in Diagnosis of 124 Cases of Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    吴俊改; 韩红敬; 黄秀兰; 李彦军; 刘宝芝; 李红华

    2011-01-01

    Objective: To study hysteroscopy combinedType-B ultrasonic exceeds abnormal uterine bleeding in the diagnosis and treatment of clinical value. Methods: A total of 124 cases of abnormal uterine bleeding were retrospectively analyzed. All the patients were performed hysteroscopy plus Bultrasound detection. The materials removed or scraped off from theuterine cavity were sent for histologi-calexamination. Results: 124 patients were diagnosed by pathological examination for endometrial polyps 84 cases (67.7%), combined with cervical polyp 10 cases; Endome- trial hyperplasia disease in 16 (12.9%), including simple hyperplasia in 12 cases, complexity hyperplasia in 4; Endometriosis dysplasia 1 cases (0.8%); Submucosal uterine fibroids in 12 cases (9.7%); Sample endometrial adenocar-cinoma 6 patients (4.8%); Endometritis 3 cases (2.4%); Embryos residues in 2 cases (1.6%). Conclusion: Hysteroscopy plus Bultrasound is the best detection for diagnosis of abnormal uterine bleeding.%目的:探讨宫腔镜联合B超在诊治异常子宫出血的临床价值.方法:对124例异常子宫出血的病例进行回顾性分析,所有患者作B超及宫腔镜检查,宫腔内切除物或刮出物均送病理检查.结果:124例患者经病理检查确诊为子宫内膜息肉84例(67.7%),合并宫颈息肉10例;子宫内膜增生症16例(12.9%),其中单纯性增生12例,复杂性增生4例;子宫内膜不典型增生l例(0.8%);子宫粘膜下肌瘤12例(9.7%);子宫内膜样腺癌6例(4.8%);子宫内膜炎3例(2.4%);胚物残留2例(1.6%).结论:宫腔镜联合B超检查是诊断异常子宫出血最好的方法.

  17. 宫腔镜在诊断围绝经期异常子宫出血中的应用%The application of hysteroscopy in diagnosing abnormal uterine bleeding of perimenopausal women

    Institute of Scientific and Technical Information of China (English)

    陆静

    2011-01-01

    目的 探讨官腔镜检查在围绝经期异常子宫出血中的诊断价值.方法 回顾性分析经病理检查确诊的203例围绝经期异常子宫出血患者的临床资料,比较宫腔镜检查、B超和病理诊断的符合率.结果 官腔镜诊断子宫内膜息肉60例,子宫粘膜下肌瘤26例,子宫颈管内膜息肉23例,子宫颈管粘膜下肌瘤7例,子宫内膜增殖症19例,子宫内膜炎13例,子宫内膜癌4例,与病理诊断总的符合率为87.4%,B超诊断与病理诊断的符合率为57.5%.结论 官腔镜在直视下观察宫腔病变并定位取活检,使诊断更直接、更准确,是诊断围绝经期异常子宫出血的有效手段.%Objective To evaluate the value of hysteroscopy to diagnose abnormal uterine bleeding of perimenopausal women. Methods Retrospectively analyse 203 patients of abnormal uterine bleeding. The diagnostic coincident rate of hysterosco py and transvagianal uitrasonography were compared with pathological examination. Results 60 cases of endometrial polypus 、26 cases of submucous myoma 、23 cases of endometrial polypus in cervical canal 、7 cases of submucous myoma in cervical canal 、19 cases of endometrial hyperplasia 、13 cases ofcendometritis and 4 cases of endometrial carcinoma were diagnosed by hysteroscopy, with the coincident rate as 87.4% ;The coincident rate of transvagianal uitrasonography was 57. 5%. Conclusion The diseases in the uterine cavity can be observed and taken biopsy by hysteroscopy which makes the diagnosis more directly and correctly. Hyste roscopy is an effective method to diagnose abnormal uterine bleeding of perimenopausal women.

  18. 宫腔镜治疗异常子宫出血197例疗效观察%The observation of treating 197 cases of abnormal uterine bleeding with hysteroscope

    Institute of Scientific and Technical Information of China (English)

    李琼

    2012-01-01

      Objective: To analyze the clinical effect of treating abnormal uterine bleeding with hysteroscope. Methods: Choosed 197 cases of abnormal uterine bleeding from Jan. 2009 to Jan. 2011 to treat with uterine fibroids electric resection, endometrial polyps electric resection, endometrial electric resection single or combined, and combined medicine treatment. Results: Folowed up 185 cases, the satisfation rate was 91.35%. There were 157 cases menstrual improvement, the total effetive rate was 84.87%. Conclusion: Hysteroscope as a minimaly invasive surgery could treat abnormal uterine bleeding effetively, and has a low recurrence to extend in clinic.%  目的分析宫腔镜治疗对于异常子宫出血患者的临床效果.方法对2009年1月到2011年1月在我院接受异常子宫出血手术的197例患者,根据不同病情,选择单独或联合采用子宫肌瘤电切除手术,子宫内膜息肉电切除手术,子宫内膜电切除手术,并配合进行药物治疗.结果197例病患中,医院随机访问185例,对于手术满意的患者为169名,满意度为91.35%.月经明显改善157例,有效率达84.87%.结论宫腔镜技术作为一种微创手术治疗方式有效治疗异常子宫出血,复发率低,手术时间短,手术创伤小等优点大大增加了其在临床应用的价值.

  19. 子宫内膜息肉对患者子宫异常出血影响的研究%Inlfuence of Endometrial Polyps in Patients with Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    宋文榕

    2015-01-01

    Objective: To study the influence on the influence of abnormal bleeding in patients with endometrial polyp of uterus.Methods:80 cases of patients with polyps resection operation were selected in 2012 January to 2014 January received in our hospital,all patients with Jun Youtong a physician hold knife to accept operation treatment.According to the physiological period of patients,the patients were divided into group of childbearing age and menopause group.Results:Two groups of patients with polyps of different sizes and cause of abnormal uterine bleeding were statistically significant (P 0.05),wherein the menopause group polyps smaller than 10mm remission rate was significantly higher than that of childbearing age group,the difference was significant (P 0.05).Two groups of multiple polyps remission compared,the difference was significant (P 0.05).Conclusion:Polyps and polyp size in patients with abnormal uterine bleeding has certain connection,polyps resection operation can significantly improve the caused by the factors of abnormal uterine bleeding.%目的:研究子宫内膜息肉对患者子宫异常出血的影响.方法:选取2012年1月至2014年1月在我院接受息肉切除手术的患者80例,所有患者均由同一位医师执刀接受手术治疗.根据患者的生理期,将患者分为育龄组和绝经组,各40例.结果:两组患者因息肉大小不同而引发的子宫异常出血均具有统计学意义(P0.05),其中绝经组小于10mm的息肉缓解率明显高于育龄组,差异具有显著性(P0.05).两组多发息肉的缓解情况相比,差异具有显著性(P0.05).结论:单发息肉及息肉大小与患者子宫异常出血具有一定的联系,息肉切除手术能够明显改善由上述因素引起的子宫异常出血.

  20. Clinical value of hysteroscopy in diagnosis of postmenopausal uterine bleeding%宫腔镜检查对绝经后子宫出血的诊断价值

    Institute of Scientific and Technical Information of China (English)

    夏秋霞; 潘升华; 蔡珠华; 曹华妹

    2010-01-01

    Objective To investigate the value of hysteroscopy in the diagnosis of postmenopausal uterine bleeding.Methods 106 cases of outpatient of postmenopausal bleeding were analyzed.Hysteroscopic diagnosis and the biopsy result were compared in all patients.Results Histological diagnosis was 73 cases of uterine cavity abnormality,33 cases of normal were diagnosed in hysteroscopy.78 cases of pathological abnormalities,and 28 cases of normal were diagnosed.Comparing to histology, sensitivity was 95.89% ,specificity 84.85% , positive predictive value 93.33% , negative predictive value of 90.32%.Conclusion Hysteroscopy combined pathology was the best method to diagnose postmenopausal uterus bleeding.%目的 探讨宫腔镜检查对绝经后子宫出血的诊断价值.方法 门诊行宫腔镜检查的绝经后子宫出血患者共106例,术中行定位取材送活检,并对宫腔镜诊断与病理结果进行比较.结果 宫腔镜诊断子宫腔内异常病变73例,正常33例,病理检查异常78例,正常28例.与病理结果比较,宫腔镜检查敏感性为95.89%,特异性为84.85%,阳性预测值93.33%,阴性预测值90.32%.结论宫腔镜检查联合病理检查是诊断绝经后子宫出血的主要方法之一.

  1. Lajjalu treatment of uterine prolapse

    Science.gov (United States)

    Shivanandaiah, T. M.; Indudhar, T. M.

    2010-01-01

    Mimosa pudica was found useful in cases of uterine prolapse with bleeding, consistent with my experience of working with the condition for more than 45 years, and treating hundreds of such cases of uterine prolapse. Hysterectomy has been avoided up to this date, and is not now expected to be recommended. PMID:21836800

  2. Lajjalu treatment of uterine prolapse

    Directory of Open Access Journals (Sweden)

    T M Shivanandaiah

    2010-01-01

    Full Text Available Mimosa pudica was found useful in cases of uterine prolapse with bleeding, consistent with my experience of working with the condition for more than 45 years, and treating hundreds of such cases of uterine prolapse. Hysterectomy has been avoided up to this date, and is not now expected to be recommended.

  3. Hypothalamic dysfunction

    Science.gov (United States)

    ... common causes of hypothalamic dysfunction are surgery, traumatic brain injury, tumors, and radiation. Other causes include: Anorexia nervosa or bulimia Bleeding Genetic disorders that cause iron ...

  4. 围绝经期子宫异常出血子宫内膜病理变化分析%Pathology of the endometrium in perimenopausal women with abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    雷亚平; 胡雪涛

    2015-01-01

    Objective: To investigate the pathologic features of endometrium in perimenopausal women with abnormal uterine bleeding. Methods: The pathologic data of endometrium in 152 perimenopausal women with abnormal uterine bleeding were retrospectively analyzed. Results:Among 152 cases,the hyperplasis endometria in 74 cases(48. 68% ),proliferated phase of endometria in 48 cases(31. 58% ),secretory endometria in 18 cases(11. 84% ),hormone therapy endometria in 2 cases(1. 32% ),endometrial polyps in 7 cases( 4. 61% ),local endometrial cancer in 1 case(0. 66% ) and incomplete abortion in 2 cases(1. 32% ) were identified. Conclusions:Hyperplasis is the most common cause of the abnormal uterine bleeding in perimenopausal women, thereby the pathological diagnosis of endometrium should be noted.%目的::探讨围绝经期子宫异常出血患者的子宫内膜病理变化。方法:回顾性分析152例子宫异常出血患者诊刮子宫内膜的组织病理学资料。结果:152例子宫内膜中,增生性改变74例(48.68%),子宫内膜增殖期48例(31.58%),子宫内膜分泌期18例(11.84%),激素治疗后反应 2例(1.32%),子宫内膜息肉7例(4.61%),局灶癌变1例(0.66%),不全流产 2例(1.32%)。结论:子宫内膜增生性改变是围绝经期子宫异常出血最常见的原因之一,故应重视围绝经期子宫异常出血诊刮子宫内膜的病理诊断。

  5. Clinical observation on NovaSure endometrial ablation for treatment of abnormal uterine bleeding%诺舒子宫内膜去除术治疗异常子宫出血的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨宏燕; 李斌; 宋菁华

    2013-01-01

    目的:探讨诺舒(NovaSure)子宫内膜去除术治疗异常子宫出血的疗效、安全性及满意度.方法:选取采用诺舒治疗异常子宫出血患者20例,术后1、3、6、12、18月随访,观察疗效及并发症.结果:术后随访1、3、6、12、18月其有效率分别为100%(20/20)、95% (19/20)、95% (19/20)、95% (19/20)、95% (19/20),治疗满意度分别为100% (20/20)、95% (19/20)、95% (19/20)、95% (19/20)、95% (19/20),术中、术后末出现明显并发症.结论:诺舒是一种新的治疗异常子宫出血的力法,有效、简便、快速、安全,并发症少,满意度高.%Objective: To explore the curative effect, safety, and degree of satisfaction of NovaSure endometrial ablation for treatment of abnormal uterine bleeding. Methods: Twenty patients with abnormal uterine bleeding treated by NovaSure endometrial ablation were selected, and all the patients were followed up at 1 , 3, 6, 12, and 18 months after surgery, the curative effect and complications were observed. Results: The effective rate at 1 , 3, 6, 12, and 18 months after surgery were 100% (20/20) , 95% ( 19/20) , 95% ( 19/20) , 95% ( 19/20) , and 95% (19/20) , respectively; the degrees of satisfaction were 100% (20/20) , 95% (19/20) , 95% (19/20) , 95% ( 19/20) , and 95% ( 19/20) , respectively; no severe perioperative and postoperative complications occurred. Conclusion: NovaSure endometrial ablation is a new method for treatment of abnormal uterine bleeding, which is effective, convenient, fast, safe, and it has less complications and high degree of satisfaction.

  6. Clinical study of two kinds of endometrial ablation in the treatment of abnormal uterine bleeding%两种子宫内膜祛除术治疗异常子宫出血的临床研究

    Institute of Scientific and Technical Information of China (English)

    刘海绒

    2016-01-01

    Objective:To study the clinical effect of two kinds of endometrial ablation in the treatment of abnormal uterine bleeding.Methods:65 patients with abnormal uterine bleeding were selected.They were divided into two groups Hysteroscopy in the treatment of endometrial resection;the NovaSure group with NovaSure endometrial ablation.Clinical effect was compared. Results:The NovaSure group 1 year amenorrhea rate was significantly higher than that of hysteroscopy group;electrolyte disorder was lower than that of hysteroscopy group(P<0.05).Conclusion:The NovaSure endometrial removal surgery and hysteroscopic endometrial resection in treatment of abnormal uterine bleeding all have certain effect,but the NovaSure endometrial removal surgery can decrease the trauma,reduce interfere with the body,increase the rate of amenorrhea,combined with actual choice suitable operation.%目的:研究两种子宫内膜祛除术治疗异常子宫出血的临床效果。方法:收治异常子宫出血患者65例,分两组。宫腔镜组以宫腔镜子宫内膜切除术治疗;诺舒组以诺舒子宫内膜祛除术治疗。比较临床效果。结果:诺舒组1年闭经率明显高于宫腔镜组,电解质紊乱率低于宫腔镜组(P<0.05)。结论:诺舒子宫内膜祛除术和宫腔镜子宫内膜切除术治疗异常子宫出血均有一定效果,但诺舒子宫内膜祛除术可减轻创伤,减轻机体干扰,提高闭经率,需结合患者实际选择合适术式。

  7. 诺舒(NovaSure)阻抗控制子宫内膜切除系统治疗异常子宫出血的临床研究%NovaSure System for Abnormal Uterine Bleeding

    Institute of Scientific and Technical Information of China (English)

    宋菁华; 李斌; 刘桂芝

    2011-01-01

    目的 探讨诺舒( NovaSure)阻抗控制子宫内膜切除系统治疗异常子宫出血的可行性、安全性及有效性.方法 2010年6月~ll月,采用诺舒治疗异常子宫出血25例,术后l、3、6个月门诊随访,观察疗效及并发症.结果 25例 均完成手术过程,NovaSure治疗时间78 ~ 122 s,(98.4±9.2)s,术中出血<10 ml.术后1、3和6个月的有效率分别为100%(25/25)、96%( 24/25)和96%( 24/25);闭经率分别为76%( 19/25)、64% (16/25)和56%( 14/25).术中及术后均未出现明显并发症.结论 诺舒操作简单且安全,疗效好,适用于多种良性疾病所致的异常子宫出血,尤其适用于有严重合并症的患者.%Objective To investigate the feasibility, safety and efficacy of NovaSure system for abnormal uterine bleeding control. Methods From June 2010 to November 2010, 25 women with abnormal uterine bleeding who received NovaSure system for treatment were retrospectively analyzed. The clinical effect and complications were followed up at months 1,3, and 6. Results The procedures was completed successfully in all the patients. The mean operation time was (98.4 ±9.2) s (ranged from 78 to 122 s). During the operation, the blood loss was less than 10 ml. All the patients were followed-up for 6 months. The rate of satisfaction was 100% (25/25), 96% (24/25), and 96% (24/25) respectively at months 1, 3, and 6. And the rate of amenorrhea was 76% (19/25), 64% (16/25), and 56% (14/25), respectively. No severe perioperative or postoperative complications occurred. Conclusion NovaSure system shows good efficacy, safety and convenience in the treatment of abnormal uterine bleeding, especially for the patients with severe complication.

  8. The HysNiche trial: Hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial

    NARCIS (Netherlands)

    A.J.M.W. Vervoort; L.F. Van der Voet; M. Witmer; A.L. Thurkow; C.M. Radder; P.J.M. van Kesteren; H.W.P. Quartero; W.K.H. Kuchenbecker (Walter); M.Y. Bongers; P.M.A.J. Geomini; L.H.M. de Vleeschouwer; M.H.A. van Hooff (Marcel); H.A. van Vliet; S. Veersema (S.); W.B. Renes; H.S. van Meurs (Hannah); B. Bosmans; K.O. Rengerink (Katrien Oude); H.A.M. Brölmann (H. A M); B.W.J. Mol (Ben W.J.); J.A.F. Huirne (Judith)

    2015-01-01

    textabstractBackground: A caesarean section (CS) can cause a defect or disruption of the myometrium at the site of the uterine scar, called a niche. In recent years, an association between a niche and postmenstrual spotting after a CS has been demonstrated. Hysteroscopic resection of these niches is

  9. The HysNiche trial : hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial

    NARCIS (Netherlands)

    Vervoort, A J M W; Van der Voet, L F; Witmer, M; Thurkow, A L; Radder, C M; van Kesteren, P J M; Quartero, H W P; Kuchenbecker, W K H; Bongers, M Y; Geomini, P M A J; de Vleeschouwer, L H M; van Hooff, M H A; van Vliet, H A A M; Veersema, S; Renes, W B; van Meurs, H S; Bosmans, J; Oude Rengerink, K; Brölmann, H A M; Mol, B W J; Huirne, J A F

    2015-01-01

    BACKGROUND: A caesarean section (CS) can cause a defect or disruption of the myometrium at the site of the uterine scar, called a niche. In recent years, an association between a niche and postmenstrual spotting after a CS has been demonstrated. Hysteroscopic resection of these niches is thought to

  10. Diagnostic Effect of Endometrial Biopsy in Abnormal Uterine Bleeding%子宫内膜活检在异常子宫出血中的诊断效果

    Institute of Scientific and Technical Information of China (English)

    邢志艳

    2016-01-01

    Objective To discuss the clinical effect of the application of endometrial biopsy in the diagnosis of abnormal u-terine bleeding. Methods 120 cases of patients with abnormal uterine bleeding treated in the department of gynaecology of our hospital from March 2013 to March 2015 were selected as the research object and all patients received endometrial biopsy, the diagnostic effect was discussed. Results The 120 cases of patients after endometrial biopsy showed that 19.2%were with uterine organic disease, among them, 21.7%were with abortion, 17.4%were with chronic endometritis, 8.7%were with uterine body adenocarcinoma, 52.2% were with endometrial polyp; and 40.8% were with endometria functional change caused by hormonal imbalance, among them, 59.2% were with hyperplasia, 10.2% were with poor endometrial secretion, 14.3%were with complex hyperplasia, 6.1%were with out-of-sync endometrial secretion response, 10.2%were with irregu-lar shedding endometrial secretion; 40.0% were with endometrium of each phase in normal menstrual cycle, among them, 31.3% were with secretory phase endometria, 56.3% were with estrin phase endometria, 12.5% were with menstrual phase endometria. Conclusion The application of endometrial biopsy in abnormal uterine bleeding has an obvious clinical diag-nostic effect, and it can obviously improve the diagnostic rate of endometrial lesions and is convenient to timely diagnosis and treatment with high clinical value, which is worth promotion.%目的:探讨在诊断异常子宫出血患者中应用子宫内膜活检的临床效果。方法随机选取该院妇科2013年3月-2015年3月收治的异常子宫出血患者120例作为研究对象,所有患者均行子宫内膜活检,探讨其诊断效果。结果120例患者接受子宫内膜活检后发现19.2%为子宫器质性疾病,其中21.7%流产,17.4%为慢性子宫内膜炎,8.7%为宫体腺癌,52.2%为子宫内膜息肉;40.8%为激素水平失调后导致的子宫内膜功能

  11. Comparison of Hysteroscopy and Traditional Diagnostic Curettage Applied in the Diagnosis of Abnormal Uterine Bleeding%比较宫腔镜与传统诊刮术在子宫异常出血中诊断的应用

    Institute of Scientific and Technical Information of China (English)

    钱月芳

    2014-01-01

    目的:比较宫腔镜与传统诊刮术在子宫异常出血中诊断的应用。方法选取该院2012年1月_2014年3月期间收治的54例子宫异常出血患者,所有患者均经诊断性刮宫术,并行宫腔镜治疗。比较两种诊断与术后病理诊断结果的符合率。结果54例子宫异常出血患者经病理学诊断,32例为子宫内膜息肉,20例为子宫粘膜下肌瘤;与病理学诊断比较,宫腔镜检查符合率﹙90.6%﹚明显高于诊断性刮宫术﹙68.8%﹚﹙P<0.05﹚;子宫粘膜下肌瘤宫腔镜检查符合率﹙85.0%﹚明显高于诊断性刮宫术﹙65.0%﹚,两组数据比较差异有统计学意义﹙P<0.05﹚。结论宫腔镜下检查与治疗术在子宫内膜息肉和子宫粘膜下肌瘤引起的子宫异常出血的诊断中有明显的优势,值得临床推广。%Objective To compare the value of hysteroscopy and traditional diagnostic curettage applied to the diagnosis of abnor_mal uterine bleeding. Methods 54 cases with abnormal uterine bleeding admitted in our hospital from January 2012 to March 2014 were selected. All the patients underwent the diagnostic curettage and treated by hysteroscopy. And the diagnostic result of these two methods was compared with that of postoperative pathologic diagnosis; the diagnostic accordance rate was compared be_tween the two methods. Results Of the 54 patients with abnormal uterine bleeding, 32 cases were diagnosed with endometrial polyp and 20 cases with submucosal myoma of uterus by pathology. Compared with the pathological diagnosis, the diagnostic ac_cordance rate of hysteroscopy(90.6%) was much higher than that of diagnostic curettage(68.8%)(P<0.05); the diagnostic accordance rate of hysteroscopy for submucosal myoma of uterus(85.0%) was obviously higher than that of the diagnostic curettage(65.0%), the difference between the data of the two groups was statistically significant(P<0.05). Conclusion The examination and treatment un_der hysteroscope for the

  12. 子宫瘢痕憩室致异常子宫出血156例临床分析%Clinical analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum

    Institute of Scientific and Technical Information of China (English)

    龙英丽; 孙亚玲; 于景荣; 秦玉静

    2015-01-01

    目的:分析子宫瘢痕憩室引起异常子宫出血患者的临床表现、检查方法,为预防及治疗提供依据。方法回顾性分析因剖宫产术后子宫憩室引起异常子宫出血患者156例的临床资料,对检出率、患者临床症状出现时间及相关影响因素、检查情况、误诊情况进行分析。结果2010年异常出血者中发现憩室12例(5.6%),2011年发现憩室30例(10.5%),2012年发现憩室26例(8.6%),2013年发现憩室37例(14.4%),2014年发现憩室51例(17.7%)。48例患者症状出现时间为术后恢复月经1~6个月,89例为术后恢复月经6个月至2年,19例为术后恢复月经2年后。98例(62.82%)患者多次超声检查未发现明显异常,43例患者行诊断性刮宫,后位子宫与前位、中位子宫相比阴道流血时间明显延长。结论剖宫产子宫切口憩室致异常子宫出血发病率虽低,但是有较高的误诊、漏诊率,需进一步提高其诊断率,进一步研究其预防及治疗方法。%Objective To investigate the clinical manifestation and inspection method about abnormal uter-ine bleeding due to cesarean section scar diverticulum.Methods retrospective analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum.Analysis the relevance ratio,the starting time of clinical symptom,related influencing factors,the information of examine and misdiagnose.Results there are 12 cases cesare-an section scar diverticulum in 2010;30 cases in 2011;26 cases in 2012;37 cases in 2013;51 cases in 2014.The starting time of clinical symptom is 1 ~6 month pose menstrual in 48 cases;6 months to 2 years pose menstrual in 89 cases,2 years later pose menstrual in 19 cases.98 cases don′t have evidential abnormality even through many times ultrasonograph.43 patients subjected diagnosis curettage.The uterine bleeding time obviously longer comparing retro-position of uterus with

  13. Analysis of Hysteroscopy in the Examination of 188 Cases of Abnormal Uterine Bleeding%188例异常子宫出血宫腔镜检查的临床分析

    Institute of Scientific and Technical Information of China (English)

    杜敏

    2011-01-01

    目的 分析异常子宫出血(abnormal uterine bleeding,AUB)原因,探讨宫腔镜在异常子宫出血中的应用价值.方法 回顾分析188 例AUB患者宫腔镜检查和诊断结果.结果 AUB患者良性病变占95.74%(169/188),包括子宫内膜息肉、粘膜下肌瘤、子宫内膜炎等;恶性病变子宫内膜癌占4.26%(188).结论 宫腔镜对诊断异常子宫出血的准确率高,对有些良性病变可同时治疗,是一种安全可靠的方法.

  14. The Clinical Effect Observation on the Treatment of Abnormal Uterine Bleeding by Hysteroscopy%宫腔镜治疗子宫异常出血的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    栾立娟

    2015-01-01

    目的:观察宫腔镜对子宫异常出血患者的临床治疗效果。方法搜集2013年6月~2014年6月我院收治子宫异常出血患者36例,按照不同治疗方式进行分组。对观察组18例进行宫腔镜治疗,对照组18例进行常规治疗,观察两组疗效,并分析对比。结果与对照组相比,观察组治疗有效率较高,月经改善有差异,有统计学意义(P<0.05)。结论宫腔镜治疗子宫异常出血的临床效果较好。%Objective To observe the clinical treatment of the abnormal uterine bleeding by hysteroscopy. Methods We divided the 36 cases patients into the control group(18 cases)and the observation group(18 cases). Al the patients were chosen from June 2013 to June 2014,the observation group adopted the hysteroscope treatment and the control group adopted the conventional treatment,we compared the difference between the two groups. Results The treatment effectiveness in the observation group was much higher than the control group,the menstrual also improved,it was in a high treatment efficiency and obvious difference between the two groups and the statistical y significant(P<0.05). Conclusion It is good to adopt the hysteroscope treatment on abnormal uterine bleeding.

  15. 经阴道超声联合宫腔镜对老年子宫出血的诊断运用评价%Evaluation of the Diagnosis of Uterine Bleeding in Aged Patients by Transvaginal Ultrasound Combined With Hysteroscopy

    Institute of Scientific and Technical Information of China (English)

    张越

    2015-01-01

    目的:探讨老年妇女绝经后子宫异常出血的诊断价值。方法利用阴道超声和宫腔镜检查我院老年妇女异常出血的情况。结果我院妇产科2014年1月~2015年1月来我院检查98例患者,其中老年妇女异常出血居多。结论本研究采用阴道超声和宫腔镜2种方法检查老年妇女子宫的敏感度,特异度,对子宫出血进行正确的治疗。%Objective To investigate the diagnostic value of postmenopausal uterine bleeding in elderly women.MethodsUsing of transvaginal ultrasound and hysteroscopy to check the elderly women with abnormal bleeding.Results 98 cases were examined in our hospital from January 2014 to January 2015 in our hospital,and most of them were abnormal bleeding in aged women.ConclusionThe two methods of vaginal ultrasound and hysteroscopy were used to examine the sensitivity and specificity of the uterine bleeding in elderly women,and make proper treatment on uterine bleeding.

  16. Uterine transplantation: a systematic review

    Science.gov (United States)

    Ejzenberg, Dani; Mendes, Luana Regina Baratelli Carelli; de Paiva Haddad, Luciana Bertocco; Baracat, Edmund Chada; D’Albuquerque, Luiz Augusto Carneiro; Andraus, Wellington

    2016-01-01

    Up to 15% of the reproductive population is infertile, and 3 to 5% of these cases are caused by uterine dysfunction. This abnormality generally leads women to consider surrogacy or adoption. Uterine transplantation, although still experimental, may be an option in these cases. This systematic review will outline the recommendations, surgical aspects, immunosuppressive drugs and reproductive aspects related to experimental uterine transplantation in women. PMID:27982170

  17. Uterine transplantation: a systematic review

    Directory of Open Access Journals (Sweden)

    Dani Ejzenberg

    Full Text Available Up to 15% of the reproductive population is infertile, and 3 to 5% of these cases are caused by uterine dysfunction. This abnormality generally leads women to consider surrogacy or adoption. Uterine transplantation, although still experimental, may be an option in these cases. This systematic review will outline the recommendations, surgical aspects, immunosuppressive drugs and reproductive aspects related to experimental uterine transplantation in women.

  18. Using phytoestrogens as aprophylaxis against irregular uterine bleeding possibly occurring while using Depot-medroxyprogesterone acetate (DMPA as a contraceptive method

    Directory of Open Access Journals (Sweden)

    Iman Ali Abd El Fattah

    2014-08-01

    Methods: Fifty cases of depot provera users are selected and divided into two groups: group I: 25 cases will start the injection alone. Group II: 25 cases will start the injection with using regular daily phytoestrogen. All cases are followed up for the first six months after the injection for the occurrence of break-through bleeding, and the endometrial thickness using the trans-vaginal ultrasonography. Results: There was a statistically significant difference in the endometrial thickness between group receiving depot provera alone and the group receiving both depot provera and phytoestrogen. Conclusions: We can use phytoestrogens to decrease DMPA-associated vaginal bleeding. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 977-981

  19. Gastrointestinal bleeding

    Science.gov (United States)

    ... Sigmoidoscopy Alternative Names Lower GI bleeding; GI bleeding; Upper GI bleeding; Hematochezia Images GI bleeding - series Fecal occult blood test References Kovacs TO, Jensen DM. Gastrointestinal hemorrhage. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

  20. Abnormal Bleeding During Menopause Hormone Therapy: Insights for Clinical Management

    OpenAIRE

    2013-01-01

    Objective Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy. Methods A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding. Results Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women a...

  1. SU-D-204-06: Integration of Machine Learning and Bioinformatics Methods to Analyze Genome-Wide Association Study Data for Rectal Bleeding and Erectile Dysfunction Following Radiotherapy in Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Oh, J; Deasy, J [Memorial Sloan Kettering Cancer Center, New York, NY (United States); Kerns, S [University of Rochester Medical Center, Rochester, NY (United States); Ostrer, H [Albert Einstein College of Medicine, Bronx, NY (United States); Rosenstein, B [Mount Sinai School of Medicine, New York, NY (United States)

    2016-06-15

    Purpose: We investigated whether integration of machine learning and bioinformatics techniques on genome-wide association study (GWAS) data can improve the performance of predictive models in predicting the risk of developing radiation-induced late rectal bleeding and erectile dysfunction in prostate cancer patients. Methods: We analyzed a GWAS dataset generated from 385 prostate cancer patients treated with radiotherapy. Using genotype information from these patients, we designed a machine learning-based predictive model of late radiation-induced toxicities: rectal bleeding and erectile dysfunction. The model building process was performed using 2/3 of samples (training) and the predictive model was tested with 1/3 of samples (validation). To identify important single nucleotide polymorphisms (SNPs), we computed the SNP importance score, resulting from our random forest regression model. We performed gene ontology (GO) enrichment analysis for nearby genes of the important SNPs. Results: After univariate analysis on the training dataset, we filtered out many SNPs with p>0.001, resulting in 749 and 367 SNPs that were used in the model building process for rectal bleeding and erectile dysfunction, respectively. On the validation dataset, our random forest regression model achieved the area under the curve (AUC)=0.70 and 0.62 for rectal bleeding and erectile dysfunction, respectively. We performed GO enrichment analysis for the top 25%, 50%, 75%, and 100% SNPs out of the select SNPs in the univariate analysis. When we used the top 50% SNPs, more plausible biological processes were obtained for both toxicities. An additional test with the top 50% SNPs improved predictive power with AUC=0.71 and 0.65 for rectal bleeding and erectile dysfunction. A better performance was achieved with AUC=0.67 when age and androgen deprivation therapy were added to the model for erectile dysfunction. Conclusion: Our approach that combines machine learning and bioinformatics techniques

  2. Thermal balloon endometrinl ablation combined with hysteroscope operation in the treatment of abnormal uterine bleeding.%宫腔镜联合子宫内膜热球剥除术治疗异常子宫出血42例

    Institute of Scientific and Technical Information of China (English)

    常乐; 朱根海; 杨舒盈

    2011-01-01

    Objective To compare the efficacy and complications of thermal balloon endometrial ablation (TBEA) with those of TBEA combined with hysteroscopy operation in the treatment of abnormal uterine bleeding, and then expand the indication of TBEA. Methods 128 patients with abnormal uterine bleeding were performed hysteroscopy before TBEA was taken. According the result of hysteroscopy, 128 cases were divided into two groups: Group A (86 cases) was treated with TBEA only; Group B (42 cases) was treated with hysteroscopy operation to resect hysteromyoma under endometrium, adhering zone, endometrial polyps and uterus septum which are not suitable to be managed by TBEA, and then with TBEA. The efficacies and complications of two groups were compared and analyzed. Results All the cases in two groups had been followed-up for 6 months, and the effective rates of Group A and Group B were 97.7% (84/86) and 95.2% (40/42), respectively, and there was no significant difference between two groups. There was no severe complication and infection during and after the procedure. Conclusion TBEA can treat abnormal uterine bleeding effectively, with simple procedure, little trauma and short timc. Hysteroscopy operation can expand the indications of TBEA.%目的 比较子宫内膜热球剥除术(TBEA)及TBEA联合官腔镜手术治疗异常子宫出血的疗效及并发症,以扩大TBEA的适应证.方法 128例因异常子宫出血而行TBEA的患者,术前均行官腔镜检查,根据检查结果分两组.A组:86例,TBEA前无需再行官腔镜手术,B组:42例,TBEA前先行官腔镜手术,切除不适合行TBEA的黏膜下子宫肌瘤、粘连带、子宫内膜息肉及子宫纵膈.然后行再TBEA.比较两组的治疗效果及并发症.结果 术后随访6个月,A组及B组的有效率分别是97.7%(84/86)和95.2%(40/42),比较差异无统计学意义.治疗中和治疗后两组均无严重不良反应和感染发生.结论 TBEA可有效地治疗异常子宫出血,操作简单、

  3. 去氧孕烯炔雌醇治疗围绝经期子宫异常出血的效果观察%Efficacy observation of ethinyl estradiol desogestrel in treatment of peri-menopausal abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    朱兰玉

    2014-01-01

    Objective To study the clinical effect of ethinyl estradiol desogestrel in the treatment of perimenopausal abnormal uterine bleeding. Methods 128 patients with perimenopausal abnormal uterine bleeding treated in our hospi-tal from March 2012 to May 2013 were selected and randomly divided into study group and control group,64 cases in each group.Mifepristone was given to the control group,ethinyl estradiol desogestrel was taken to the study group.The clinical effects,hemostatic effect and endometrial thickness changes of two groups were compared,adverse reactions were analyzed between the two groups. Results The total effective rate of study group was 95.31%,higher than 81.25% of the control group (P0.05), after treatment,the endometrial thickness of two groups was thinner (P<0.05),and the study group was thinner than that of the control group (P<0.01).The adverse reaction rate of study group was 1.56%,lower than 6.25%of the control group (P<0.01). Conclusion Ethinyl estradiol desogestrel in treatment of perimenopausal abnormal uterine bleeding has sig-nificant effects.%目的:研究去氧孕烯炔雌醇治疗围绝经期子宫异常出血的临床效果。方法选取本院2012年3月~2013年5月确诊并收治的128例围绝经期子宫异常出血患者,将其随机分为研究组和对照组各64例。对照组患者应用米非司酮进行治疗,研究组患者应用去氧孕烯炔雌醇进行治疗。比照两组的疗效、止血效果及子宫内膜厚度变化,统计不良反应。结果研究组总有效率为95.31%,显著高于对照组的81.25%,差异有统计学意义(P<0.05)。研究组出血缓解时间及止血时间显著短于对照组(P<0.01);治疗前两组子宫内膜厚度差异无统计学意义(P跃0.05),治疗后两组子宫内膜厚度均显著变薄(P<0.05),且研究组变薄程度显著优于对照组(P<0.01)。研究组不良反应发生率为1.56%,显著低于对照组的6.25%,差异有统计学意义(字2=51.955

  4. [Uterine defibrillation in uterine inertia. Report of 2 cases].

    Science.gov (United States)

    Viñals, F; Correa, G; Quiroz, V

    1993-01-01

    The uterine atony are the most common cause of postpartum hemorrhage. Manual compression and pharmacologic methods are usually used with a successful result. When pharmacologic methods fail to control hemorrhage from atony, surgical measures should be undertaken to arrest the bleeding before it becomes life-threatening. We presents the utilization of electrical uterine defibrillation in two cases with acute hemorrhage confirming the effectivity of the proceeding.

  5. Clinical application of hysteroscopy in the diagnosis and therapy of pa-tients with abnormal uterine bleeding%宫腔镜在异常子宫出血诊治中的临床应用

    Institute of Scientific and Technical Information of China (English)

    厉霞玲; 刘德佩; 张月存; 冷丽丽

    2015-01-01

    Objective To explore the clinical value of hysteroscopy in the diagnosis and treatment of patients with ab-normal uterine bleeding. Methods Clinic date of 65 cases of abnormal uterine bleeding admitted in Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing University of Chinese Medicine from January to November 2014 were retrospectively analyzed. The patients were checked by hysteroscopy, lesion removal, biopsy for diagnosis and treatment. Through the comparative analysis of the above methods, the clinical application of hysteroscopy in the diagnosis and treatment of abnormal uterine bleeding was analyzed. Results Hysteroscopy found that various degree of endometrial hyperplasia in 20 cases,13 cases of endometrial polyps, 16 cases of endometritis, 9 cases of endometrial hyperplasia or secretory phase change, 4 cases of uterine fibroids, 3 cases of pregnancy residues. After hysteroscopy, all patients were given biopsy,curettage, lesion removal (large polyps and submucosal fibroids were givn hysteroscopic polypectomy). Pathology showed that 27 cases of various degree of endometrial hyperplasia, 10 cases of endometrial polyps, 9 cases of endometritis, 4 cases of endometrial hyperplasia or secretory phase change, submucous myoma of uterus 2 cases, 3 cases of pregnancy residues. The coincidence rate of diagnosis between pathology and pathological examination was 78.46%. Postoperative follow-up, 5 cases of recurence, recurence rate was 9.09%; 50 cases of cure, the cure rate was 93.85%. Conclusion Hysteroscopy can directly observe the intrauterine pathologies, and to assist pathological examination in the diagnosis and treatment of abnormal uterine bleeding, achieve the goal of comprehen-sive, detailed and accurate, is worthy of clinical promotion.%目的:探讨宫腔镜在异常子宫出血诊治中的临床价值。方法回顾分析2014年1~11月南京中医药大学附属南京市中西医结合医院异常子宫出血患者65例的临床

  6. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Directory of Open Access Journals (Sweden)

    Miller JD

    2015-01-01

    Full Text Available Jeffrey D Miller,1 Gregory M Lenhart,1 Machaon M Bonafede,1 Cindy M Basinski,2 Andrea S Lukes,3 Kathleen A Troeger4 1Truven Health Analytics, Cambridge, MA, 2Basinski, LLC, Newburgh, IN, 3Carolina Women’s Research and Wellness Center, Durham, NC, 4Hologic, Inc, Marlborough, MA, USA Objectives: Abnormal uterine bleeding (AUB interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods: A health state transition (semi-Markov model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results: Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial and $3,000 (Medicaid; cost savings versus hysterectomy were $6,500 (commercial and $8,900 (Medicaid. Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities

  7. Sterility of the uterine cavity

    DEFF Research Database (Denmark)

    Møller, Birger R.; Kristiansen, Frank V.; Thorsen, Poul

    1995-01-01

    from the same sites. Nearly a quarter of all the patients harbored one or more microorganisms in the uterus, mostly Gardnerella vaginalis, Enterobacter and Streptococcus agalactiae. We found that in a significant number of cases, the uterine cavity is colonized with potentially pathogenic organisms...... which may play a causative role in endometritis. The results indicate that inflammation of the uterine cavity should be evaluated by hysteroscopic examination before hysterectomy is undertaken in patients with persistent irregular vaginal bleeding. Udgivelsesdato: 1995-Mar...

  8. 药物流产后异常子宫出血患者血清雌激素、孕激素和人绒毛促性腺激素水平%Estrogen, Progesterone, and Human Chorionic Gonadotrophin Levels in Patients with Abnormal Uterine Bleeding after Drug Abortion

    Institute of Scientific and Technical Information of China (English)

    陈永红; 王素平

    2013-01-01

    Objective: To investigate the relationship of estrogen (E2) , progesterone (P) , and human chorionic gonadotrophin (hCG) levels with abnormal uterine bleeding in patients with drug abortion. Methods: A total of 59 patients taking mifepristone plus misoprostol for abortion were divided into two groups. In the control group (29 cases, group C) , the time of uterine bleeding was less than 14 days; in the abnormal uterine bleeding (30 cases, group A) , the time of uterine bleeding was more than 14 days. The levels of E2, P and hCG of the 2 groups in 14, 18 and 22 days after initiation of bleeding were compared. Results: There was no significant difference of E2 levels between the 2 groups (P >0.05); On the 14th day, P level of group A was higher than that of group C (P < 0.05); On the 14th , 18th , and 22nd days, the hCG levels in group A were significantly higher than those in group C (P <0. 05). Conclusion: The abnormal uterine bleeding in patients with medical abortion is related with P and hCG levels.%目的:研究药物流产后患者体内雌激素(E2)、孕激素(P)及人绒毛促性腺激素(hCG)水平与异常子宫出血的关系.方法:59例患者口服米非司酮配伍米索前列醇药物终止早期妊娠,将子宫出血时间超过14 d的30例患者作为异常子宫出血组,子宫出血时间少于14 d的29例患者作为对照组,比较2组外周静脉血清中E2、P及hCG水平.结果:两组患者体内E2差异无显著性(P>0.05),在出血第14天时,异常子宫出血组患者体内P明显高于对照组(P<0.05),在第14、18和22天hCG均高于对照组(P<0.05).结论:药物流产后异常子宫出血与患者体内P和hCG水平有关.

  9. Features of Postmenopausal Uterine Haemorrhage

    OpenAIRE

    Izetbegovic, Sebija; Stojkanovic, Goran; Ribic, Nihad; Mehmedbasic, Eldar

    2013-01-01

    ABSTRACT Introduction: Postmenopausal uterine bleeding is a „cancer until proven otherwise”. Endometrial cancer is a typical disease among postmenopause woman, because every bleeding in this age etiology associated with endometrial cancer (10-30%). The lifespan of women today has been extended and post menopause today last one third of a woman’s life. Early diagnosis of endometrial cancer has a very high cure rate. Screening for this cancer has limits in practice and is necessary given the de...

  10. Vaginal Bleeding

    Science.gov (United States)

    Menstruation, or period, is a woman's monthly bleeding.Abnormal vaginal bleeding is different from normal menstrual periods. It could be bleeding that is between periods, is very heavy, or lasts much ...

  11. Uterine Cancer

    Science.gov (United States)

    ... is pregnant. There are different types of uterine cancer. The most common type starts in the endometrium, ... the uterus. This type is also called endometrial cancer. The symptoms of uterine cancer include Abnormal vaginal ...

  12. B-ultrasound Diagnosis of the Cause of Abnormal Uterine Bleeding and Pathological Diagnosis Rate of Clinical Analysis%B超检查诊断异常子宫出血病因与病理诊断符合率的临床分析

    Institute of Scientific and Technical Information of China (English)

    张春风

    2014-01-01

    目的:比较B超、宫腔镜联合B超诊断子宫异常出血与病理诊断结果的符合率,以探讨B超、宫腔镜联合B超在异常子宫出血中的诊断价值。方法:对300名子宫异常出血患者行B超、宫腔镜联合引导B超和病例诊断,比较B超、宫腔镜结果与病理诊断结果的符合率。结果:B超结果与病理诊断符合率为59.00%,宫腔镜联合B超符合率为85.67%。宫腔镜联合B超诊断符合率显著高于B超检查(χ2=12.369,P<0.001)。结论:相比于单纯的运用B超,为了提高子宫异常出血的诊断正确率,宜综合使用B超检查和宫腔镜检查,以更有效的判断是否有子宫异常出血。%Objective :To compare the B‐ultrasound ,B‐ultrasound diagnostic hysteroscopy combined with the patho‐logical diagnosis of abnormal uterine bleeding results in line with rates in order to explore the B‐ultrasound ,B‐diagnos‐tic value of hysteroscopy in abnormal uterine bleeding .Methods :300 patients with abnormal uterine bleeding B‐ultra‐sound ,B‐ultrasound and hysteroscopy to guide the diagnosis of cases ,more B‐ultrasound ,hysteroscopy results in line with the pathological diagnosis rate .Results:B‐ultrasound results with pathological diagnosis rate of 59 .00% ,hysteros‐copy combined with B‐ultrasound coincidence was 85 .67% .B‐ultrasound diagnostic hysteroscopy was significantly higher than the B‐ultrasound (χ2 =12 .369 ,P<0 .001) .Conclusion:Compared to the simple use of B ,abnormal uterine bleeding in order to improve diagnostic accuracy ,should be integrated use of B‐ultrasound and hysteroscopy to deter‐mine whether there is a more effective abnormal uterine bleeding .

  13. 改良B-Lynch缝合联合宫腔填纱在剖宫产术中难治性出血中的应用%Application of modified B-Lynch suture combined with filling uterine cavity with gauze in intractable bleeding during cesarean section

    Institute of Scientific and Technical Information of China (English)

    胡莉琴; 章桂莲; 黄贤梅

    2012-01-01

    Objective o To explore the curative effect of modified B - Lynch suture combined with filling uterine cavity with gauze in intractable bleeding during cesarean section. Methods: Eighteen patients who were found with intractable bleeding during cesarean section from May 2008 to June 2011 were selected, including twelve patients with placenta previa, one patient with shallow placental implantation, two patients with placental abruption and uterine apoplexy, and three patients with uterine inertia. Modified B - Lynch suture combined with filling uterine cavity with gauze was used for hemostasis by compression. Results: Bleeding was stopped in the eighteen patients, gauze was pulled out after 24 hours, and bleeding didnt appeared. After operation, two patients were found with temperature more than 38. 5t, and One patient was found with temperature more than 39%. All the patients left the hospital at 5 -7 days after operation, involution of uterus was good at 42 days after delivery. Conclusion: The clinical efficacy of modified B - Lynch suture combined with filling uterine cavity with gauze is satisfactory in controlling intractable bleeding during cesarean section, the method is easy to operate and safe, which reserves the reproductive function of the patients and it is worthy to be popularized in clinic.%目的:探讨改良B-Lynch缝合联合宫腔填纱在剖宫产术中难治性出血的治疗效果.方法:选择2008年5月~2011年6月剖宫产术中出现难治性出血18例患者,其中前置胎盘12例,胎盘浅植入1例,胎盘早剥子宫卒中2例,宫缩乏力3例.采用改良B-Lynch缝合联合宫腔填纱压迫止血.结果:18例患者均止血成功,24h取纱未出现再出血.术后体温超过38.5C2例,超过39℃1例.全部病例术后5~7天出院,产后42天子宫复旧良好.结论:改良B-Lynch缝合联合宫腔填纱控制剖宫产术中难治性出血效果满意,操作简单、安全,保留了患者生育机能,值得临床推广应用.

  14. Hysteroscopy Combined with B-uitrasonography for the Diagnosis of Abnormal Uterine Bleeding%B超与宫腔镜诊治子宫异常出血的价值

    Institute of Scientific and Technical Information of China (English)

    张帅; 刘世兰; 张艳军

    2012-01-01

    Objective To investigate the value of hysteroscopy combined with B-ultrasonography in diagnosing abnormal uterine bleeding. Methods From January 2008 to December 2010, with hysteroscopy, diagnostic curettage or positioning biopsy was performed on 528 patients with abnormal uterine bleeding ( AUB). Under direct vision, biopsy of the suspected lesions was made with hysteroscopy; pathological assessment was considered to be the gold standard. Based on the pathological assessment, the accuracy, sensitivity, and specificity of B-ultrasonography and hysteroscopic diagnosis were determined. Results The procedure was successfully completed in all the patients. Pathological examination revealed 10 cases of endometrial cancer, 198 cases of endometrial hyperplasia, 104 cases of endometrial polyps, 121 cases of uterine fibroids or gland fibroids, 63 cases of endometritis, 16 cases of pregnancy mass, and 16 cases of endometrium in secreting stage. Endometrium in secreting stage was regarded as pathological negative, the other cases that need further treatment were all made pathologically positive. The accuracy, sensitivity, and specificity of B-ultrasonography were 90. 3% (477/528), 92. 6% (474/512), 18. 8% (3/16), and those of hysteroscopy were 96. 6% (510/528) , 99.2% (508/512) , and 12.5% (2/16) , respectively. The accuracy and sensitivity of hysteroscopy were significantly higher than B-ultrasonography (x2 = 16. 886, 28. 701, P - 0. 000) , but no difference existed in the specificity between the two methods (x2 = 0.000, P = 1. 000). Conclusions B-ultrasonography is the first step for the diagnosis of AUB, so that to primarily detect the pelvic cavity. If B-ultrasonography cannot rule out endometrial lesions, biopsy by hysteroscopy shall be carried out for further treatment.%目的 探讨宫腔镜联合B超检查在诊断子宫异常出血中的应用价值. 方法 2008年1月~2010年12月,采用宫腔镜检查联合诊断性刮宫或定位活

  15. The Nursing Care of 66 Cases of Patients with Uterine Tamponade Bleeding Treated by the Sliver Treatment Caesarean Section%66例宫腔填塞纱条治疗剖腹产术中大出血的护理

    Institute of Scientific and Technical Information of China (English)

    秦琳

    2013-01-01

    Objective:To explore effancy of the nursing care of 66 cases of patients with uterine tamponade bleeding treated by the sliver treatment caesarean section.Methods:66 cases of patients with uterine tamponade bleeding were chosed to give the treatment of the sliver treatment caesarean section,and the treatment effect was observed.Results:Through the active treatment and intensive care,the patient’s temperature returned to normal,the shock symptoms disappeared,none postoperative flatulence have been found,the anus exhaust were normal,none re-bleeding and infection was happened. All patients were discharged.Conclusion:The nursing care of patients with uterine tamponade bleeding treated by the sliver treatment caesarean section was effectively.%  目的:探讨宫腔填塞纱条治疗剖腹产术中大出血的护理疗效。方法:选取笔者所在医院妇产科66例因剖腹产手术后大出血紧急给予宫腔填塞纱条治疗的患者作为研究对象,观察治疗效果。结果:经积极治疗和精心护理,患者体温均恢复正常,休克症状消失,术后无胀气,子宫正常,肛门排气正常,无再次出血和感染发生,患者痊愈出院。结论:宫腔填塞纱条治疗剖腹产术中大出血,配合严密的护理具有较好的疗效。

  16. Research on the core herb pairs of uterine bleeding cases in the three Mingyi Leian books%3部名医类案医籍中崩漏医案核心药对探析

    Institute of Scientific and Technical Information of China (English)

    毛萌; 李献平

    2012-01-01

    Objective: Analysizing the recipe cases from the medical records with uterine bleeding of ancient famous doctors by statistic method and summarizing the characters of the classified prescriptions from herb pairs probably could enrich the theory of machnism, method, prescription and provide valuable information for clinical practices. Methods: 235 medical cases and 345 flavour herbs were collected from 3 classified medical records of famous doctors. SQL correlation analysis and frequency statistics were used to have a research, hunt core herb pairs and explore application values. Results: Radix Paeoniae Alba-Radix Angelica Sinensis; Radix Paeoniae Alba-Rhizoma Atractylodis Macrocephalae; Radix Paeoniae Alba-Radix Glycyrrhizae; Radix Angelica Sinensis-Rhizoma Atractylodis Macrocephalae; Radix Angelica Sinensis-Radix Glycyrrhizae; Radix Angelica Sinensis-Radix Astragali seu Hedysari; Radix Ginseng-Rhizoma Atractylodis Macrocephalae; Radix Glycyrrhizae-Rhizoma Atractylodis Macrocephalae; Radix Astragali seu Hedysari-Rhizoma Atractylodis Macrocephalae; Poria- Rhizoma Atractylodis Macrocephalae; Radix Ginseng-Radix Glycyrrhizae; Radix Astragali seu Hedysar- Radix Glycyrrhizae; Poria-Radix Glycyrrhizae were choosen to be the core herb pairs. Conclusion: SQL correlation analysis can be used in the analysis of the compatibility of the prescriptions. The herb pairs which have their compatibility basis and theoretical value, can focus on pathology and machnism of uterine bleeding, and have certain meaning in clinical treatment.%目的:通过对古代名医崩漏验案的的统计分析,从药对入手,归纳有关崩漏的处方特点,以期丰富崩漏的理法方药理论,为临床提供有价值的诊疗信息.方法:从3部名医类案医籍中共收集235首医案,345味中药.应用SQL相关性分析及频数统计法对其进行研究,寻找其中的核心药对,探索其应用价值.结果:筛选出白芍-当归;白芍-白术;白芍-炙甘草、当归-白术、当

  17. Investigation and Analysis of Influence Factors on Abnormal Uterine Bleeding in Adolescents%青春期子宫异常出血的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    刘铭; 罗龙军; 张凤; 唐威; 魏华; 易村犍

    2014-01-01

    目的探讨湖北省荆州地区青春期子宫异常出血的影响因素,为降低青春期子宫异常出血发生率提供流行病学数据。方法选择2012年11月至2013年5月在荆州地区13所中学随机抽取年龄为12~16岁的初中在校女生5000名(受试者)及其所填写的问卷为研究对象。采用自行设计的《青春期女生月经情况和一般情况调查表》,对受试者的基本信息(年龄、家庭地址、身高、体质量),月经情况(月经初潮时间、月经周期、月经量)及其他因素(居住环境、经期护理、健康状况)等内容进行调查。此外,另自行设计《心理因素对青春期子宫异常出血影响调查表》,对因心理因素导致青春期子宫异常出血单独进行问卷调查。结果本调查问卷共计发放5000份,剔除436名月经未来潮者所填写的问卷,回收有效问卷4564份,问卷有效回收率为91.28%。根据本研究设定的子宫异常出血判断标准,子宫异常出血者为2177名(47.69%),月经正常者为2387名(52.31%)。不同居住环境女生的子宫异常出血发生率比较,差异无统计学意义(χ2=4.08,P>0.05);青春期女生不同身体健康状况(经期是否有感染史、结核、其他疾病与无疾病)、经期护理情况(护理良好与护理不良)及心理因素得分(≥35分与0.05).There were significant differences of incidence rates of abnormal uterine bleeding among different health situation, menstrual nursing and psychological pressure (χ2=13.39,12.82,10.43;P<0.05). Health situation, menstrual nursing and psychological pressure were risk factors for abnormal uterine bleeding in adolescents (OR=3.65,95%CI:2.53-4.34,P<0.05;OR=0.97,95%CI:0.86-1.09,P<0.05;OR=0.57, 95%CI:0.33-0.64,P<0.05).Conclusion Moderate exercises,balanced nutrition,good mentality and menstrual nursing can promote women′s reproductive health.

  18. 阴道三维超声对剖宫产术后子宫切口憩室导致的子宫异常出血的诊断价值%The diagnostic value of transvaginal three-dimensional ultrasound in uterus abnormal bleeding caused by uterine incision diverticulum after cesarean section

    Institute of Scientific and Technical Information of China (English)

    高晓艳; 张玲; 张鹏

    2016-01-01

    Objective To explore the diagnostic value of transvaginal three-dimensional ultrasound in uterus abnormal bleeding caused by uterine incision diverticulum after cesarean section. Methods We collected 480 cases with cesarean section patients from January 2011 to July 2015 in our hospital. A retrospective analysis of the cases was performed by transvaginal ultrasound , if the incision diverticulum was found , for measuring and recording the depth , length , width and assessing the residual muscle layer thickness and the shape and volume of the diverticulum with vaginal bleeding in the following up. Results 118 cases were found incision diverticu-lum by ultrasound in 480 patients , including 70 cases of triangular , 33 cases of semicircle , 15 cases of other shapes , of which 56 patients of uterine abnormal bleeding were significantly correlated with the volume and depth of the diverticulum. While menstruation PBAC scores were higher , the greater probability associated with abnormal uterine bleeding , but bleeding did not associate with the shape and length and width of diverticula; In this study we also found that OR value (OR = 15.809) of the diverticulum volume maximum was the key factors leading to the abnormal uterine bleeding in uterine incision diverticulum. Conclusion Transvaginal three-dimen-sional ultrasound can be convenient , fast and accurate diagnosis of uterine abnormal bleeding caused by incision diverticulum , and is of important significance for guiding clinical medication and surgical treatment.%目的:探讨经阴道三维超声检查对剖宫产术后子宫切口憩室导致的子宫异常出血的诊断价值。方法:收集2011年1月至2015年7月在本院就诊,行阴道超声检查的480例有剖宫产史患者的临床资料进行回顾性分析,如发现存在切口憩室,则测量并记录其深度、长度、宽度及憩室前方残存肌层厚度,描述憩室的形状,经三维处理计算憩室容积大小,同时在整

  19. Correlative evaluation between the volume of postcaesarean section scar defects after cesarean section and abnormal uterine bleeding by transvaginal three-dimensional ultrasound%三维超声容积测量对剖宫产切口憩室与异常子宫出血的相关性评价

    Institute of Scientific and Technical Information of China (English)

    兰莉; 汤飞云; 岳婷; 郑华敏; 郑磊; 周梦林

    2016-01-01

    目的:探讨经阴道三维超声检查剖宫产切口憩室(PCSD)形态大小与子宫异常出血的关系。方法:分析72例PCSD患者超声图像的深度肌层比值、憩室容积、宽度、高度、长度,对比月经正常组与异常子宫出血组的PCSD参数特点。结果:本组患者均是剖宫产后经阴道三维超声检查发现PCSD,异常子宫出血组PCSD 深度肌层比值、憩室容积、宽度、高度、长度均大于月经正常组(P<0.05),通过多因素logistic回归分析, PCSD容积是剖宫产后异常子宫出血的危险因素(OR=2.211,P<0.01)。结论:经阴道三维超声能重建PCSD选定切面的容积,PCSD容积是子宫异常出血的危险因素。%Objective: To explore the correlation between the size of post-caesarean section scar defects (PCSD) after cesarean section and abnormal uterine bleeding by transvaginal three-dimensional ultrasound. Methods: Seventy two patients with PCSD of ultrasound images with regard to the PCSD of deep muscle layer ratio, volume of the diverticulum, width, height and length were analyzed, compared with the parameters of PC-SD in the normal group and the abnormal utrine bleeding group.Results: All patients in this group with PCSD were found by transvaginal three-dimensional ultrasound examination. The abnormal uterine bleeding group was greater than the normal menstruation group in regard of PCSD of deep muscle layer ratio, volume of the diver-ticulum, width, height and length (P<0.05). By multivariate logistic regression analysis, PCSD volume was the risk factor for abnormal uterine bleeding after cesarean section (OR=2.211,P<0.01).Conclusion: Transvaginal three-dimensional ultrasound can reconstruct the volume of selected sections of PCSD, which is a risk factor for abnormal uterine bleeding.

  20. Study overview of dysfunctional uterine bleeding%功能失调性子宫出血的研究概况

    Institute of Scientific and Technical Information of China (English)

    刘吉凤; 丁俊

    2008-01-01

    功能失调性子宫出血(DUB)是妇科常见病之一,常见于月经初潮至绝经期任何年龄的女性,由于本病常因调节生殖的神经内分泌机制失常所致,临床的药物治疗以调整内分泌为基本原则,其中尤以性激素治疗占主导地位而成为治疗DUB的一线药物。在妇科临床中,治疗DUB的科学研究也不断深入,妇科临床的医生和科研人员试图多途径、多方位的探索,希望找到治疗本病的较好方法,追求更好的治疗效果,大大丰富了DUB治疗的内容,笔者现就近年来治疗DUB临床研究的文献资料综述如下。

  1. Oral Contraceptive in Treatment of Dysfunctional Uterine Bleeding%口服避孕药治疗功能失调性子宫出血

    Institute of Scientific and Technical Information of China (English)

    孟琳

    2007-01-01

    功能失调性子宫出血(DUB)为妇科门诊常见病,严重危害妇女身心健康.口服避孕药(OC)是妇女最常用药物之一,安全性好,方便性强,用于DUB的治疗有较好疗效.本文综述DUB的发病率、机制及治疗方法,特别是OC对DUB的治疗,包括用药方法,疗效观察和OC对40岁左右妇女应用的安全性.OC除避孕作用外,在治疗DUB的同时,对妇女其他疾病尚有治疗作用.

  2. Bleeding disorders

    Science.gov (United States)

    ... can occur when certain factors are low or missing. Bleeding problems can range from mild to severe. Some bleeding disorders are present at birth and are passed through families (inherited). Others develop from: Illnesses such as vitamin ...

  3. Bleeding gums

    Science.gov (United States)

    ... periodontal exam. DO NOT use tobacco, since it makes bleeding gums worse. Control gum bleeding by applying pressure directly on the gums with a gauze pad soaked in ice water. If you have been diagnosed with a ...

  4. Internal Bleeding

    Science.gov (United States)

    ... in Paralyzed Monkeys Additional Content Medical News Internal Bleeding By Amy H. Kaji, MD, PhD, Associate Professor, ... Emergency First Aid Priorities Cardiac Arrest Choking Internal Bleeding Wounds Soft-Tissue Injuries Severed or Constricted Limbs ...

  5. The clinical observation of mixture of traditional Chinese medicine for the treatment of abnormal uterine bleeding after placing intrauterine device%中药合剂治疗放置宫内节育器后子宫异常出血的临床观察

    Institute of Scientific and Technical Information of China (English)

    陈小萍

    2015-01-01

    目的:探究中药合剂治疗放置宫内节育器后子宫异常出血的临床效果。方法:收治放置节育器后而导致的子宫异常出血患者80例,随机分成两组。一组服用传统抗炎症药物进治疗,另一组服用中药合剂,比较两组治疗效果。结果:中药合剂组的治疗效果明显优于传统治疗组。结论:中药合剂能加速患者子宫异常出血症状的改善。%Objective:To explore the clinical effect of mixture of traditional Chinese medicine for the treatment of abnormal uterine bleeding after placing intrauterine device.Methods:80 patients with abnormal uterine bleeding after placing intrauterine device were selected.They were randomly divided into two groups.One group was treated with traditional anti-inflammatory drugs, and the other was treated with mixture of traditional Chinese medicine,then we compared the treatment effect of two groups. Results:In the mixture of traditional Chinese medicine group,the treatment effect was obviously better than the traditional treatment group.Conclusion:The mixture of traditional Chinese medicine can improve the symptoms of patients with abnormal uterine bleeding.

  6. Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Seon; Lee, Do Yon; Kim, Yong Tae; Park, Ki Hyun; Park, Yong Won; Cho, Jae Sung; Kim, Myung Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of); Won, Je Hwan [Ajou Univ. College of Medicine, Suwon (Korea, Republic of); Kang, Byung Chul [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired.

  7. Nano copper/low-density polyethylene intrauterine device reduces post-implantation uterine bleeding and pain%纳米铜/低密度聚xdkf201530乙烯复合材料宫内节育器对置器后子宫出血及疼痛的影响

    Institute of Scientific and Technical Information of China (English)

    刘娟妮; 闫飞艳; 王燕

    2015-01-01

    背景:裸铜结构宫内节育器在铜离子释放过程中含有大量氧化物,容易导致女性出现出血和疼痛等.而纳米铜/低密度聚乙烯复合材料宫内节育器则可以很好地解决以上弊端,有利于维持育龄妇女的生殖健康.目的:分析纳米铜/低密度聚乙烯复合材料宫内节育器对置器后子宫出血、疼痛的影响.方法:将 98 例自愿要求放置宫内节育器的女性随机均分为两组,观察组放置纳米铜/低密度聚乙烯宫内节育器,对照组放置铜T型220C宫内节育器.放置结束后随访12个月,观察两组不良事件发生情况,包括子宫出血和疼痛等.结果与结论:置器后随访12个月,观察组有1例出现子宫出血,2例患者出现疼痛现象,不良事件发生率为6%;对照组有5例出现子宫出血,8例出现疼痛,不良事件发生率为27%;两组不良事件发生率比较差异有显著性意义(P < 0.05).表明纳米铜/低密度聚乙烯复合材料宫内节育器可有效减少置器后子宫出血和疼痛的出现.%BACKGROUND:Intrauterine device made of bare copper can release a great amount of oxides that are easy to cause bleeding and pain in women. Nano copper/low-density polyethylene intrauterine device can wel solve the above drawbacks, which is conducive to the maintenance of the reproductive health of women of childbearing age. OBJECTIVE:To explore the effect of nano copper/low-density polyethylene intrauterine device on post-implantation uterine bleeding and pain. METHODS:A total of 98 voluntary women asking for intrauterine device insertion were selected and randomized into control group (n=49) with 220C (TCu220C) T type copper intrauterine device and observation group (n=49) with nano copper/low-density polyethylene intrauterine device. Al the women were folowed up for 12 months, and incidence of adverse events, including uterine bleeding and pain, was observed and compared between the two groups. RESULTS AND CONCLUSION: During the

  8. Perimenopausal vaginal bleeding caused by endometrial lesions%围绝经期子宫内膜病变所致阴道流血

    Institute of Scientific and Technical Information of China (English)

    梁海燕; 凌斌

    2012-01-01

    For perimenopausal women, abnormal u-terine bleeding mostly resulted from endometrial disorders including dysfunctional uterine bleeding, endometrial polyp, endometritis, endometrial hyperplasia and endometrial cancer. This article summarized the salient literature on the etiology, pathology, diagnosis and management of these disorders or introduced some improvements.%围绝经期异常子宫出血的主要原因之一是子宫内膜病变,包括功能失调性子宫出血、子宫内膜炎、子宫内膜息肉、子宫内膜增殖症和子宫内膜癌等.该文总结了这些疾病的病因、病理、诊断和治疗以及相关的研究进展.

  9. Perimenopausal Bleeding and Bleeding After Menopause

    Science.gov (United States)

    ... Patients About ACOG Perimenopausal Bleeding and Bleeding After Menopause Home For Patients Search FAQs Perimenopausal Bleeding and ... 2011 PDF Format Perimenopausal Bleeding and Bleeding After Menopause Gynecologic Problems What are menopause and perimenopause? What ...

  10. Perimenopausal Bleeding and Bleeding After Menopause

    Science.gov (United States)

    ... Patients About ACOG Perimenopausal Bleeding and Bleeding After Menopause Home For Patients Search FAQs Perimenopausal Bleeding and ... 2011 PDF Format Perimenopausal Bleeding and Bleeding After Menopause Gynecologic Problems What are menopause and perimenopause? What ...

  11. Uterine Fibroids

    Science.gov (United States)

    ... permits the doctor to see fibroids inside the uterine cavity. Hysterosalpingography is a special X-ray test. It ... used to remove fibroids that protrude into the cavity of the uterus. A resectoscope is inserted through the hysteroscope. The ...

  12. Uterine Prolapse

    Science.gov (United States)

    ... Lose weight if you're overweight or obese. Kegel exercises Kegel exercises strengthen your pelvic floor muscles, which support ... from symptoms associated with uterine prolapse. To perform Kegel exercises, follow these steps: Tighten (contract) your pelvic ...

  13. Clinical Research on the Application of TCRP for Patients with Endometrial Polyps Causing Abnormal Uterine Bleeding%分析TCRP用于子宫内膜息肉致异常子宫出血患者治疗中的临床研究

    Institute of Scientific and Technical Information of China (English)

    冯敏锋; 董晶; 吴丽琼; 梁景梅

    2016-01-01

    Objective:To analyze clinical curative effect of TCRP for patients with endometrial polyps causing abnormal uterine bleeding under hysteroscopy.Methods:90 cases with endometrial polyp causing ab-normal uterine bleeding treated in a hospital from January 2014 to December 2015 taken as research objects, who were randomly divided into control group and observation group with 45 cases in each group.The con-trol group were treated with curet curettage under hysteroscopy and the observation group were treated by TCRP.Then compare the curative effect of two groups.Results:The total effective rate of the observation group was 88.9%,significantly higher than 64.4% of the control group (P<0.05).Conclusion:Applying TCRP for patients with endometrial polyps causing abnormal uterine bleeding can remove uterine polyps and endometrium tissue thoroughly,which is of remarkable curative effect and worthy of promotion.%目的::分析宫腔镜下子宫内膜息肉切除术(TCRP)用于子宫内膜息肉致异常子宫出血患者治疗中的临床疗效。方法:选取某院2014年1月~2015年12月收治的子宫内膜息肉致异常子宫出血90例患者,随机分为对照组45例和观察组45例,采用宫腔镜下刮匙刮除术对对照组患者进行治疗,采用TCRP对观察组患者进行治疗,比较两组的疗效。结果:观察组的治疗总有效率为88.9%,明显高于对照组的64.4%(P<0.05)。结论:针对子宫内膜息肉致异常子宫出血患者应用 TCRP 进行治疗,能够将子宫息肉及其内膜组织彻底去除,疗效显著,具有推广的价值。

  14. An unusual case of postmenopausal vaginal bleeding: retention of fetal bone.

    Science.gov (United States)

    Sahinoglu, Zeki; Kuyumcuoglu, Umur

    2003-01-01

    Retention of intrauterine fetal bones is a rare finding in patient suffering from abnormal uterine bleeding or secondary infertility. Detailed patient history, pelvic ultrasonography and hysteroscopy are diagnostic tools. Here, we describe a case of postmenopausal persistent uterine bleeding and pelvic pain caused by prolonged retention of fetal bones after a midtrimester abortion 17 years ago.

  15. Gastrointestinal bleeding.

    Science.gov (United States)

    Marek, T A

    2011-11-01

    Gastrointestinal bleeding remains one of the most important emergencies in gastroenterology. Despite this, only about 100 abstracts concerning gastrointestinal bleeding (excluding bleeding complicating endoscopic procedures) were presented at this year's Digestive Disease Week (DDW; 7-10 May 2011; Chicago, Illinois, USA), accounting for less than 2% of all presented lectures and posters. It seems that the number of such abstracts has been decreasing over recent years. This may be due in part to the high level of medical care already achieved, especially in the areas of pharmacotherapy and endoscopic treatment of gastrointestinal bleeding. In this review of gastrointestinal bleeding, priority has been given to large epidemiological studies reflecting "real life," and abstracts dealing more or less directly with endoscopic management. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Comparison of transvaginal ultrasonography and hysteroscopy in the diagnosis of uterine pathologies

    OpenAIRE

    Babacan, Ali; Gun, Ismet; Kizilaslan, Cem; Ozden, Okan; Muhcu, Murat; Mungen, Ercument; Atay, Vedat

    2014-01-01

    A thorough evaluation of the uterine cavity is frequently required in gynecology practice. The aim of this study was to compare the diagnostic values of transvaginal ultrasound examination and hysteroscopy in detecting uterine abnormalities in a group of patients within a range of menopausal status and symptomatology. This study included 285 patients admitted with complaints of abnormal uterine bleeding, postmenopausal bleeding, lower abdominal pain, abnormal vaginal discharge or for a routin...

  17. 肝硬化患者合并非妊娠异常子宫出血的诊断和治疗%The diagnosis and treatment of abnormal uterine bleeding in nonpregnant patients with hepatic cirrhosis

    Institute of Scientific and Technical Information of China (English)

    刘军; 王玲; 刘敏; 白玉清

    2011-01-01

    目的 探讨肝硬化患者合并非妊娠异常子宫出血(AUB)的临床诊断和治疗特点.方法 对2008年10月-2009年10月在地坛医院住院的432例女性肝硬化患者按随机数字法抽取病历100份,检索其月经史;回顾性分析2005年12月-2009年12月诊断和治疗的72例肝硬化合并非妊娠AUB患者的临床资料.采用SPSS10.0软件进行统计分析,构成比用x2检验.结果 100例肝硬化住院女性患者中,61例(61%)有AUB记载,平均年龄(45.4±3.6)岁.4年间到妇科诊断和治疗的非妊娠AUB肝硬化患者72例,处于围绝经期患者58例(80.6%).代偿期及失代偿期肝硬化AUB患者中月经过多者分别为42.5%(17/40)、68.8%(22/32),两组患者比较,x2=7.189,P=0.027,差异有统计学意义.因AUB大出血急诊入院患者18例,代偿期及失代偿期肝硬化患者分别为6例、12例,两组患者比较,x2=4.80,P=0.028,差异有统计学意义.52例行诊断性刮宫,39例(75.0%)患者内膜有病理变化.随访3个月到1年,共随访67例,药物保守治疗的患者58.8%(10/17)有效;子宫切除的16例患者均无术后并发症发生.结论肝硬化女性患者非妊娠AUB的发生率较高,多发生在围绝经期,大部分患者子宫内膜有不同程度的病理变化.失代偿期肝硬化非妊娠AUB患者出血模式以月经过多为主,并且易发生子宫急性大出血.%Objective To investigate the clinical characteristics of abnormal uterine bleeding (AUB) in nonpregnant hepatic cirrhosis patients and to assess the treatment and curative effects of AUB. Methods A retrospective analysis was conducted on 72 nonpregant AUB patients treated in Ditan Hospital from October 2008 to October 2009. Data were assessed with SPSS 10.0 and the constituent ratio was examined by chisquare tests. Results 58 out of the 72 nonpregnant AUB patients were climacteric patients (80.56%).Approximately 42.5% and 68.8% ( x 2 = 7.189, P = 0.027) of the AUB patients were diagnosed with compensated and

  18. Systemic causes of heavy menstrual bleeding

    NARCIS (Netherlands)

    Verschueren, Sophie

    2017-01-01

    Heavy menstrual bleeding (HMB) is a common problem in fertile women. In addition to local factors, such as a polyp or a uterine fibroid, systemic causes may lead to HMB. These systemic causes are discussed in this thesis. For years, women with HMB were tested underlying thyroid disorder, but our res

  19. Clinical study of levonorgestrel-releasing intrauterine system in the treatment of perimenopausal uterine bleeding.%左旋炔诺酮宫内缓释系统治疗围绝经期功血的90例疗效观察

    Institute of Scientific and Technical Information of China (English)

    李红

    2012-01-01

    Objective To observe the clinical efficacy of levonorgestrel-releasing intrauterine system in the treatment of perimenopausal uterine bleeding. Methods 90 patients with perimenopausal uterine bleeding were treated with levonorgestrel-releasing intrauterine system, and all the patients were followed up 3-7 days after menstrual for 6 months. The menstrual flow, endometrial thickness, uterine size, ovaries size, and hemoglobin changes before and after treatment were recorded. Results There were no statistically significant differences in the uterine size, ovarian volume before and after treatment (P>0.05). The endometrial thickness was (13.69±0.35) mm before treatment and (7.36±1.29) mm after treatment (P<0.05), showing statistically significant difference. The hemoglobin content was (53.66±3.22) g/L before the treatment, significantly lower than (102.96±4.62) g/L after treatment (P<0.05). Conclusion Levonorgestrel-releasing intrauterine system for treatment of perimenopausal uterine bleeding can effectively reduce the menstrual flow, control the endometrial hyperplasia, and increase hemoglobin levels, with satisfactory clinical result, which is worthy to be promoted in clinical practice.%目的 观察左炔诺孕酮宫内缓释系统治疗围绝经期功血的临床疗效.方法 对90例围绝经期功血患者采用左炔诺孕酮宫内缓释系统治疗,全部病例均于每次月经后3 ~7d内随访,共随访6个月.记录服药前后月经出血情况、子宫内膜厚度、子宫大小、双侧卵巢大小、血红蛋白含量的变化.结果 患者用药前后的子宫大小、卵巢体积比较差异无统计学意义(P>0.05);患者在用药前的子宫内膜厚度为(13.69±0.35) mm,用药后为(7.36±1.29) mm,治疗前后的子宫内膜厚度改变比较差异有统计学意义(P<0.05);患者用药前的血红蛋白含量为(53.66±3.22) g/L,治疗后为(102.96±4.62) g/L,治疗前后的血红蛋白含量改变比

  20. 经阴道超声联合宫腔镜对围绝经期异常子宫出血的诊断价值%Value of transvaginal sonography combined with hysteroscopy in diagnosis of perimenopausal abnormal uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    崔艳萍; 班清媚; 钟小烨; 余文洁

    2011-01-01

    Objective: To explore the value of transvaginal sonography combined with hysteroscopy in diagnosis of perimenopausal abnormal uterine bleeding Methods: 124 hospitalized patients with perimenopausal abnormal uterine bleeding from September 2004 to May 2009 received transvaginal sonography and hysteroscopy, and biopsy under hysteroscope was carried out, the results of transvaginal sonography and hysteroscopy were compared with pathological results. Results: The sensitivity of transvaginal sonography was 97. 67%, the specificity of transvaginal sonography was 52. 63%, the positive predictive value of transvaginal sonography was 82. 35%, the negative predictive value of transvaginal sonography was 90. 91%, the accurate rate of transvaginal sonography was 83.87%; the sensitivity of hysteroscopy was 98.85%, the specificity of hysteroscopy was 89. 19%, the positive predictive value of hysteroscopy was 95.56%, the negative predictive value of hysteroscopy was 97. 06%, the accurate rate of hysteroscopy was 95.97%. Conclusion: Hysteroscopy plays an important role in diagnosis of perimenopausal abnormal uterine bleeding, transvaginal sonography combined with hysteroscopy can define the causes of perimenopausal abnormal uterine bleeding and increase the accurate rate of diagnosis.%目的:探讨阴道超声和宫腔镜对围绝经期异常子宫出血的诊断价值.方法:2004年9月~2009年5月就诊的124例围绝经期异常子宫出血患者进行阴道超声和宫腔镜检查,并在宫腔镜下进行活检,将阴道超声和宫腔镜检查结果与病理检查结果进行比较.结果:阴道超声检查的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为97.67%、52.63%、82.35% 、90.91%和83.87%;宫腔镜检查的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为98.85%、89.19%、95.56%、97.06%和95.97%.结论:宫腔镜检查对围绝经期异常子宫出血的诊断具

  1. Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy.

    Science.gov (United States)

    Lee, Jae-Yeon; Hwang, Kyu-Ri; Won, Kyu-Hee; Lee, Da-Yong; Jeon, Hye-Won; Moon, Min-Hwan

    2014-12-01

    Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

  2. Iatrogenic Uterine Diverticulum in Pregnancy After Robotic-assisted Myomectomy.

    Science.gov (United States)

    DeStephano, Christopher C; Jernigan, Amelia M; Szymanski, Linda M

    2015-01-01

    Uterine diverticula are rare outpouchings of the uterus associated with abnormal uterine bleeding, pelvic pain, dysmenorrhea, and adverse obstetric events. At the time of cesarean delivery at 36 5/7 weeks' gestation during the patient's first pregnancy and 36 6/7 weeks during the second pregnancy, a fundal iatrogenic uterine diverticulum at the site of a prior robotic-assisted myomectomy was noted. The outpouching communicated with the endometrial cavity and was extremely attenuated, palpably 2 to 3 mm thick. Further research is needed to determine the incidence of iatrogenic uterine diverticulum after robotic myomectomy and whether these malformations increase the risk of adverse obstetric outcomes.

  3. The etiopathogenesis of uterine fibromatosis

    Science.gov (United States)

    Manta, L; Suciu, N; Toader, O; Purcărea, RM; Constantin, A; Popa, F

    2016-01-01

    Uterine fibroids or uterine leiomyomas are the most common benign tumors of the uterus among women of fertile age, while the etiology is still incompletely elucidated. The occurrence and development of the fibromatosis may be related to certain risk factors and genic mechanisms, although the exact causes are not yet fully known. The development of uterine fibroids is correlated not only with the metabolism and with the level of female sexual hormones, estrogen, and progesterone, but also with the number of these hormone receptors expressed on the surface of the myometrium. Proliferative effects of estrogen and progesterone may be exercised through proinflammatory factors (TNF alpha), growth factors (IGF1, IGF2, TGFbeta3 and betaFGF) or inhibitors of apoptosis (p53 suppression). A number of predisposing factors such as ethnicity – black skin, early menarche, nulliparity, caffeine and alcohol, chronic inflammation, obesity, were also identified. Approximately 40% of the uterine fibroids are caused by the same cytogenetic alterations found in the other tumor types such as kidney, lung, or leiomyosarcoma. As part of a system dysfunction, uterine fibromatosis was connected to other disorders such as AHT (arterial hypertension), endometrium adenocarcinoma, adenomyosis, endometriosis, diabetes mellitus, breast tumors, seemingly with a common causality. The action and effect of some hormonal imbalances over the various organs depend on the histological and local expression particularities of the various receptors, being the cause for many disorders, among which the uterine fibromatosis, coexisting or accompanying the later. This article examines and summarizes the latest data refreshed literature etiopathogenesis offering indicators of uterine fibroids. PMID:27974911

  4. Diagnostic value of vaginal ultrasonography and hysteroscopy for pathogenesis of perimenopausal abnormal uterine bleeding%阴道超声检查与宫腔镜检查对围绝经期异常子宫出血病因的诊断价值

    Institute of Scientific and Technical Information of China (English)

    蔡双

    2015-01-01

    目的:探究在围绝经期异常子宫出血病因的诊断方面阴道超声检查与宫腔镜检查的诊断价值。方法123例围绝经期异常子宫出血的患者进行阴道超声和宫腔镜检查,在宫腔镜检查同时进行活检,将阴道超声和宫腔镜检查结果与病理检查结果进行对比。结果阴道超声检查正常的确诊率为90.9%,阴道超声检查异常的确诊率为86.1%;宫腔镜检查正常的确诊率为96.0%,宫腔镜检查异常的确诊率为89.8%;两种检查方法确诊率比较差异无统计学意义(P>0.05)。结论对于围绝经期的异常子宫出血,可先进行阴道超声检查,查看子宫内膜是否厚于10 mm,并查看子宫壁及宫腔外是否有病变,若存在病变,则可确诊,若检查不到,则进行进一步的宫腔镜检查,与此同时,也要对患者在宫腔镜下取标本做病理,进而达到确诊的目的。%Objective To explore the diagnostic value of vaginal ultrasonography and hysteroscopy for pathogenesis of perimenopausal abnormal uterine bleeding.Methods A total of 123 patients with perimenopausal abnormal uterine bleeding received vaginal ultrasonography and hysteroscopy, along with biopsy during hysteroscopy. Comparison was made on results between pathological examination, vaginal ultrasonography and hysteroscopy.Results The accuracy of vaginal ultrasonography was 90.9% for normal detection, and that was 86.1% for abnormal detection. Hysteroscopy had the accuracy for normal detection as 96.0%, and that for abnormal detection as 89.8%. There was no statistically significant difference of accuracy between the two detection methods (P>0.05).Conclusion Vaginal ultrasonography is preferred in perimenopausal abnormal uterine bleeding for 10 mm of endometrium thickness and lesions in uterus wall and out uterine cavity. Diagnosis can be made on the basis of lesion, while further hysteroscopy examination is necessary if there is no detected lesion. Meanwhile, hysteroscopic

  5. Study on volume of bleeding and postoperative complications of mifepristone combined with misoprostol complete curettage of uterine cavity in treatment of embryos stop developing%米非司酮联合米索前列醇清宫术治疗胚胎停止发育的出血量及术后并发症研究

    Institute of Scientific and Technical Information of China (English)

    高琛; 陈锦果; 徐斌

    2016-01-01

    Objective To study the volume of bleeding and postoperative complications of mifepristone combined with misoprostol complete curettage of uterine cavity in treatment of embryos stop developing. Methods 240 cases of patients with embryos stop developing cured in our hospital from November 2011 to December 2013 were selected as the research objects. According to the hospital sequence, they were randomly divided into observation group and control group with 120 cases in each. Patients in observation group were treated with mifepristone combined with misoprostol complete curettage of uterine cavity, and patients in control group were treated with misoprostol complete curettage of uterine cavity. Operation conditions, adverse reaction and complications, cervix softening and expansion effect of the two groups were compared. Results On the patients of observation group, its operation time was short, and less bleeding during operation, its success rate of embryo natural discharge and 1 palace embryo were higher, and its cervix softening and expansion total effective rate were significantly higher. Compared with control group, the differences were all statistically significant (P 0.05). Conclusion Mifepristone combined with misoprostol complete curettage of uterine cavity in treatment of embryos stop developing could help to reduce the volume of bleeding and complications of patients. It was a safe and efficient way of clinical treatment.%目的:研究米非司酮联合米索前列醇清宫术治疗胚胎停止发育的出血量及术后并发症情况。方法以2011年11月~2013年12月我院接收的240例胚胎停止发育患者为研究对象,按照住院先后顺序随机分成两组,各120例患者。观察组患者给予米非司酮联合米索前列醇清宫术治疗,对照组给予米索前列醇与清宫术治疗。对比两组患者的手术情况、不良反应以及并发症情况、宫颈软化与宫口扩张效果。结果观察组患者的手术时

  6. Relationship between VEGF and Related Factors and Abnormal Uterine Bleeding Induced by Intrauterine Device%血管内皮生长因子及相关因子与含铜宫内节育器致子宫异常出血的关系

    Institute of Scientific and Technical Information of China (English)

    赵璐; 殷震惠; 杨华

    2014-01-01

    Intrauterine device(IUD) is one of the widely used long-acting contraceptive methods. At present,our country has the widespread use of copper containing IUD ,but the placement of IUD women often have some adverse reactions ,such as menorrhagia,irregular bleeding,abnormal vaginal discharge,pain,especially with the highest incidence of abnormal uterine bleeding. Patients with a serious impact on recognition of copper containing IUD and acceptance ,which has been plagued by a problem that can not be ignored in clinic. At present it has been proved that human endometrium contains a variety of angiogenesis factor. Vascular endothelial growth factor (VEGF) is an important regulator of endometrial vessels formed,and affected by many factors. A number of research on the relationship between VEGF and related factors and the copper IUD induced abnormal uterine bleeding ,the copper containing IUD side reactions of targeted therapy has opened up a new prospect.%宫内节育器(intrauterine device,IUD)是目前广泛使用的长效避孕方法之一。目前中国已普遍使用含铜IUD,但是放置含铜IUD的妇女常出现一些不良反应,如月经过多、不规则出血、白带异常和疼痛等,其中以子宫异常出血发生率最高,严重影响了患者对含铜IUD的认可和接受性,这也是一直困扰临床的一个不可忽视的问题。目前已证明人子宫内膜存在多种血管生成因子。其中血管内皮生长因子(VEGF)是子宫内膜血管形成的重要调控因子,并受多种因子调控。对VEGF及相关因子与含铜IUD致子宫异常出血关系的多项研究,为含铜IUD不良反应的靶向治疗开辟了新的前景。

  7. The management of uterine leiomyomas.

    Science.gov (United States)

    Vilos, George A; Allaire, Catherine; Laberge, Philippe-Yves; Leyland, Nicholas

    2015-02-01

    The aim of this guideline is to provide clinicians with an understanding of the pathophysiology, prevalence, and clinical significance of myomata and the best evidence available on treatment modalities. The areas of clinical practice considered in formulating this guideline were assessment, medical treatments, conservative treatments of myolysis, selective uterine artery occlusion, and surgical alternatives including myomectomy and hysterectomy. The risk-to-benefit ratio must be examined individually by the woman and her health care provider. Implementation of this guideline should optimize the decision-making process of women and their health care providers in proceeding with further investigation or therapy for uterine leiomyomas, having considered the disease process and available treatment options, and reviewed the risks and anticipated benefits. Published literature was retrieved through searches of PubMed, CINAHL, and Cochrane Systematic Reviews in February 2013, using appropriate controlled vocabulary (uterine fibroids, myoma, leiomyoma, myomectomy, myolysis, heavy menstrual bleeding, and menorrhagia) and key words (myoma, leiomyoma, fibroid, myomectomy, uterine artery embolization, hysterectomy, heavy menstrual bleeding, menorrhagia). The reference lists of articles identified were also searched for other relevant publications. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date limits but results were limited to English or French language materials. Searches were updated on a regular basis and incorporated in the guideline to January 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, and national and international medical specialty societies. The majority of fibroids are asymptomatic and require no intervention or further

  8. Bleeding Disorders in Women

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Past Emails Bleeding Disorders in Women Language: English Español (Spanish) Recommend ... risk for a bleeding disorder. What is excessive bleeding in women? Women with excessive bleeding may experience ...

  9. 诺舒与热球子宫内膜去除术治疗异常子宫出血的效果对比%Efficacy comparison of abnormal uterine bleeding treated by NovaSure and Thermal balloon en-dometrial ablation

    Institute of Scientific and Technical Information of China (English)

    高湘玲

    2016-01-01

    目的:对比分析诺舒子宫内膜去除术和热球子宫内膜去除术治疗异常子宫出血的临床效果。方法对2013年2月至2015年2月80例异常子宫出血患者进行研究,随机分为对照组和观察组,对照组采用热球子宫内膜去除术进行治疗,观察组采用诺舒子宫内膜去除术进行治疗,对比观察两组患者的治疗效果以及术后并发症的发生情况。结果两组闭经率在术后第1、6个月相比差异未见统计学意义(P ﹥0.05),但在第12、18个月时差异有统计学意义(P ﹤0.05);两组总有效率相比差异未见统计学意义(P ﹥0.05);对照组低热和腹痛等不良反应总发生率(22.5%)显著高于观察组(5.0%),差异有统计学意义(P ﹤0.05)。结论采用诺舒子宫内膜去除术和热球子宫内膜去除术治疗异常子宫出血患者均可以取得较好的效果,但诺舒子宫内膜去除术操作简单、效果更佳,并且显著降低了术后并发症的发生率,安全性较高,值得进一步推广运用。%Objective To contrastively analyze the clinical effects of NovaSure and Thermal bal-loon endometrial ablation on abnormal uterine bleeding. Methods From February 2013 to February 2015,80 patients with abnormal uterine bleeding were randomly divided into the control group and the treatment group. The control group was treated by thermal balloon endometrial ablation,and the treat-ment group was treated by NovaSure endometrial ablation. The treatment effects and occurrence of postop-erative complications were compared. Results There was no significant difference in the amenorrhea rate of the first and sixth month after treatment( P ﹥ 0. 05),but at the twelfth and eighteenth month, there was significant difference(P ﹤ 0. 05). There was no significant difference in the total effective rate between the two groups(P ﹥ 0. 05). The total rate of the adverse reactions such as the low-grade fever

  10. Effect of motherwort on metalloproteinases in decidual tissue in abnormal uterine bleeding induced by drug abortion%益母草对药物流产引起的子宫异常出血患者蜕膜组织基质金属蛋白酶水平的影响

    Institute of Scientific and Technical Information of China (English)

    林秀芝; 杨赛敏; 冯泽蛟

    2016-01-01

    Objective To investigate the the effect of motherwort on metalloproteinases in decidual tissue in the treatment of abnormal uterine bleeding induced by drug abortion in patients.Methods 76 patients with abnormal uterine bleeding by drug abortion in this study form Cangnan County Maternity & Child Healthcare Hospital were selected and divided into 2 group, 38 cases of each group.The control group received mifepristone, misoprostol and progynova treatment,the experimental group received more with motherwort.The serum hormones change and matrix metalloproteinases in decidual tissue by S-P method were determine,while adverse reaction were compared after the treatment.Results Compared with before treatment,levels of serum estradiol increased,progesterone decreased,content of the matrix metalloproteinase(MMP-3)and MMP-9 in decidual tissue increased,tissue inhibitor of metalloproteinase(TIMP-1)in decidual tissue decreased,the differences were statistically significant(P<0.05),compared with the control group,levels of serum estradiol in the experimental group were higher,progesterone were lower,contents of MMP-9 and MMP-3 in the tissues were higher, levels of TMP-1 were lower, and bleeding duration was shorter, vaginal bleeding was less ( P <0.05 ) .Conclusion Motherwort in the treatment of abnormal uterine bleeding by drug abortion in patients has good curative effect,it could increase the levels of MMP-3 and MMP-9,reduce levels of TIMP-1 in decidual tissue,and reduce the bleeding time and bleeding volume.%目的:探讨益母草对流产引起的子宫异常出血患者蜕膜组织基质金属蛋白酶水平变化。方法温州苍南妇幼保健院收治的早孕药物流产后子宫异常出血患者76例,按随机数字表法分为2组,各38例,对照组予以常规米非司酮,米索前列醇及戊酸雌二醇治疗,研究组在常规治疗基础上予以益母草颗粒,采血测定激素变化,取蜕膜组织采用S-P法测定基质金属蛋白酶含

  11. COMPARISON OF TRANSVAGINAL ULTRASONOGRAPHY AND HYSTEROSCOPY IN THE EVALUATION OF PERI AND POSTMENOPAUSAL BLEEDING

    Directory of Open Access Journals (Sweden)

    Pratibha

    2016-03-01

    Full Text Available Anything that can significantly improve the accuracy of diagnosis, the cause of abnormal uterine bleeding in peri-menopausal and postmenopausal women can reduce the frequency of hysterectomy as a cure. Abnormal uterine bleeding has become more important on 2nd half of twentieth century, because women are experiencing more menstrual cycles during their reproductive life. AIM To evaluate intrauterine abnormalities in symptomatic peri and postmenopausal bleeding by transvaginal ultrasonography and hysteroscopy. METHOD This prospective study was carried out on 60 patients with peri and postmenopausal bleeding attending Gynaecology OPD at Batra Hospital. RESULT Hysteroscopy has higher sensitivity for diagnosing endometrial abnormalities compared to TVS.

  12. Misdiagnosed Uterine Rupture of an Advanced Cornual Pregnancy

    Directory of Open Access Journals (Sweden)

    Christian Linus Hastrup Sant

    2012-01-01

    Full Text Available Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability.

  13. Misdiagnosed uterine rupture of an advanced cornual pregnancy

    DEFF Research Database (Denmark)

    Sant, Christian Linus Hastrup; Andersen, Poul Erik

    2012-01-01

    Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination...... and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability....

  14. Acute lymphoblastic leukemia presenting with a uterine cervical mass

    Directory of Open Access Journals (Sweden)

    N Geetha

    2015-01-01

    Full Text Available Involvement of female genital tract with acute lymphoblastic leukemia (ALL is extremely rare, and it is even rarer for a patient to have symptomatic presentation. We report the case of a middle-aged lady with ALL, who presented with severe abnormal uterine bleeding and a uterine cervical mass. Biopsy of the cervical mass showed infiltration by leukemic blasts. She received chemotherapy with Berlin-Frankfurt-Munster protocol and is alive in remission after 10 years.

  15. Superselective uterine arterial embolization with pingyangmycin-lipiodol emulsion for management of symptomatic uterine leiomyoma

    Institute of Scientific and Technical Information of China (English)

    单鸿; 黄明声; 关守海; 姜在波; 朱康顺; 李征然

    2004-01-01

    Background Uterine arterial embolization (UAE) is a safe and effective therapy for symptomatic uterine leiomyoma. This study was to assess the effectiveness and the feasibility of pingyangmycin-lipiodol emulsion (PLE) for the management of symptomatic uterine leiomyoma.Methods One hundred consecutive patients (aged 21-53 years, with 38 in average) with symptomatic uterine leiomyoma underwent superselective UAE with PLE. Clinical symptoms of the patients (including menorrhagia, bulk-related symptoms, and postprocedure-related abdominal pain) and the changes in uterine volume and tumor size after the embolization were analyzed. The patients were followed up for 8-21 months (mean, 15 months).Results Ninety-nine patients (99%, 99/100) were interviewed in their first menses circle after embolization, showing improvements in their abnormal bleeding and bulk-related symptoms to some extent. Imagiological results during follow-up showed a mean of 48% reduction in uterine volume at 6 months and a mean of 75% reduction in tumor size at 9 months. Eighty-three percent of the patients reported complete resolution of postprocedure pain within 7 days.Conclusions PLE is effective in the management of uterine leiomyoma, having superiority in alleviating postprocedure-related pain.

  16. Review literature on uterine carcinosarcoma

    Directory of Open Access Journals (Sweden)

    Rajendra Singh

    2014-01-01

    Full Text Available Carcinosarcoma of the uterus is a rare gynaecological neoplasm, which is also known as malignant mixed mesodermal tumor. Traditionally this tumour has been regarded as a subtype of uterine sarcoma, and its origin remains controversial. The exact nature and prognosis was not clear in the past. It is believed that uterine carcinosarcoma have a Mullerian duct origin and have a capacity to differentiate into various mesenchymal and epithelial components. Regarding the histogensis, various theories have been given; of which ′conversion theory′ was broadly accepted. Carcinosarcoma are mostly of monoclonal origin with the carcinomatous component being the driving force. This type of tumor is broadly divided into two groups, homologous and heterologous, depending on the characteristics of the stroma or mesenchymal components of endometrial tissue. It is more frequent in black women and postmenopausal women. Radiation is a possible etiological factor but the exact etiology is not known yet. However, tamoxifen may induce carcinogenesis in some patients. Its clinical feature is very similar to endometrial carcinoma i.e. postmenopausal vaginal bleeding, have a very aggressive behavior and a poor prognosis. This pelvic malignancy is treated by multimodality therapy including surgery, chemotherapy and radiotherapy. Here we are reviewing old concepts about the disease and modern understandings of the origin, classification, pathogenesis and recent advances in the treatment of the uterine carcinosarcoma.

  17. Uterine fibroids: clinical manifestations and contemporary management.

    Science.gov (United States)

    Doherty, Leo; Mutlu, Levent; Sinclair, Donna; Taylor, Hugh

    2014-09-01

    Uterine fibroids (leiomyomata) are extremely common lesions that are associated with detrimental effects including infertility and abnormal uterine bleeding. Fibroids cause molecular changes at the level of endometrium. Abnormal regulation of growth factors and cytokines in fibroid cells may contribute to negative endometrial effects. Understanding of fibroid biology has greatly increased over the last decade. Although the current armamentarium of Food and Drug Administration-approved medical therapies is limited, there are medications approved for use in heavy menstrual bleeding that can be used for the medical management of fibroids. Emergence of the role of growth factors in pathophysiology of fibroids has led researchers to develop novel therapeutics. Despite advances in medical therapies, surgical management remains a mainstay of fibroid treatment. Destruction of fibroids by interventional radiological procedures provides other effective treatments. Further experimental studies and clinical trials are required to determine which therapies will provide the greatest benefits to patients with fibroids.

  18. Abnormal Bleeding During Menopause Hormone Therapy: Insights for Clinical Management

    Science.gov (United States)

    de Medeiros, Sebastião Freitas; Yamamoto, Márcia Marly Winck; Barbosa, Jacklyne Silva

    2013-01-01

    Objective Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy. Methods A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding. Results Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women at higher risk for bleeding, and adapt the regimen to suit eachwoman’s characteristics. Abnormal bleeding with progesterone/progestogen only, combined sequential, or combined continuous regimens may be corrected by changing the progestogen, adjusting the progestogen or estrogen/progestogen doses, or even switching the initial regimen to other formulation. Conclusion To diminish the occurrence of abnormal bleeding during hormone therapy (HT), it is important to tailor the regimen to the needs of individual women and identify those with higher risk of bleeding. The use of new agents as adjuvant therapies for decreasing abnormal bleeding in women on HT awaits future studies. PMID:24665210

  19. Giant Uterine Fibromyoma. A Case Report

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    Tahiluma Santana Pedraza

    2013-12-01

    Full Text Available The uterus is the common site for multiple benign and malignant conditions. Giant uterine fibromyoma is a benign tumor of low incidence. Its management poses a challenge for the surgical team because of the volume of the surgical specimen and the variations in the distribution of intra-abdominal organs caused by uterine growth. A case of a 43-year-old patient with a history of bronchial asthma and hypertension who presented with enlargement of the abdomen and vaginal bleeding is reported. The patient was attended by the General Surgery Department of the María Genoveva Guerrero Ramos Comprehensive Diagnostic Center in the Libertador Municipality, Capital District, Venezuela. Total abdominal hysterectomy and complementary appendectomy were performed. The histopathological study showed a giant uterine fibromyoma. Postoperative progress was satisfactory. It was decided to present the case due to its rarity.

  20. Uterine Fibroid Embolization (UFE)

    Science.gov (United States)

    ... embolization. This occurs when fibroids located inside the uterine cavity detach after embolization. Women with this problem may require a procedure called D & C (dilatation and curettage) to ... who undergo uterine fibroid embolization, normal menstrual cycles resume after the ...

  1. Long-term intermittent pharmacological therapy of uterine fibroids – a possibility to avoid hysterectomy and its negative consequences

    Directory of Open Access Journals (Sweden)

    Anita Olejek

    2016-03-01

    Full Text Available Uterine fibroids are found in almost 20-40% of women of reproductive age. For each woman an individualised treatment method should be applied because the hysterectomy procedure is not a good option in every case. The uterus is an organ necessary not only in reproduction. Its removal may result in: pelvic floor dysfunction and stress urinary incontinence, negative impair on life quality, depressive disorders, increased risk of cardiovascular and neurodegenerative diseases, and higher incidence of neoplastic disease. According to the last scientific reports, selective progesterone receptor modulators are the effective therapeutic option in uterine fibroids in women of reproductive age because progesterone is an important factor in their pathogenesis. Ulipristal acetate (UPA is a progesterone receptor antagonist. It inhibits cell proliferation and angiogenesis in uterine fibroids and also reduces collagen deposits in extracellular matrix. Significant data concerning ulipristal acetate efficacy have been provided by scientific research, especially from the consecutive PEARL studies. Oral ulipristal acetate effectively and safely controls bleeding and pain in patients with symptomatic fibroids. It reduces fibroid volume and restores quality of life. The results of UPA long-term intermittent treatment are largely maintained during the off-treatment periods.

  2. Understanding Minor Rectal Bleeding

    Science.gov (United States)

    ... Home / For Patients / Patient Information Understanding Minor Rectal Bleeding What are the possible causes of minor rectal bleeding? Hemorrhoids Anal fissures Proctitis (inflammation of the rectum) ...

  3. Menorrhagia (Heavy Menstrual Bleeding)

    Science.gov (United States)

    Diseases and Conditions Menorrhagia (heavy menstrual bleeding) By Mayo Clinic Staff Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy ...

  4. In vivo measurements of uterine cavities in 795 women of fertile age.

    Science.gov (United States)

    Kurz, K H; Tadesse, E; Haspels, A A

    1984-06-01

    The uterine sound length, the functional length of the cervix including the zone of internal cervical os and the fundus transversal were determined in 795 fertile women in vivo using a measuring device, the Cavimeter. The functional cavity length was calculated by subtracting the functional length of the cervix from the uterine sound length. With growing parity, the uterine length and width increase, but with advance in age, the uterine cavity changes are not so distinct. The wide ranges found by the investigation demonstrate the individuality of the uterine cavity and the desire to measure it prior to fitting an IUD. The use of adapted IUDs according to the size of the uterine cavity leads to a remarkable reduction of side effects, particularly expulsion, bleeding and cramps caused mainly by dimensional incompatibility. Therefore prefit uterine cavity measurement can lead to better efficacy of IUDs, increased rates of acceptance and higher continuation rates.

  5. Lower uterine segment pregnancy with placenta increta complicating first trimester induced abortion: diagnosis and conservative management

    Institute of Scientific and Technical Information of China (English)

    刘欣燕; 范光升; 金征宇; 杨宁; 姜玉新; 盖铭英; 郭丽娜; 王友芳; 郎景和

    2003-01-01

    Objective To discuss the diagnosis of and conservative management for lower uterine segment pregnancy with placenta increta complicating first trimester abortion. Methods Four patients with previous caesarean section and severe hemorrhage in induced abortion during the first trimester were studied. Uterine artery embolization (UAE) was used to control bleeding and preserve the uterus. Results UAE controlled heavy uterine bleeding satisfactorily. One of the four patients asked for a hysterectomy after UAE, and her pathology report confirmed "lower uterine segment pregnancy with placenta increta". Conclusion Previous caesarean section is a risk factor for lower uterine segment pregnancy with placenta increta. UAE is one of the best conservative management methods for heavy hemorrhage, especially for women who desire future fertility.

  6. [The clinical characteristics of women with uterine hemorrhages in premenopause].

    Science.gov (United States)

    Rachev, E

    1989-01-01

    The clinical characteristics was studied on 431 women with uterine bleedings during the premenopaussal phase of the climacterium. The author established that menarche, duration of menstrual interval and the menstruation itself before the bleeding did not differ from those of female population in the country. The same was referred to the reproductive characteristics. Premenopausal bleeding reached its peak between 46 and 48 years of age as its duration was relatively great. It was connected with frequent neuro-endocrine and metabolic pathology. The most frequent manifestations were obesity and hypertension. The number of the former hepatitis patients was comparatively large. Diseases of the uterine body were frequent in the structure of genital pathology. The frequency of benign, precancerous and malignant neoplastic processes (without myoma) was high-12.7%.

  7. Case report: Malignant teratoma of the uterine corpus

    Directory of Open Access Journals (Sweden)

    Christmas Timothy

    2009-06-01

    Full Text Available Abstract Background Teratomas are the commonest germ cell tumours and are most frequently found in the testes and ovary. Extragonadal teratomas are rare and mainly occur in midline structures. Uterine teratomas are extremely rare with only a few previous case reports, usually involving mature teratomas of the uterine cervix. Case Presentation We report an 82-year-old lady presenting with post-menopausal bleeding. Initial investigations revealed a benign teratoma of the uterus which was removed. Her symptoms persisted and a recurrent, now malignant, teratoma of the uterine corpus was resected at hysterectomy. Six months after surgery she relapsed with para-aortic lymphadenopathy and was treated with a taxane, etoposide and cisplatin-containing chemotherapy regimen followed by retroperitoneal lymph node dissection. Conclusion In this report we discuss the aetiology, diagnosis and management of uterine teratomas, and review previous case studies.

  8. Intra-uterine contraceptive devices.

    Science.gov (United States)

    Elias, J

    1985-05-01

    Among the advantages of IUDs are the device's high continuation rate, the lack of systemic side effects, and the absence of a need for continual motivation to practice contraception. The effectiveness of plastic IUDs is directly proportional to their surface area, but the degree of excessive bleeding experienced is inversely related to device size. Thus, devices represent a compromise between large size for effectiveness and small size for acceptability. The optimum time to fit an IUD is during the 1st hald of the menstrual cycle. Absolute contraindications to IUD use include the presence of active pelvic inflammatory disease, undiagnosed irregular bleeding, a history of ectopic pregnancy or tubal surgery, and a distorted uteine cavity. Failure rates associated with IUD use range from 2-3% in the 1st year and then decrease. Since the main mechanism of action appears to be production of a sterile inflammatory reaction in the uterine cavity, the IUD prevents intrauterine pregnancy more effectively than ectopic pregnancy. Nonetheless, there is little evidence to suggest that IUD use actually increases the incidence of ectopic pregnancy. Resumption of fertility after IUD removal is not delayed. There is not need to change inert plastic IUDs in women who remain symptom free. The copper devices should be changed every 3-4 years. A search is under way for antifertility agents that can be incorporated into the device to reduce side effects. In general, the IUD is most suitable for older, parous women.

  9. 妈富隆治疗绝经过渡期功能失调性子宫出血的研究%Marvelon Treatment of Dysfunctional Uterine Bleeding during Menopausal Transition

    Institute of Scientific and Technical Information of China (English)

    梁英

    2013-01-01

    目的 观察妈富隆治疗绝经过渡期功能失调性子宫出血(DUB)的临床效果.方法 选取2010年9月至2011年10月在深圳市西乡人民医院诊治的82例绝经过渡期DUB患者,按照随机数字表法分为两组,分别给予妈富隆和米非司酮治疗,比较两组的治疗效果.结果 妈富隆组较米非司酮组完全止血时间缩短,治疗后血红蛋白(Hb)水平显著升高(P0.05).结论 妈富隆治疗绝经过渡期DUB止血快、疗效好,不良反应轻微,值得推广应用.

  10. 射频消融子宫内膜治疗功能失调性子宫出血105例临床分析%Clinical analysis of endometrial radiofrequency ablation for 105 patients with dysfunctional uterine bleeding

    Institute of Scientific and Technical Information of China (English)

    陈梅娟; 欧幼英

    2011-01-01

    目的 探讨射频消融术治疗功能失调性子宫出血(DUB)的临床效果.方法 105例无生育要求,但要求保留子宫的DUB患者,在B超监视下用自凝刀经阴道行子宫内膜射频消融术,术后定期随访.结果 射频消融术治疗DUB手术时间短、术中出血少,105例手术后完全闭经96例,月经明显减少9例,有效率为100%,无一例脏器损伤.结论 射频消融术治疗DUB是一种安全、有效、简便、快速、副作用少的方法,尤适于年龄45岁以上患者.

  11. A systematic review and meta-analysis of the effect of prophylactic tranexamic acid treatment in major benign uterine surgery

    DEFF Research Database (Denmark)

    Topsoee, Märta F; Settnes, Annette; Ottesen, Bent;

    2017-01-01

    BACKGROUND: The value of tranexamic acid (TA) treatment as bleeding prophylaxis in major uterine surgery is unclear. OBJECTIVES: To evaluate the antihemorrhagic effect of prophylactic TA treatment in major benign uterine surgery. SEARCH STRATEGY: PubMed, Embase, Cochrane Library, and Web of Science...

  12. Uterine artery embolization for cervical ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Qiao Zhou, MD

    2015-12-01

    Full Text Available A 36-year-old woman with 3 prior C-sections is diagnosed with a caesarean scar ectopic pregnancy. Despite receiving intramuscular and transvaginal methotrexate injection 2 months before presentation, the beta human chorionic gonadotropin was recorded to be 73 mIU/mL at the time of encounter. The patient complained of vaginal bleeding with a significant drop in hematocrit from 40% to 33%. Transvaginal ultrasound confirmed retroplacental hemorrhage and because of the patient's desire to retain fertility, interventional radiology was consulted to perform an uterine artery embolization. The uterine artery embolization was successful in achieving hemostasis and resulted in a decrease of betaHCG to 46 on postprocedure day 1 to <1 mIU/mL by postoperative week 3.

  13. Bleeding esophageal varices

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000268.htm Bleeding esophageal varices To use the sharing features on ... veins in the esophagus to balloon outward. Heavy bleeding can occur if the veins break open. Any ...

  14. Bleeding into the skin

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003235.htm Bleeding into the skin To use the sharing features on this page, please enable JavaScript. Bleeding into the skin can occur from broken blood ...

  15. [Obscure gastrointestinal bleeding].

    Science.gov (United States)

    Pastor, J; Adámek, S

    2013-08-01

    Obscure gastrointestinal bleeding represents 5% of all cases of bleeding into the gastrointestinal tract (GIT). The cause of this type of bleeding cannot be found by gastroscopy or colonoscopy - the most common cause being bleeding from the source in the small intestine. In other cases it is bleeding from other parts of the digestive tube which has already stopped or was not noticed during admission endoscopy. Imaging methods (X-ray, CT, MRI, scintigraphy) and endoscopic methods (flexible or capsule enteroscopy) are used in the diagnosis and treatment. If, despite having used these methods, the source of bleeding is not found and the bleeding continues, or if the source is known but the bleeding cannot be stopped by radiologic or endoscopic intervention, surgical intervention is usually indicated. The article provides an overview of current diagnostic and treatment options, including instructions on how to proceed in these diagnostically difficult situations.

  16. Ileo-uterine fistula in a degenerated posterior wall fibroid after Caesarean section.

    Science.gov (United States)

    Shehata, Ayman; Hussein, Naglaa; El Halwagy, Ahmed; El Gergawy, Adel; Khairallah, Mohamed

    2016-03-01

    Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.

  17. Post-Operative hemorrhage after myomectomy: Safety and efficacy of transcatheter uterine artery embolization

    Energy Technology Data Exchange (ETDEWEB)

    Wan, Alvin Yu Hon [Dept. of Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China); Shin, Ji Hoon; Yoon, Hyun Ki; Ko, Gi Young; Park, Sang Gik [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Seong, Nak Jong; Yoon, Chang Jin [Dept. of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam (Korea, Republic of)

    2014-06-15

    To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage. We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted. The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients. Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.

  18. Uterine Artery Pseudoaneurysm in the Setting of Delayed Postpartum Hemorrhage: Successful Treatment with Emergency Arterial Embolization

    Directory of Open Access Journals (Sweden)

    Ankur M. Sharma

    2011-01-01

    Full Text Available Postpartum hemorrhage is a major cause of maternal mortality. Though uncommon, uterine artery pseudoaneurysm can follow uterine dilatation and curettage (D + C and needs to be considered in the differential diagnosis. This 30-year-old G1P1 woman presented with right upper quadrant pain and vaginal bleeding. She was afebrile but her white blood count was significantly increased (22.2×109 /L. One week prior, she had undergone a Cesarean delivery which was complicated by hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP, fetal dystocia, and chorioamnionitis. Uterine dilatation and curettage (D & C and placement of a Bakri intrauterine balloon, performed for suspected retained products of conception, failed to control her postpartum bleeding. The patient wished to have a hysterectomy only as a last resort in order to preserve fertility. Emergency uterine artery angiography revealed a left uterine artery pseudoaneurysm and contrast extravasation. The patient was successfully treated with selective embolization. Computed tomography (CT later revealed dehiscence of her uterine Cesarean section incision with an intra-abdominal fluid collection. This collection was drained. She also developed disseminated intravascular coagulopathy (DIC syndrome as well as multiple pulmonary emboli which were both successfully treated. We discuss this unique case of uterine artery pseudoaneurysm with associated uterine dehiscence.

  19. Clinicopathological evaluation of abnormal uterine bleeding in perimenopausal women

    Directory of Open Access Journals (Sweden)

    Lithingo Lotha

    2016-09-01

    Conclusions: Clinicopathological evaluation of AUB showed that fibroid uterus followed by DUB is the most common cause in perimenopausal women. Occurrences of endometrial hyperplasia increases in perimenopause which is of great value as it is a forerunner of carcinoma. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3072-3074

  20. Abnormal uterine bleeding: a critical analysis of two diagnostic methods

    Directory of Open Access Journals (Sweden)

    Manisha Jain

    2014-02-01

    Conclusions: Fibroids and polyps are the two commonest structural lesions causing AUB in the women of reproductive age group. TVS has a role as primary screening method for the initial work-up AUB before resorting to invasive procedure such as hysteroscopy. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 48-53

  1. Cultural aspects and mythologies surrounding menstruation and abnormal uterine bleeding.

    Science.gov (United States)

    Tan, Delfin A; Haththotuwa, Rohana; Fraser, Ian S

    2017-04-01

    The objective of this chapter is to present an overview of how menstruation, a normal bodily function, was and is perceived in various ethnic groups and cultures in the world, from ancient mythology, historical, or traditional practices to contemporary belief systems. Mythical tales about menstruation abound in the legends and prehistory of ancient cultures. These tales characterize menstrual blood variously as sacred, a gift from the gods, or a punishment for sin, but it is almost always magical and powerful. In contrast, most world religions view menstruation, with varying degrees of severity, as a major problem, a sign of impurity and uncleanliness, and therefore, menstruating women are isolated, prohibited from polluting the holy places, and shunned. Many of these myths and cultural misperceptions persist to the present day, reflected in a wide range of negative attitudes toward menstruation, which can have serious and direct implications for reproductive health. In view of the increasingly globalized nature of current clinical practice, it is crucial that health care providers are familiar with existing cultural and social views and attitudes toward the menstrual function. The ultimate goal is to be able to provide women culturally sensitive and medically appropriate therapies for their menstrual disorders. This biocultural approach to menstruation management is desirable in contemporary medical practice.

  2. Management Of Abnormal Uterine Bleeding In Perimenarche: Diagnostic Challenges

    OpenAIRE

    Siregar, Muhammad Fidel Ganis

    2016-01-01

    An 18-year-old girl—virgin, Indonesian, Bataknese, Moslem, student—was admitted to the Emergency Department of Haji Adam Malik Hospital, Medan, and presented with prolonged menstruation for the past 3 years, volume 5–6 pads/day, lasting for 3 weeks, dark red, clotting (+), regular menstrual cycles. Vital signs were within normal limits. Physical examination revealed pale inferior conjunctiva palpebral and soft abdomen, with no palpable mass. As the patient was unmarried, speculum and vaginal...

  3. Uterine Leiomyoma: Hysterosalpingographic Appearances

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2008-01-01

    Full Text Available Uterine leiomyoma is the most common benign tumor of genital tract. The etiology of myomasis unknown. Leiomyoma shows a broad spectrum of radiographic appearances depending on thenumber, size, and location of the tumor. The diagnostic method for uterine leiomyomas is basedprimarily on the clinical situation. Despite of the varied diagnostic options such as; transvaginalsonography, sonohysterography, hysteroscopy, laparoscopy and MRI; hysterosalpingography isstill one of the valuable imaging methods for identification of uterine leiomyoma.The various features of the proved leiomyoma are illustrated in this pictorial review. The incidence,risk factors and clinical features will also be discussed briefly.

  4. A rare case of uterine leiomyosarcoma: a case report

    Directory of Open Access Journals (Sweden)

    Chinamotu Rao N

    2010-07-01

    Full Text Available Abstract Introduction Malignant change in a leiomyoma or uterine fibroid is termed leiomyosarcoma. It arises from smooth muscle of the uterus and is a rare tumor that accounts for 2% to 5% of all uterine malignancies. Very few cases are reported in the literature. Our patient did not have any history of genital bleeding, which is the usual presentation in uterine sarcoma. We report an original case report of an unusual presentation of this rare tumor arising from the uterus. Case presentation A 40-year-old nulliparous woman of South Indian origin presented with a mass in her abdomen for one year with a rapid increase in size over the previous three months. Tumor marker CA-125 was raised, and a computed tomography scan showed a mass arising from the pelvis. An exploratory laparotomy was performed and the histopathology report confirmed the diagnosis of uterine leiomyosarcoma. Conclusion Because of their rarity, uterine sarcomas are not suitable for screening. Diagnosis is by histopathologic examination and surgery is the only treatment. The prognosis for women with uterine sarcoma primarily depends on the extent of disease at the time of diagnosis and the mitotic index.

  5. Pseudoaneurysm of uterine artery: as a cause of secondary post partum haemorrhage

    Directory of Open Access Journals (Sweden)

    Prabha Devi Kodey

    2015-12-01

    Conclusions: Uterine artery embolization is an effective and reliable method for control of haemorrhage in pseudoaneurysm. One should have doubt about pseudoaneurysm in cases of secondary PPH where the bleeding is recurrent and cause not acertainable and to be referred in time where the facility of uterine artery embolization is available. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1821-1824

  6. Nonvariceal upper gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Burke, Stephen J.; Weldon, Derik; Sun, Shiliang [University of Iowa, Department of Radiology, Iowa, IA (United States); Golzarian, Jafar [University of Iowa, Department of Radiology, Iowa, IA (United States); University of Iowa, Department of Radiology, Carver College of Medicine, Iowa, IA (United States)

    2007-07-15

    Nonvariceal upper gastrointestinal bleeding (NUGB) remains a major medical problem even after advances in medical therapy with gastric acid suppression and cyclooxygenase (COX-2) inhibitors. Although the incidence of upper gastrointestinal bleeding presenting to the emergency room has slightly decreased, similar decreases in overall mortality and rebleeding rate have not been experienced over the last few decades. Many causes of upper gastrointestinal bleeding have been identified and will be reviewed. Endoscopic, radiographic and angiographic modalities continue to form the basis of the diagnosis of upper gastrointestinal bleeding with new research in the field of CT angiography to diagnose gastrointestinal bleeding. Endoscopic and angiographic treatment modalities will be highlighted, emphasizing a multi-modality treatment plan for upper gastrointestinal bleeding. (orig.)

  7. Uterine primitive neuroectodermal tumor.

    Science.gov (United States)

    Aminimoghaddam, Soheila; Seifirad, Soroush; Abbasi Dezfouli, Golbahar; Abbasi, Neda; Zare Mehrjardi, Ali; Razavi, Seyed Mohsen; Mahmoudzadeh, Fatemeh

    2015-04-01

    Primitive neuroectodermal tumors are fairly rare in uterus. A case of uterine body primitive neuroectodermal tumor in a 32-year-old Iranian woman is presented. The patient was admitted with abdominal pain and fever and underwent emergency exploratory surgery with total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. Posterior wall of the uterus was necrotic and ruptured and a huge tumor disrupted the uterine body. The tumor was strongly positive for CD99, NSE, and chromogranin; No reaction was seen for CD10, CD45 and myogenin. To the best of our knowledge, this is the first report of an uterine body primitive neuroectodermal tumor and the second report of uterine primitive neuroectodermal tumor from Iran.

  8. Uterine Cancer Statistics

    Science.gov (United States)

    ... Research AMIGAS Fighting Cervical Cancer Worldwide Stay Informed Statistics for Other Kinds of Cancer Breast Cervical Colorectal ( ... Skin Vaginal and Vulvar Cancer Home Uterine Cancer Statistics Language: English Español (Spanish) Recommend on Facebook Tweet ...

  9. Uterine Fibroid Embolization (UFE)

    Science.gov (United States)

    ... resembling coarse sand Gelfoam™, a gelatin sponge material microspheres, polyacrylamide spheres with a gelatin coating All of ... who wishes to have more children consider surgical removal of the individual tumors rather than undergo uterine ...

  10. Spontaneous uterine rupture

    African Journals Online (AJOL)

    After ultrasound scan, uterine rupture was diagnosed and an ... delivery. The birth weights ranged between 2900 and 3200g. The last 2 .... abdominal pains and signs of shock, at which made up of altered blood and we think that the.

  11. Upper gastrointestinal bleeding.

    Science.gov (United States)

    Feinman, Marcie; Haut, Elliott R

    2014-02-01

    Upper gastrointestinal (GI) bleeding remains a commonly encountered diagnosis for acute care surgeons. Initial stabilization and resuscitation of patients is imperative. Stable patients can have initiation of medical therapy and localization of the bleeding, whereas persistently unstable patients require emergent endoscopic or operative intervention. Minimally invasive techniques have surpassed surgery as the treatment of choice for most upper GI bleeding. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. A large uterine leiomyoma leading to non-puerperal uterine inversion: A case report

    Directory of Open Access Journals (Sweden)

    Batool Teimoori

    2017-08-01

    Full Text Available Background: Although leiomyomas are the most common gynecologic disorders, non-puerperal uterine inversion due to leiomyoma is considered as a rare clinical problem. This condition can occur as a complication of a large sub-mucous leiomyoma that leads to dilate cervix and protrude into vagina. The patient may have several symptoms such as heavy vaginal bleeding, pelvic pain and intermittent acute urinary retention. Case: We presented a 32-year-old nulliparous woman with 17 years of unexplained infertility and diagnosis of a large vaginal prolapsed non-pedunculated leiomyoma. Conclusion: Haultain’s procedure was used to reposition uterine inversion and remove leiomyoma through a posterior incision, using laparotomy

  13. Spontaneous Regression of Uterine Arteriovenous Malformations with Conservative Management

    Science.gov (United States)

    Oishi, Sugiko; Akamine, Kozue; Heshiki, Chiaki

    2017-01-01

    Uterine arteriovenous malformation (AVM) can cause massive hemorrhage and is often treated with uterine artery embolization (UAE), which may lead to ovarian insufficiency. Thus, avoiding UAE should be considered, particularly in women undergoing fertility treatments. We present three women diagnosed with postmiscarriage AVM on color Doppler by transvaginal ultrasound imaging. They had no genital bleeding and a small mass, measuring 16–22 mm. If estradiol was >300 pg/mL when AVM was diagnosed, then a gonadotropin-releasing hormone agonist was administered. All three women underwent follow-up observation, revealing spontaneous mass disappearance. To avoid ovarian insufficiency risk with UAE, conservative management and close follow-up observation should be considered in patients with AVM without bleeding, particularly during the fertility treatment. PMID:28299220

  14. Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction

    Directory of Open Access Journals (Sweden)

    Andrea Ciavattini

    2013-01-01

    Full Text Available Uterine leiomyomas (fibroids or myomas are benign tumors of uterus and clinically apparent in a large part of reproductive aged women. Clinically, they present with a variety of symptoms: excessive menstrual bleeding, dysmenorrhoea and intermenstrual bleeding, chronic pelvic pain, and pressure symptoms such as a sensation of bloatedness, increased urinary frequency, and bowel disturbance. In addition, they may compromise reproductive functions, possibly contributing to subfertility, early pregnancy loss, and later pregnancy complications. Despite the prevalence of this condition, myoma research is underfunded compared to other nonmalignant diseases. To date, several pathogenetic factors such as genetics, microRNA, steroids, growth factors, cytokines, chemokines, and extracellular matrix components have been implicated in the development and growth of leiomyoma. This paper summarizes the available literature regarding the ultimate relative knowledge on pathogenesis of uterine fibroids and their interactions with endometrium and subendometrial myometrium.

  15. Comparison of transvaginal ultrasonography and hysteroscopy in the diagnosis of uterine pathologies.

    Science.gov (United States)

    Babacan, Ali; Gun, Ismet; Kizilaslan, Cem; Ozden, Okan; Muhcu, Murat; Mungen, Ercument; Atay, Vedat

    2014-01-01

    A thorough evaluation of the uterine cavity is frequently required in gynecology practice. The aim of this study was to compare the diagnostic values of transvaginal ultrasound examination and hysteroscopy in detecting uterine abnormalities in a group of patients within a range of menopausal status and symptomatology. This study included 285 patients admitted with complaints of abnormal uterine bleeding, postmenopausal bleeding, lower abdominal pain, abnormal vaginal discharge or for a routine gynecological examination. All patients had available transvaginal ultrasonography and hysteroscopy data for evaluation. A biopsy was obtained from all patients during the hysteroscopy session. Sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio were calculated for both methods and compared, considering the histopathological diagnosis as the gold standard. The mean age of the patients was 49.5±12.9 years (range, 24-89 y). Majority of the patients admitted for abnormal uterine bleeding (n=198, 69.4%). For the diagnosis of polyps of any size, hysteroscopy had better sensitivity (puterine pathologies, hysteroscopy seems to offer better diagnostic value for uterine pathologies in general, and uterine polyps in particular.

  16. Uterine prolapse during late pregnancy in a nulliparous woman.

    Science.gov (United States)

    Ishida, Hiromi; Takahashi, Kazuhiro; Kurachi, Hirohisa

    2014-12-01

    A pregnancy that is complicated by a uterine prolapse is rare and primarily occurs in multiparous women during their first or second trimester. In the present report, we describe a case of a 31-year-old nulliparous woman who experienced sudden uterine prolapse at 38 weeks' gestation without labor pains. The cervix was congested, the cervical mucosa was partially lacerated, and bleeding was noted; the protruding cervix could not be repositioned into her vagina. Although the cervical congestion worsened over time, she still did not experience any labor pains. She was delivered by emergency cesarean section. Following delivery, the prolapse promptly improved and did not recur before her 1-month postpartum examination. To our knowledge, this is the first case where uterine prolapse occurred in a nulliparous woman during late gestation.

  17. Gastrointestinal Bleeding in Athletes.

    Science.gov (United States)

    Eichner, Edward R.

    1989-01-01

    Describes the scope and importance of gastrointestinal bleeding in runners and other athletes, discussing causes, sites, and implications of exercise-related bleeding. Practical tips to mitigate the problem, potentially more troublesome in women because of lower iron stores, are presented (e.g., gradual conditioning and avoidance of prerace…

  18. Surgical bleeding in microgravity

    Science.gov (United States)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  19. Bleeding gums: Duloxetine may be the cause

    Directory of Open Access Journals (Sweden)

    Balhara YPS

    2007-01-01

    Full Text Available Duloxetine is a newly introduced drug. It is being prescribed for the management of diabetic neuropathic pain and major depressive disorder. The most frequently observed adverse events with duloxetine are nausea, dry mouth and somnolence, constipation, diarrhea, decreased appetite, weight loss, feeling of fatigue, dizziness, somnolence, hypohidrosis, decreased libido and erectile dysfunction. One of the patients being prescribed the drug developed bleeding gums on being started with the drug which resolved on stopping it. We hereby report this case.

  20. CT-Monitored Percutaneous Cryoablation of Uterine Fibroids after Uterine Artery Embolization

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To investigate the effects of percutaneous cryoablation on uterine fibroids using computed tomographic (CT) guidance after uterine artery embolization.METHODS Twelve patients who failed to respond to uterine artery embolization were treated using percutaneous cryoablation. All patients had undergone previous uterine artery embolization an average of 1.2 years (0.7~1.6 years) ago. Two cases had abnormal bleeding, and the other 10 suffered from pressure and/or pelvic pain. Myoma diameters were 4 cm to 16.5 cm. By using CT guidance, 2.0, 2.4, 3.0 or 3.8 mm cryoprobes were placed into the fibroid, and two 15~20 min freezing processes were performed. Hemostasis was achieved only by pressing the incisions for several minutes.MR-imaging was performed before the procedure to measure the size and number of fibroid tumors, and follow- up MR-imaging determined the reduction of the lesions.RESULTS All patients were discharged within 48 h of treatment. Almost no hemorrhage was found in all of the cases. No bladder or bowel injury or significant postsurgery pain was reported. Ice spheres were readily visualized at CT. Beam-hardening artifact from the metal probes was present, but did not interfere with the procedure. Myomas regressed up to 76.3% after 12 months of treatment, and the primary symptoms improved in all treated women.CONCLUSION CT-monitored percutaneous cryoablation is an effective and minimally invasive therapy for symptom relief and fibroid shrinkage after the failure of uterine artery embolization.

  1. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women

    Directory of Open Access Journals (Sweden)

    Zimmermann Anne

    2012-03-01

    Full Text Available Abstract Background In 2009 the Uterine Bleeding and Pain Women's Research Study (UBP-WRS was conducted interviewing 21,479 women across 8 countries in order to gain patient-based prevalence data on uterine pain and bleeding indications and investigate uterine symptoms and women's treatment experiences. This article shows relevant results of the study for the indication uterine fibroids providing data on self-reported prevalence, symptomatology and management of uterine fibroids. Methods 2,500 women (USA: 4,500 women in each country (Brazil, Canada, France, Germany, Italy, South Korea, the UK, the USA completed an online survey. Women included were in their reproductive age (age group 15-49 years; USA: 18-49 years and had ever experienced menstrual bleedings. Quotas were applied for age, region, level of education and household income of respondents. Variables have been analyzed descriptively and exploratory statistical tests have been performed. Results The self-reported prevalence of uterine fibroids ranged from 4.5% (UK to 9.8% (Italy, reaching 9.4% (UK to 17.8% (Italy in the age group of 40-49 years. Women with a diagnosis of uterine fibroids reported significantly more often about bleeding symptoms than women without a diagnosis: heavy bleedings (59.8% vs. 37.4%, prolonged bleedings (37.3% vs. 15.6%, bleeding between periods (33.3% vs. 13.5%, frequent periods (28.4% vs. 15.2%, irregular and predictable periods (36.3% vs. 23.9%. Furthermore women with diagnosed uterine fibroids reported significantly more often about the following pain symptoms: pressure on the bladder (32.6% vs. 15.0%, chronic pelvic pain (14.5% vs. 2.9%, painful sexual intercourse (23.5% vs. 9.1% and pain occurring mid-cycle, after and during menstrual bleeding (31.3%, 16.7%, 59.7%, vs. 17.1%, 6.4%, 52.0%. 53.7% of women reported that their symptoms had a negative impact on their life in the last 12 month, influencing their sexual life (42.9%, performance at work (27

  2. Upper GI Bleeding in Children

    Science.gov (United States)

    Upper GI Bleeding in Children What is upper GI Bleeding? Irritation and ulcers of the lining of the esophagus, stomach or duodenum can result in upper GI bleeding. When this occurs the child may vomit ...

  3. Upper GI Bleeding in Children

    Science.gov (United States)

    Upper GI Bleeding in Children What is upper GI Bleeding? Irritation and ulcers of the lining of the esophagus, stomach or duodenum can result in upper GI bleeding. When this occurs the child may vomit blood ...

  4. Comparação entre os achados ultra-sonográficos, histeroscópicos e histopatológicos no sangramento uterino da pós-menopausa Comparison of ultrasonographic, hysteroscopic and histopathologic findings in women with postmenopausal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Adriana Scavuzzi

    2003-05-01

    os pontos de corte de 4 mm e 5 mm, respectivamente. Nenhum caso de lesão pré-maligna ou maligna foi observado quando foi adotado o ponto de corte de 4 mm. Os achados histeroscópicos e histopatológicos mais freqüentes foram o endométrio atrófico e os pólipos endometriais, observando-se boa taxa de concordância entre esses exames.PURPOSE: to determine the association between ultrasonographic, hysteroscopic and histopathologic findings in women with postmenopausal uterine bleeding. METHODS: a retrospective, cross-sectional study was conducted enrolling 156 women with postmenopausal bleeding attended at the Diagnostic Center - IMIP during the period of January 1995 to December 2001. According to the results of the endometrial examination (ultrasound, the patients were classified as having an abnormal or normal finding depending on the cutoffs of 4 or 5 mm. The most common histologic and hysteroscopic findings were studied and classified as premalignant/malignant lesions (hyperplasia/endometrial cancer or benign findings. These results were compared using the kappa index, to establish the agreement between these techniques. RESULTS: the frequency of endometrial thickening was 75.0 and 67.3% according to cutoffs of 4 mm and 5 mm, respectively. Hysteroscopic findings were atrophic endometrium in 59 (37.8%, endometrial polyp in 56 (35.9%, endometrial hyperplasia in 17 (10.9%, cancer in 16 (10.3%, still active endometrium in 1 (3,2, and other findings in 3 (1.9%. The two most frequent histopathologic findings were also atrophic endometrium (31.4% and endometrial polyps (26,.3%, followed by scanty material (16.0%, endometrial cancer (10.9%, endometrial hyperplastic changes (9.0%, and others (6.4%. A good agreement between hysteroscopic and histopathologic findings was observed (kappa = 0.61. CONCLUSIONS: the frequency of endometrial thickening was 75.0 and 67.3% according to cutoffs of 4 mm and 5 mm, respectively. No premalignant or malignant lesions were missed when

  5. Maternal outcomes after uterine balloon tamponade for postpartum hemorrhage.

    Science.gov (United States)

    Martin, Emmanuelle; Legendre, Guillaume; Bouet, Pierre-Emmanuel; Cheve, Marie-Therese; Multon, Olivier; Sentilhes, Loïc

    2015-04-01

    To evaluate maternal outcomes following uterine balloon tamponade in the management of postpartum hemorrhage. Retrospective case-series. Two French hospitals, a level 3 university referral center and a level 2 private hospital. All women who underwent balloon tamponade treatment for primary postpartum hemorrhage. Uterine tamponade was used after standard treatment of postpartum hemorrhage had failed. The study population was divided into two groups, successful cases where the bleeding stopped after the balloon tamponade, and failures requiring subsequent surgery or embolization. Success rates. Uterine tamponade was used in 49 women: 30 (61%) after vaginal delivery and 19 (39%) after cesarean section. Uterine atony was the main cause of hemorrhage (86%). The overall success rate was 65%. Of 17 failures, surgery was required in 16 cases, including hysterectomy in 11, and uterine artery embolization in one case. Demographic and obstetric characteristics did not differ significantly between the success and failure groups. No complications were directly attributed to the balloon tamponade in the postpartum period. Two women had a subsequent full-term pregnancy without recurrence of postpartum hemorrhage. Balloon tamponade is an effective, safe and readily available method for treating primary postpartum hemorrhage and could reduce the need for invasive procedures. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  6. Uterine mesenchymal tumors

    Directory of Open Access Journals (Sweden)

    Nikhil A Sangle

    2011-01-01

    Full Text Available Uterine mesenchymal tumors are a heterogeneous group of neoplasms that can frequently be diagnostically challenging. Differentiation between the benign and malignant counterparts of mesenchymal tumors is significant due to differences in clinical outcome, and the role of the surgical pathologist in making this distinction (especially in the difficult cases cannot be underestimated. Although immunohistochemical stains are supportive toward establishing a final diagnosis, the morphologic features trump all the other ancillary techniques for this group of neoplasms. This review therefore emphasizes the key morphologic features required to diagnose and distinguish uterine mesenchymal tumors from their mimics, with a brief description of the relevant immunohistochemical features.

  7. Clinical implications of disturbances of uterine vascular morphology and function.

    Science.gov (United States)

    Hickey, M; Fraser, I S

    2000-12-01

    Menstrual disturbances are one of the most common problems presenting to the gynaecologist. In order for the endometrium to bleed, vessels must break down. Disruption in the regulation of endometrial vascular growth and function has been found in association with spontaneous and sex steroid-induced disturbances of menstrual bleeding. Although circulating oestrogens and progestogens influence the endometrial vessels, this effect appears to be indirect, and regulation is primarily via local factors. Deficient vasoconstriction and haemostasis with excessive fibrinolysis is seen in menorrhagia. Breakthrough bleeding in users of progestogen-only contraceptives is associated with increased superficial vascular fragility and disruptions in the supporting basement membrane. Blood vessels in uterine fibroids are abnormal in distribution and appearance. Adenomyosis is also commonly associated with menstrual disturbance, and alterations in vascular distribution suggest altered angiogenesis. Successful human embryo implantation requires endometrial vascular breakdown. Excessive thrombosis associated with the antiphospholipid syndrome may interfere with this re-modelling and compromise implantation. Arteriovenous malformations are a rare but important cause of excessive or irregular vaginal bleeding. Abundant vessels with abnormal morphology, associated with aberrant angiogenesis can be seen, and embolization of these vessels may be an effective conservative treatment. Improved understanding of the regulation of the uterine vasculature is likely to lead to targeted therapies to prevent unscheduled vascular breakdown and to control menstrual disturbance at an endometrial level.

  8. Avoiding Winter Nose Bleeds

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    WINTER is the best season for peopleto do cold-endurance exercises. But thedry, windy weather makes the moisturein the nasal mucosa evaporate quickly,reducing the elasticity of capillaries andmaking for frequent nose-bleeds.

  9. GI bleeding - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100162.htm GI bleeding - series—Normal anatomy To use the sharing ... colon, and finally, the rectum and anus. The GI tract is a long, hollow, muscular tube through ...

  10. Lower gastrointestinal bleeding.

    Science.gov (United States)

    Feinman, Marcie; Haut, Elliott R

    2014-02-01

    This article examines causes of occult, moderate and severe lower gastrointestinal (GI) bleeding. The difference in the workup of stable vs unstable patients is stressed. Treatment options ranging from minimally invasive techniques to open surgery are explored.

  11. Heavy Menstrual Bleeding (Menorrhagia)

    Science.gov (United States)

    ... related to pregnancy, such as a miscarriage or ectopic pregnancy, can cause abnormal bleeding. A miscarriage is when ... called a fetus) dies in the uterus. An ectopic pregnancy is when a baby starts to grow outside ...

  12. Severe Bleeding: First Aid

    Science.gov (United States)

    ... remove the gauze or bandage. If the bleeding seeps through the gauze or other cloth on the ... up blood Bruising A tender or swollen stomach Cold, clammy skin Thirst Fractures Shock, indicated by a ...

  13. [Electrotherapy and uterine fibroids].

    Science.gov (United States)

    Deroover, J

    2009-01-01

    At the end of the 19th century, uterine fibroids cause huge therapeutic issues: on the one hand they can reach an impressive massive volume; on the other hand they provoke endless haemorrhages. Dr Apostoli develops galvanotherapy which becomes the reference in French and international medicine before its rapid downfall as gynaecological surgery makes great progress at the beginning of the 20th Century.

  14. Uterine Fibroids Fact Sheet

    Science.gov (United States)

    ... uterus through the vagina, instead of making a cut in the abdomen. In some cases hysterectomy can ... into the blood vessels. This blocks the blood supply to the fibroid, causing it to shrink. UFE can be an outpatient ... warning on power morcellators in treatment for uterine fibroids If your ...

  15. Hayman uterine compression stitch for arresting atonic postpartum hemorrhage: 5 years experience

    Directory of Open Access Journals (Sweden)

    Smiti Nanda

    2011-06-01

    Conclusion: Two parallel vertical compression sutures (Hayman stitch placed in the uterus controls bleeding effectively. The technique is easy, rapid and requires less skill and this simple procedure be tried first before other complex measures like uterine artery ligation are undertaken particularly for those obstetricians who lack sufficient training and skill.

  16. Dengue hemorrhagic fever as a rare cause of bleeding following percutaneous nephrolithotomy.

    Science.gov (United States)

    Kumar, Santosh; Pushkarna, Arawat; Ganesamoni, Raguram; Nanjappa, Bhuvanesh

    2012-04-01

    Post percutaneous nephrolithotomy (PNL) bleeding is an uncommon yet serious complication and is almost always related to a surgical cause. Nevertheless, medical cause of bleeding is rarely encountered as a cause of this dangerous complication. Dengue has been rarely reported as a cause of post operative bleeding. Bleeding diathesis in dengue occurs not only due to thrombocytopenia but also due to dysfunctional surviving platelets and increased fibrinolysis. We report a patient who developed bleeding after an uneventful PNL due to dengue hemorrhagic fever. Medical causes of bleeding such as locally endemic viral hemorrhagic fevers should also be kept in mind and evaluated especially when a surgical cause of the bleed is not found or suspected in bleeding after any surgery.

  17. The International Bleeding Risk Score

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Laine, L.; Dalton, H.

    2017-01-01

    The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding.......The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding....

  18. Adenosarcoma of the uterine body initially presenting as an interstitial small tumor of the uterus: a case report.

    Science.gov (United States)

    Miyata, H; Tsuji, N; Jimi, T; Butsuhara, Y; Terakawa, K; Nagano, T

    2014-01-01

    Adenosarcoma of the uterine body is a rare mixed tumor in which a benign epithelial component is mixed with a malignant stromal element. It has been considered that this tumor originates from the endometrium and its most common finding of imaging is a polypoid tumor occupying the uterine cavity. The authors herein present a case of 37-year-old female with a complaint of abnormal vaginal bleeding. At the first visit, transvaginal ultrasound and magnetic resonance imaging (MRI) showed a round mass with a diameter of one cm in the uterine wall. No malignant pathological finding was detected. The patient visited the authors again one year later, because of continuous bleeding. At that time, they found a polypoid tumor in the uterine cavity, which turned out to be adenosarcoma with sarcomatous overgrowth. The round mass in the uterus detected at first time seems to have been incipience of adenosarcoma. Prodromal sign of adenosarcoma has not been reported previously.

  19. Acquired uterine vascular malformations: radiological and clinical outcome after transcatheter embolotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Maleux, Geert; Heye, Sam; Wilms, Guy [University Hospitals Gasthuisberg, Department of Radiology, Leuven (Belgium); Timmerman, Dirk [University Hospitals Gasthuisberg, Department of Obstetrics and Gynecology, Leuven (Belgium)

    2006-02-01

    The purpose of this retrospective study is to assess the radiological and clinical outcome of transcatheter embolization of acquired uterine vascular malformations in patients presenting with secondary postpartum or postabortion vaginal hemorrhage. In a cohort of 17 patients (mean age: 29.7 years; standard deviation: 4.23; range: 25-38 years) 18 embolization procedures were performed. Angiography demonstrated a uterine parenchymal hyperemia with normal drainage into the large pelvic veins (''low-flow uterine vascular malformation'') in 83% (n=15) or a direct arteriovenous fistula (''high-flow uterine vascular malformation'') in 17% (n=3). Clinically, in all patients the bleeding stopped after embolization but in 1 patient early recurrence of hemorrhage occurred and was treated by hysterectomy. Pathological analysis revealed a choriocarcinoma. During follow-up (mean time period: 18.8 months; range: 1-36 months) 6 patients became pregnant and delivered a healthy child. Transcatheter embolization of the uterine arteries, using microparticles, is safe and highly effective in the treatment of a bleeding acquired uterine vascular malformation. In case of clinical failure, an underlying neoplastic disease should be considered. Future pregnancy is still possible after embolization. (orig.)

  20. Lipoleiomyoma: A rare variant of uterine leiomyoma

    Directory of Open Access Journals (Sweden)

    D Manimaran

    2014-01-01

    Full Text Available Uterine fatty tumors are rare variants of benign leiomyoma. Lipoleiomyoma, lipomyoma, fibromyolipoma are various synonyms for this lesion. They usually occur in the obese perimenopausal and postmenopausal females in the age group 50-70 years and 90% cases occur in patients older than 40 years. There were only few cases reported in the literature. These lesions are interesting due to the occasional diagnostic confusion with sarcomas and the curiosity regarding its histogenesis. We are presenting three cases of lipoleiomyoma whose age ranged from 40 to 50 years with clinical, radiologic and pathologic correlation. All three cases came with complaints of abnormal vaginal bleeding and found to have intramural heteroechoic nodule in the ultrasonogram.

  1. Tactile Electrosurgical Ablation: A Technique for the Treatment of Intractable Heavy and Prolonged Menstrual Bleeding

    Directory of Open Access Journals (Sweden)

    Ali M. El Saman

    2015-01-01

    Full Text Available Objective. To study the efficacy and safety of tactile electrosurgical ablation (TEA in stopping a persistent attack of abnormal uterine bleeding not responding to medical and hormonal therapy. Methods. This is a case series of 19 cases with intractable abnormal uterine bleeding, who underwent TEA at the Women’s Health Center of Assiut University. The outcomes measured were; patient’s acceptability, operative time, complications, menstrual outcomes, and reintervention. Results. None of the 19 counseled cases refused the TEA procedure which took 6–10 minutes without intraoperative complications. The procedure was successful in the immediate cessation of bleeding in 18 out of 19 cases. During the 24-month follow-up period, 9 cases developed amenorrhea, 5 had scanty menstrual bleeding, 3 were regularly menstruating, 1 case underwent repeat TEA ablation, and one underwent a hysterectomy. Conclusions. TEA represents a safe, inexpensive, and successful method for management of uterine bleeding emergencies with additional long-term beneficial effects. However, more studies with more cases and longer follow-up periods are warranted.

  2. Placenta increta as an important cause of uterine mass after first-trimester Curettage (case report

    Directory of Open Access Journals (Sweden)

    Safoura Rouholamin

    2014-01-01

    Full Text Available Placenta increta during the first trimester of pregnancy is very rare. This report describes two cases of placenta increta that caused prolonged vaginal bleeding after a first-trimester abortion. We were encountered two cases of placenta increta in October 2012 and May 2013. Case I: A 35-year-old patient with continues vaginal bleeding from 2 months after curettage due to missed abortion in the first trimester. The uterus was large, the human chorionic gonadotropin (BHCG level was 112 mUI/mL and ultrasound showed an echogenic mass in the lower segment of the uterine cavity. She was a candidate for curettage but received hysterectomy because of massive vaginal bleeding. Pathology reported placenta increta. Case II: A 32-year-old patient in the 12th week of gestation with missed abortion. After 6 weeks from curettage, she returned with continues vaginal bleeding, BHCG = 55 mUI/mL and sonography showing mixed echo lesion in the uterine cavity like hydatiform mole. Total abdominal hysterectomy was performed. Pathology reported placenta increta. In patients with a history of recent first-trimester abortion presenting with prolonged vaginal bleeding, uterine mass and low-level BHCG, a diagnosis of abnormal placentaion should be kept in mind.

  3. Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy

    DEFF Research Database (Denmark)

    Schlütter, Jacob Mørup; Johansen, Gry; Helmig, Rikke Bek;

    2016-01-01

    We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the fir...... masses, vague bladder symptoms or radiating pelvic pain. The diagnosis is readily made by color Doppler imaging. Elective Caesarean section should be the preferred mode of delivery to avoid rupture of the aneurysm during labor.......We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first...... case labor was induced at 37 + 4 weeks of gestation. However, due to sudden fetal distress and maternal abdominal pain, an emergency Caesarean section was performed during labor, and 3 liters of intra-peritoneal blood were encountered upon laparotomy, secondary to a ruptured uterine artery aneurysm...

  4. Short-course palliative radiotherapy for uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won [Dept. of Radiation Oncology, Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of); Nam, Ji Ho; Jeon, Sang Ho [Dept. of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2013-12-15

    The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

  5. [Management of abnormal bleeding in an intrauterine device user].

    Science.gov (United States)

    Desmons, F; Adam-steen, C

    1985-01-01

    Abnormal uterine bleeding is the most common complication of IUD use. Minor metrorrhagia during the insertion and the initial 2 or 3 cycles is common and has no pathological significance. The true complications are menorrhagia, or augmentation of the volume of blood, and metrorrhagia, or repeated intermenstrual bleeding. Inert IUDs increase the volume of menstrual blood loss by 100-140% and copper devices by 50-60%. Blood loss is directly related to the size and form of the IUD; copper devices cause less bleeding primarily because of their reduced surface area. Anemia secondary to menstrual problems is a serious problem in developing countries. Metrorrhagia in IUD users is often associated with pain and may lead to removal of the device. It may result from the same array of morphological and functional modifications of the endometrium as menorrhagia, but more often it signals a true complication, either utero-adnexal infection, an intra- or extrauterine pregnancy or spontaneous abortion, or an inadaptation to the uterine cavity or a displacement of the IUD, perhaps with perforation. Metrorrhagia may also result from appearance of a calcium deposit on the surface of an IUD in place for over 2 years, or it may reveal a pathology unrelated to the IUD, such as a myoma, polyp, endometrial hyperplasia, or adenomyosis. Menorrhagia is an almost inevitable consequence of IUD use, but metrorrhagia requires close surveillance. A clinical examination aided by diagnostic tests is needed to distinguish between complications requiring immediate treatment and simple intolerances that may spontaneously resolve. Sonography is indispensable, to confirm good placement of the IUD or to rule out uterine anomalies or pregnancy. Hysteroscopy can be performed with the IUD in place or not, to diagnose localized endometrial hyperplasias, polyps, poorly positioned IUDs, or partial or complete perforations. Hysterography after infection and pregnancy have been ruled out can reveal endocavity

  6. Nonvariceal Upper Gastrointestinal Bleeding.

    Science.gov (United States)

    Rahman, Syed Irfan-Ur; Saeian, Kia

    2016-04-01

    In the intensive care unit, vigilance is needed to manage nonvariceal upper gastrointestinal bleeding. A focused history and physical examination must be completed to identify inciting factors and the need for hemodynamic stabilization. Although not universally used, risk stratification tools such as the Blatchford and Rockall scores can facilitate triage and management. Urgent evaluation for nonvariceal upper gastrointestinal bleeds requires prompt respiratory assessment, and identification of hemodynamic instability with fluid resuscitation and blood transfusions if necessary. Future studies are needed to evaluate the indication, safety, and efficacy of emerging endoscopic techniques. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Influences of copper and design of intrauterine devices on endometrial bleeding in monkeys.

    Science.gov (United States)

    Shaw, S T; Forino, R V; Poon, C H; Moyer, D L

    1976-07-01

    Uterine bleeding in 8 rhesus monkeys was compared in response to plain vs. a specially fitted copper-wrapped IUD. All animals had utero-cutaneous surgical fistulas for accurate IUD insertion and removal. Daily observations for uterine bleeding between menstruations and quantitation of menstrual blood loss (MBL) were made. Following control periods of observation, each monkey was inserted with either a plain or a copper-wrapped IUD and then studied for 4 consecutive menstrual periods. Each IUD was especially fashioned to an estimate of individual uterine cavity size. Some were wrapped with pure copper wire of 30 sp mm surface area. In some animals the devices were later removed from the uterus, the copper wire taken off, and the plain polyethylene oval-Ts reinserted. In some animals originally wearing plain polyethylene devices, the IUDs were removed, wrapped with copper wire, and reinserted into the same monkeys. During the observed 4 consecutive preinsertion periods, MBL averaged 1.54 ml and was the same in the 4 cycles in which a plain polyethylene oval-T device was in place. No intermenstrual bleeding was observed, except slight spotting for the first 1 or 2 days. During the 4 cycles, with the copper-wound device present, mean MBL was 1.28 ml. Having individually fitted each uterine cavity with a best-fitting IUD was considered important. The addition of copper had not increased the bleeding. In humans, especially fitted contraceptive devices may minimize complications of bleeding and pain as compared with standard designs. Bleeding and pain have been the most frequent complications leading to removal of IUDs.

  8. Acquire uterine vascular malformation: Clinical outcome of transarterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Chae Hoon [Dept. of Radiology, Gangneung Asan Hospital, Gangneung (Korea, Republic of); Yang, Seung Boo; Goo, Dong Erk; Kim, Yong Jae; Lee, Jae Myung; Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of)

    2017-02-15

    To evaluate clinical outcomes of transarterial embolization of bilateral uterine arteries (UAE) in patients with acquired uterine vascular malformation (UVM). This retrospective study was performed on the medical records of all 19 patients who underwent transarterial embolization of bilateral UAE for the treatment of symptomatic UVMs from January 2003 to June 2011. Embolization was performed via the unilateral femoral artery approach with a catheter and angiographic techniques. Clinical success was defined as definitive resolution of abnormal vaginal bleeding. Post-procedural complications included all adverse events related to the embolization procedure. A total of 20 procedures were performed in 19 patients. One patient required repeat embolization because of incomplete embolization related to prominent high flow malformation. Clinically, in all patients, bleeding was controlled immediately after embolization. No complications occurred in all patients during the follow up period. In all patients who underwent successful UAE, menstrual cycles were normally restored within 1-2 months. Normal pregnancy with term delivery was observed in two of the 19 cases. Transarterial bilateral UAE is a safe and effective treatment in patients with vaginal bleeding caused by acquired UVM, and it allows the possibility of future pregnancy.

  9. Efficacy of Combined Laparoscopic and Hysteroscopic Repair of Post-Cesarean Section Uterine Diverticulum: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Cuilan Li

    2016-01-01

    Full Text Available Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum. Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS, and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery. Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p<0.05, respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40. Three patients (3/40 = 7.5% developed partial improvement, and 1/40 (2.5% was lost to follow-up. Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum.

  10. Bleeding during Pregnancy

    Science.gov (United States)

    ... FAQ090 “Early Pregnancy Loss”). What is an ectopic pregnancy? An ectopic pregnancy occurs when the fertilized egg does not implant ... vaginal bleeding is the only sign of an ectopic pregnancy. Other symptoms may include abdominal, pelvic, or shoulder ...

  11. Conservative management of uterine rupture in gestational trophoblastic neoplasia: a report of 2 cases.

    Science.gov (United States)

    Estrella, Jenny Lynn D C; Soriano-Estrella, Agnes L

    2009-12-01

    Cases of gestational trophoblastic neoplasia (GTN) with uterine rupture are often catastrophic owing to profuse bleeding, which could be potentially lethal. Management often entails removal of the uterus. Among patients in the reproductive age who have not completed their desired family size, such a procedure could be unacceptable. To address this, uterine resection of localized disease has been performed to preserve fertility. However, in some cases, resection would not leave much of the uterus for future fertility. Hence, primary repair of the rupture could be done. Two cases of uterine rupture in low-risk GTN conservatively managed with primary uterine rupture repair using hemostatic stitches and postoperative single-agent chemotherapy are presented. Both patients were in their early reproductive years and with a great desire to preserve future fertility. The extent of the disease was evaluated in both cases intraoperatively before considering this conservative approach. Such management proved to be effective for both cases. The 2 cases presented are the first reported successful cases in literature on which primary repair of uterine tumor rupture by oversewing with figure-of-eight stitches were done. One should then consider this as a new option in the management of patients who have GTN with uterine rupture, highly desirous of pregnancy, with large uterine tumors but relatively small areas of rupture for which simple stitches would suffice in providing adequate hemostasis.

  12. Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report

    Directory of Open Access Journals (Sweden)

    Perquin Denise

    2010-01-01

    Full Text Available Abstract Introduction Inversion of the uterus is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. A submucous myoma is mostly the cause of the non-puerperal inversion but diagnosis can be difficult. In young women, non-puerperal uterine inversion is likely associated with a malignancy. Case presentation A 19-year-old nulliparous woman presented with abnormal vaginal bleeding, dysmenorrhoea, and a large mass protruding from her cervix. The mass was interpreted as a prolapsed pedunculated submucosal myoma. After extirpation of the mass by clamping and twisting its pedicle, a laparotomy was required under suspicion of a uterine rupture. The diagnosis was confirmed and the patient's uterus could be preserved. Pathological examination revealed a submucous myoma. The uterine inversion happened when the uterus retracted to expel the submucous myoma with fundal attachment. By extirpating the stalk the fundus was also resected, causing a uterine rupture. Conclusion We report a case of non-puerperal uterine inversion associated with a benign submucous myoma. Non-puerperal uterine inversion is very uncommon in women of reproductive age and is usually caused by a malignant tumour. However, uterine-sparing surgery should be attempted in young women until the final pathology is known.

  13. Malignancies of the uterine body among Ibo women in Nigeria.

    Science.gov (United States)

    Osefo, N

    1980-12-01

    Out of the 85 malignancies of the uterus seen at the University of Nigeria Teaching Hospital, Enugu, in the past seven years, only seven were malignancies of the uterine body. Compared with reports by other authors, the incidence is low and suggests the influence of racial and geographical factors. With the exception of one patient, the majority presented in the 50-70 year age group. More than one half of the patients were of high parity; menorrhagia was a common presenting symptom. In the absence of facilities for radiotherapy, surgery alone produces a reasonably good result for the early stages of this disease. Abnormal uterine bleeding in women over 30 years of age should be fully investigated.

  14. Vaginal bleeding in late pregnancy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000627.htm Vaginal bleeding in late pregnancy To use the sharing features ... the blood from soaking your clothes. What Causes Bleeding Later in Pregnancy? When labor begins, the cervix ...

  15. Efficacy and safety of embolization in iatrogenic traumatic uterine vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Z.; Chen, J.; Shi, H.; Zhou, K.; Sun, H. [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Li, X., E-mail: pumch005@sina.com [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Pan, J.; Zhang, X.; Liu, W.; Yang, N.; Jin, Z. [Department of Radiology, Peking Union Medical College Hospital, Beijing (China)

    2012-06-15

    Aim: To retrospectively evaluate the efficacy of embolotherapy in patients with iatrogenic traumatic uterine arteriovenous malformations (AVMs). Materials and methods: A retrospective review of all patients who underwent uterine arterial embolization in Peking Union Medical College Hospital between January 2000 and December 2010 was performed. Forty-two patients were diagnosed with a uterine vascular malformation. All patients had obstetric manipulations before. Serial beta-human chorionic gonadotropin ({beta}-HCG) levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of bilateral uterine arteries. The complications, control of haemorrhage, and outcome of subsequent pregnancies were assessed. Results: A total of 49 embolization procedures were performed in 42 patients. Seven patients required repeated embolizations for recurrence of bleeding. The technical success rate of embolization was 100%. Bleeding was controlled in 35 of 42 patients (83%) after the first embolization procedures, and bleeding was controlled in another two patients who underwent repeat embolization at a median follow-up of 29 months (range 3 months to 5 years). The overall clinical success rate was 88% (37/42). Thirteen patients subsequently became pregnant and eight of 13 patients had uneventful intrauterine pregnancies carried to term. Seven patients had post-embolization syndrome and no other complication occurred. Conclusion: Percutaneous embolotherapy is a safe and effective treatment for traumatic AVMs. Future pregnancy is still possible after embolization.

  16. Uterine fibroid: a review.

    Science.gov (United States)

    Akinyemi, B O; Adewoye, B R; Fakoya, T A

    2004-01-01

    Uterine fibroid is a benign tumour of uterine smooth muscle. The purpose of this review is to bring to light the current spectra of presentation and management status of this benign and very important cause of menstrual and fertility disturbance in African women and the Black race in general. This is especially so with the trivialization of its aetological factors and treatment by claims from alternative medical practitioners. This review, therefore sought to document what is currently known about the condition and what could possibly be done to achieve better results in its management. Literature on the subject above was reviewed using manual library search, electronic books such as CD-ROMS and journals articles published by various local and international authors on the subject; it also included internet search on relevant aspects of the topic. Fibroid is the commonest benign tumour of the female genital tract, it contributes about 70 to 80% of new growths in the female genital tracts, it is a cause of significant morbidity in women of reproductive age group and when complicated could be a significant cause of mortality. Spectrum of presentation mainly involves disturbance of menstruation, reduction in fertility, pressure and obstructive symptoms and rarely malignant presentations. When recognized early effective conservative and definitive therapies are available to offer relief for women and to make their menstrual and reproductive life more meaningful. From the literature reviewed, it was obvious that the subject of uterine fibroid is still not fully exhausted and there were a lot of research questions waiting to be answered on the aetiopathogenesis of the disease. There is also the need to fashion out better treatment alternatives that will reduce morbidity in the process of managing the patient as well as those that will further enhance reproductive potentials after treatment.

  17. Platelet function in bleeding disorders

    NARCIS (Netherlands)

    van Bladel, E.R.

    2013-01-01

    The first bleeding diathesis we studied was hemophilia A. Since FVIII activity level does not always correlate with the bleeding tendency in individual patients, bleeding tendency must also be influenced by other factors. Earlier studies excluded the remaining clotting factors and FVIII genotype as

  18. Approach to the bleeding newborn

    OpenAIRE

    1998-01-01

    Bleeding in the newborn can lead to serious cardiovascular and neurological effects. Routine administration of vitamin K has reduced the incidence of hemorrhagic disease of the newborn, but abnormal bleeding can occur in babies from many causes. A practical approach to the diagnosis and treatment of bleeding in the newborn is described in this article.

  19. Localized leiomyosarcoma of the uterine cervix with rapid lung metastases

    Directory of Open Access Journals (Sweden)

    Joao Casanova

    2015-08-01

    Full Text Available Cervical sarcomas are extremely rare tumors associated with a poor prognosis. We report the case of a 63-year-old woman who was admitted to our institution due to abnormal vaginal bleeding and abdominal pain. Physical examination revealed a large cervical mass that was biopsied. Pathological features were compatible with a leiomyosarcoma of the uterine cervix. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. All histological and Immunohistochemical findings confirmed the diagnosis of leiomyosarcoma of the cervix. Adjuvant chemotherapy was started but unfortunately the disease progressed and 1 year after completion of the chemotherapy the patient developed lung metastases and eventually died.

  20. Acute upper gastrointestinal bleeding.

    Science.gov (United States)

    Kurien, Matthew; Lobo, Alan J

    2015-10-01

    Acute upper gastrointestinal bleeding (AUGIB) is a frequently encountered medical emergency with an incidence of 84-160/100000 and associated with mortality of approximately 10%. Guidelines from the National Institute for Care and Care Excellence outline key features in the management of AUGIB. Patients require prompt resuscitation and risk assessment using validated tools. Upper gastrointestinal endoscopy provides accurate diagnosis, aids in estimating prognosis and allows therapeutic intervention. Endoscopy should be undertaken immediately after resuscitation in unstable patients and within 24 hours in all other patients. Interventional radiology may be required for bleeding unresponsive to endoscopic intervention. Drug therapy depends on the cause of bleeding. Intravenous proton pump inhibitors should be used in patients with high-risk ulcers. Terlipressin and broad-spectrum antibiotics should be used following variceal haemorrhage. Hospitals admitting patients with AUGIB need to provide well organised services and ensure access to relevant services for all patients, and particularly to out of hours endoscopy. © Royal College of Physicians 2015. All rights reserved.

  1. Uterine Artery Embolization for Symptomatic Uterine Fibroids: a Prospective Study on 102 Patients in Iran

    Directory of Open Access Journals (Sweden)

    M. Shakiba

    2005-06-01

    Full Text Available Background/Objectives : To evaluate the safety, efficacy an d complication rate of uterine artery embolization in symptomatic fibroid patients in Iran. Patients and Methods: A hundred and two patients aged 20-48 years (mean age: 35.7 ±6.4 years with symptomatic fibroids entered th e study from September 2001 to November 2004. The most common presenting symptom was increased menstrual bleeding, which occurred in 74.5% of all patients. Urinary symptoms occurred in 43%, and bulk-related symptoms were seen in 63.7 % of our patients. We performed bilateral UAE (uterine artery em bolization using PVA (pol yvinyl alcohol particles (500-710 micron and assessed the patients before UAE and at regular follow- ups at 1, 3, 6 and 12-month intervals by questionnaires / interviews and ultrasound. MRI without gadolinium (Gd-DTPA injection was done before emboliz ation and at 6 and 12 months after the procedure. Results: By Friedman test, sequential follow-up (up to 12 months showed that the vaginal bleeding severity significantly decreased (p <0.0001, with menorrhagia resolving in 59.4% of patients at 1 month, and in 69% at 12 months. The mean uterus volume decreased 38.5 ±30% after 12 months .The paired t-test showed that dominant fibroid volume changed from 273.7±439.2 cm3 to 112.1±141.6 cm3 at month 6 (n=58, p=0.001 and from 246.1±314.5 cm3 to 70.1±73.5 cm3 at month 12 (n=41, p<0.0001 . The initial size of the fibroids did not affect the success rate. Conclusion: The study showed the high efficacy of UAE in controlling fibroid related symptoms, with only few complications.

  2. Rectal bleeding and its management after irradiation for cervix cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Mi Son; Kang, Seung Hee; Kil, Hoon Jong; Oh, Young Taek; Sohn, Jeong Hye; Ryu, Hee Suk; Lee, Kwang Jae [School of Medicine, Ajou University, Suwon (Korea, Republic of); Jung, Hye Young [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    2002-12-15

    Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. The study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. A total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The point A dose from the HDR brachytherapy was 28 Gy to 30 Gy (4 Gy x 7, or 5 Gy x 6). The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months (12 {approx} 86 months). The incidence of rectal bleeding was 12.7% (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was 8.5%. Most complications (92.6%) developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding: an icruCRBED greater than 100 Gy (19.7% vs. 4.2%), an EBRT dose to the parametrium over 55 Gy (22.1% vs. 5.1%) and higher stages of III and IV (31.8% vs. 10.5%). In the multivariate analysis, the icruCRBED was the only significant factor ({rho} > 0.0432). The

  3. Uterine Contraction Modeling and Simulation

    Science.gov (United States)

    Liu, Miao; Belfore, Lee A.; Shen, Yuzhong; Scerbo, Mark W.

    2010-01-01

    Building a training system for medical personnel to properly interpret fetal heart rate tracing requires developing accurate models that can relate various signal patterns to certain pathologies. In addition to modeling the fetal heart rate signal itself, the change of uterine pressure that bears strong relation to fetal heart rate and provides indications of maternal and fetal status should also be considered. In this work, we have developed a group of parametric models to simulate uterine contractions during labor and delivery. Through analysis of real patient records, we propose to model uterine contraction signals by three major components: regular contractions, impulsive noise caused by fetal movements, and low amplitude noise invoked by maternal breathing and measuring apparatus. The regular contractions are modeled by an asymmetric generalized Gaussian function and least squares estimation is used to compute the parameter values of the asymmetric generalized Gaussian function based on uterine contractions of real patients. Regular contractions are detected based on thresholding and derivative analysis of uterine contractions. Impulsive noise caused by fetal movements and low amplitude noise by maternal breathing and measuring apparatus are modeled by rational polynomial functions and Perlin noise, respectively. Experiment results show the synthesized uterine contractions can mimic the real uterine contractions realistically, demonstrating the effectiveness of the proposed algorithm.

  4. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding : a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Herman, Malou C.; van den Brink, Marian; Geomini, Peggy M.; van Meurs, Hannah S.; Huirne, Judith A.; Eising, Heleen P.; Timmermans, Anne; Pijnenborg, Johanna M. A.; Klinkert, Ellen R.; Coppus, Sjors F.; Nieboer, Theodoor E.; Catshoek, Ruby; van der Voet, Lucet F.; van Eijndhoven, Hugo W. F.; Graziosi, Giuseppe C. M.; Veersema, Sebastiaan; van Kesteren, Paul J.; Langenveld, Josje; Smeets, Nicol A. C.; van Vliet, Huib A. A. M.; van der Steeg, Jan Willem; Lisman-van Leeuwen, Yvonne; Dekker, Janny H.; Mol, Ben W.; Berger, Marjolein Y.; Bongers, Marlies Y.

    2013-01-01

    Background: Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As

  5. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding: a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Herman, M.C.; Brink, M.J. van den; Geomini, P.M.; Meurs, H.S. van; Huirne, J.A.; Eising, H.P.; Timmermans, A.; Pijnenborg, J.; Klinkert, E.R.; Coppus, S.F.P.J.; Nieboer, T.; Catshoek, R.; Voet, L.F. van der; Eijndhoven, H.W. van; Graziosi, G.; Veersema, B.S.; Kesteren, P.J.M. van; Langenveld, J.; Smeets, Nathalie; Vliet, H.A. Van; Steeg, J.W. van der; Leeuwen, Y.L.; Dekker, J.H.; Mol, B.W.; Berger, M.Y.; Bongers, M.Y.

    2013-01-01

    BACKGROUND: Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As

  6. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding : a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Herman, Malou C.; van den Brink, Marian; Geomini, Peggy M.; van Meurs, Hannah S.; Huirne, Judith A.; Eising, Heleen P.; Timmermans, Anne; Pijnenborg, Johanna M. A.; Klinkert, Ellen R.; Coppus, Sjors F.; Nieboer, Theodoor E.; Catshoek, Ruby; van der Voet, Lucet F.; van Eijndhoven, Hugo W. F.; Graziosi, Giuseppe C. M.; Veersema, Sebastiaan; van Kesteren, Paul J.; Langenveld, Josje; Smeets, Nicol A. C.; van Vliet, Huib A. A. M.; van der Steeg, Jan Willem; Lisman-van Leeuwen, Yvonne; Dekker, Janny H.; Mol, Ben W.; Berger, Marjolein Y.; Bongers, Marlies Y.

    2013-01-01

    Background: Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As

  7. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding: a multicentre randomised controlled trial

    NARCIS (Netherlands)

    Herman, M.C.; Brink, M.J. van den; Geomini, P.M.; Meurs, H.S. van; Huirne, J.A.; Eising, H.P.; Timmermans, A.; Pijnenborg, J.; Klinkert, E.R.; Coppus, S.F.P.J.; Nieboer, T.; Catshoek, R.; Voet, L.F. van der; Eijndhoven, H.W. van; Graziosi, G.; Veersema, B.S.; Kesteren, P.J.M. van; Langenveld, J.; Smeets, Nathalie; Vliet, H.A. Van; Steeg, J.W. van der; Leeuwen, Y.L.; Dekker, J.H.; Mol, B.W.; Berger, M.Y.; Bongers, M.Y.

    2013-01-01

    BACKGROUND: Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As

  8. [Submucous varicose veins of the lower uterine segment--a rare cause of pre- and postpartal hemorrhages].

    Science.gov (United States)

    Wunsch, M; Czekelius, P

    1986-01-01

    Report about one case of submucous varicosis of the lower uterine segment during pregnancy. Arrosion of these veins during labour was the reason of a severe postpartal bleeding. Recurrent haemorrhages ante partum presumably can be attributed to lesions of these veins, too.

  9. Use of Intrauterine Balloon Tamponade Test to Determine the Feasibility of Dilation and Evacuation as a Treatment for Early Uterine Artery Pseudoaneurysm

    Directory of Open Access Journals (Sweden)

    Liangcheng Wang

    2016-12-01

    Full Text Available Uterine artery embolization is the most common treatment for uterine vascular abnormalities. Herein, we report the successful use of dilation and evacuation as a treatment for uterine artery pseudoaneurysm. A 36-year-old woman complained of vaginal bleeding after an uncomplicated vaginal delivery. Ultrasonography showed a 12.8-mm anechoic area inside the uterus. Color Doppler revealed a to-and-fro sign, indicating an arteriovenous malformation. A blood test showed a low level of human chorionic gonadotropin. Therefore, a diagnosis of early uterine artery pseudoaneurysm following spontaneous delivery was suspected. Under monitoring with transabdominal color Doppler sonography, intrauterine balloon tamponade induced complete disappearance of abnormal blood flow. With bleeding determined to be under control with balloon tamponade, dilation and evacuation was performed. The patient had a favorable postoperative course.

  10. Levonorgestrel-releasing intrauterine system use in premenopausal women with symptomatic uterine leiomyoma: a systematic review.

    Science.gov (United States)

    Jiang, Wenxiao; Shen, Qi; Chen, Miaomiao; Wang, Ying; Zhou, Qingfeng; Zhu, Xuejie; Zhu, Xueqiong

    2014-08-01

    A systematic review is done to determine the efficacy and safety of levonorgestrel-releasing intrauterine systems as a treatment using in premenopausal women with symptomatic uterine leiomyoma. We searched the Medline, Central and ICTRP databases for all articles published from inception through July 2013 that examined the following outcomes: uterine volume, uterine leiomyoma volume, endometrial thickness, then menstrual blood loss, blood haemoglobin, ferritin and hematocrit levels, treatment failure rate, device expulsion rate, hysterectomy rate and side effects. From 645 studies, a total of 11 studies met our inclusion criteria with sample sizes ranging from 10 to 104. Evidence suggested that levonorgestrel-releasing intrauterine systems could decrease uterine volume and endometrial thickness, significantly reduce menstrual blood loss, and increase blood haemoglobin, ferritin and hematocrit levels. There was no evidence for decreasing uterine leiomyoma volume. There were no adverse effects on the ovarian function except for ovarian cysts. Device expulsion rates were low, which associated with leiomyoma size (larger than 3cm) but not with leiomyoma location. Irregular bleeding/spotting was observed at the beginning of the follow-up period and then decreased progressively. Results of this systematic review indicate that levonorgestrel-releasing intrauterine systems may be effective and safe treatment for symptomatic uterine leiomyoma in premenopausal women.

  11. Story: A Bleeding Watermelon

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    Nor bzang

    2010-12-01

    Full Text Available A Bleeding Watermelon was written by Norsang (Nor bzang;b. 1988, a native of Dpa ris (Rab rgyas (Huazangsi 华藏寺 Township, Tianzhu 天祝 Tibetan Autonomous County,Gansu 甘肃 Province. Norsang writes: I heard that a university student opened an elevator door in a campus building still under construction. The elevator shaft was empty and he fell to his death. Many people had questions about his death. This inspired me to write this story.

  12. Uterine Tissue Engineering and the Future of Uterus Transplantation.

    Science.gov (United States)

    Hellström, Mats; Bandstein, Sara; Brännström, Mats

    2016-12-19

    The recent successful births following live donor uterus transplantation are proof-of-concept that absolute uterine factor infertility is a treatable condition which affects several hundred thousand infertile women world-wide due to a dysfunctional uterus. This strategy also provides an alternative to gestational surrogate motherhood which is not practiced in most countries due to ethical, religious or legal reasons. The live donor surgery involved in uterus transplantation takes more than 10 h and is then followed by years of immunosuppressive medication to prevent uterine rejection. Immunosuppression is associated with significant adverse side effects, including nephrotoxicity, increased risk of serious infections, and diabetes. Thus, the development of alternative approaches to treat absolute uterine factor infertility would be desirable. This review discusses tissue engineering principles in general, but also details strategies on how to create a bioengineered uterus that could be used for transplantation, without risky donor surgery and any need for immunosuppression. We discuss scaffolds derived from decellularized organs/tissues which may be recellularized using various types of autologous somatic/stem cells, in particular for uterine tissue engineering. It further highlights the hurdles that lay ahead in developing an alternative to an allogeneic source for uterus transplantation.

  13. Target Therapies for Uterine Carcinosarcomas: Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Salvatore Giovanni Vitale

    2017-05-01

    Full Text Available Carcinosarcomas (CS in gynecology are very infrequent and represent only 2–5% of uterine cancers. Despite surgical cytoreduction and subsequent chemotherapy being the primary treatment for uterine CS, the overall five-year survival rate is 30 ± 9% and recurrence is extremely common (50–80%. Due to the poor prognosis of CS, new strategies have been developed in the last few decades, targeting known dysfunctional molecular pathways for immunotherapy. In this paper, we aimed to gather the available evidence on the latest therapies for the treatment of CS. We performed a systematic review using the terms “uterine carcinosarcoma”, “uterine Malignant Mixed Müllerian Tumors”, “target therapies”, “angiogenesis therapy”, “cancer stem cell therapy”, “prognostic biomarker”, and “novel antibody-drug”. Based on our results, the differential expression and accessibility of epithelial cell adhesion molecule-1 on metastatic/chemotherapy-resistant CS cells in comparison to normal tissues and Human Epidermal Growth Factor Receptor 2 (HER2 open up new possibilities in the field of target therapy. Nevertheless, future investigations are needed to clarify the impact of these new therapies on survival rate and medium-/long-term outcomes.

  14. Characterising and predicting bleeding in high-risk patients with an acute coronary syndrome.

    Science.gov (United States)

    Khan, Razi; Lopes, Renato D; Neely, Megan L; Stevens, Susanna R; Harrington, Robert A; Diaz, Rafael; Cools, Frank; Jansky, Petr; Montalescot, Gilles; Atar, Dan; Lopez-Sendon, Jose; Flather, Marcus; Liaw, Danny; Wallentin, Lars; Alexander, John H; Goodman, Shaun G

    2015-09-01

    In the Apixaban for Prevention of Acute Ischemic Events (APPRAISE-2) trial, the use of apixaban, when compared with placebo, in high-risk patients with a recent acute coronary syndrome (ACS) resulted in a significant increase in bleeding without a reduction in ischaemic events. The aim of this analysis was to provide further description of these bleeding events and to determine the baseline characteristics associated with bleeding in high-risk post-ACS patients. APPRAISE-2 was a multinational clinical trial including 7392 high-risk patients with a recent ACS randomised to apixaban (5 mg twice daily) or placebo. Bleeding including Thrombolysis in Myocardial Infarction (TIMI) major or minor bleeding, International Society on Thrombosis and Haemostasis (ISTH) major or clinically relevant non-major (CRNM) bleeding, and any bleeding were analysed using an on-treatment analysis. Kaplan-Meier curves were plotted to describe the timing of bleeding, and a Cox proportional hazards model was used to identify predictors of ISTH major or CRNM bleeding and any bleeding. Median follow-up was 241 days. The proportion of patients who experienced TIMI major or minor, ISTH major or CRNM, and any bleeding was 1.5%, 2.2% and 13.3%, respectively. The incidence of bleeding was highest in the immediate post-ACS period (0.11 in the first 30 days vs 0.03 after 30 days events per 1 patient-year); however, >60% of major bleeding events occurred >30 days after the end of the index hospitalisation. Gastrointestinal bleeding was the most common cause of major bleeding, accounting for 45.9% of TIMI major or minor and 39.5% of ISTH major or CRNM bleeding events. Independent predictors of ISTH major or CRNM bleeding events included older age, renal dysfunction, dual oral antiplatelet therapy, smoking history, increased white cell count and coronary revascularisation. When compared with placebo, the use of apixaban is associated with an important short-term and long-term risk of bleeding

  15. Uterine/Endometrial Cancer: Chemotherapy

    Science.gov (United States)

    ... Types of Gynecologic Cancers Uterine/Endometrial Cancer Chemotherapy Chemotherapy Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for endometrial cancer is usually given intravenously (injected ...

  16. Postpartum uterine health in cattle.

    Science.gov (United States)

    Sheldon, I M; Dobson, H

    2004-07-01

    Uterine health is often compromised in cattle because postpartum contamination of the uterine lumen by bacteria is ubiquitous, and pathogenic bacteria frequently persist causing clinical disease. The subfertility associated with uterine infection involves perturbation of the hypothalamus, pituitary and ovary, in addition to the direct effects on the uterus, and appears to persist even after clinical resolution of the disease. Absorption of bacterial components from the uterus can prevent the follicular phase LH surge and ovulation. In addition, the first postpartum dominant follicle has a slower growth rate and secretes less estradiol at the end of the growth phase. There are also localised ovarian effects of high uterine bacterial growth density, because fewer first dominant follicles are selected in the ovary ipsilateral than contralateral to the previously gravid uterine horn. Thus, it is important to diagnose and treat uterine disease promptly and effectively. Examination of the contents of the vagina for the presence of pus is the most useful method for diagnosis of endometritis. The character and odor of the vaginal mucus can be scored and this endometritis score is correlated with the growth density of pathogenic bacteria in the uterus, and is prognostic for the likely success of treatment. The challenge for the future is to design prevention and control programs to reduce the incidence of disease, and understand how the immune and endocrine systems are integrated.

  17. New procedures for uterine prolapse.

    Science.gov (United States)

    Khunda, Azar; Vashisht, Arvind; Cutner, Alfred

    2013-06-01

    Traditionally, vaginal hysterectomy and Manchester repair were the surgical approaches to treating uterine prolapse; however, both are associated with a relatively high subsequent vaginal vault recurrence. Laparoscopic uterine suspension is a new way of maintaining uterine support. Many women are keen to keep their uterus for a variety of reasons, including maintaining reproductive capability and the belief that the uterus, cervix, or both, may play a part of their gender identity. Non-removal of the uterus may retain functional (e.g. bowel, bladder and sexual) benefits. Therefore, the concept of uterine preservation for pelvic-organ prolapse has been of interest to pelvic-floor surgeons for many decades. In this review, we provide an overview of the available evidence on treating uterine prolapse surgically. We describe techniques to support the vault during hysterectomy, and examine the evidence for uterine-sparing surgery. Comparative outcomes for vaginal, abdominal and laparoscopic routes will be made. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Uterine artery embolization: The interventional treatment of female genital diseases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Yang, Seung Boo [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Goo, Dong Erk; Kim, Yong Jae [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of); Lee, Jae Myeong [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kang, Chae Hoon [Dept. of Radiology, Gangneung Asan Hospital, Gangneung (Korea, Republic of); Ohm, Joon Young [Dept. of Radiology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon (Korea, Republic of); Kim, Young Jun [Dept. of Radiology, Presbyterian Medical Center, Jeonju (Korea, Republic of)

    2017-01-15

    The uterus is the major female sex organ and is essential for pregnancy. The organ is located in the pelvic cavity. It is usually fist-sized with its volume changing from 75 to 200 cc depending on the menstrual cycle. There are various diseases associated with the uterus, including malignancy, uterine myoma, postpartum hemorrhage, and vascular malformation. The conventional surgical treatment for these diseases is hysterectomy. However, hysterectomy has some risk, and there may be complications associated with the surgery and anesthesia. In addition, hysterectomy results in loss of fertility and loss of female characteristics, both of which may lead to emotional problems. After uterine artery embolization (UAE) was performed for post-partum bleeding in 1979 and for uterine myoma in 1995, interventional treatment of UAE replaced the existing surgical treatment of hysterectomy. UAE is performed widely as a minimally invasive treatment modality that can preserve the uterus, make pregnancy and childbirth possible and resolve emotional problems. The interventional treatment has become increasingly popular to treat various female genital diseases.

  19. Uterine Carcinosarcoma in a Patient with Didelphys Uterus

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    C. Iavazzo

    2013-01-01

    Full Text Available Background. Didelphys uterus is a noncommon finding in women. Till now, few cases with benign mesenchymal tumors in patients with didelphys uterus are described. We present a case of a patient with carcinosarcoma arising in a didelphys uterus. Case. A 73-year-old patient presented with profuse watery postmenopausal bleeding. On examination under anesthesia, left and right cervixes were identified. Tumor extended from the left cervix into the lower third of the vagina and was adherent to the right vaginal sidewall. There was no evidence of parametrial extension. Tissue was sent for biopsy which revealed high-grade uterine carcinosarcoma. Two uterine fundi and two vaginas in keeping with uterine didelphys were identified on imaging. The patient underwent vaginal excision of the protruding tumor measuring  cm with harmonic scalpel followed by total abdominal hysterectomy and bilateral salpingooophorectomy. Although a number of pelvic and paraaortic lymph nodes were also identified on imaging, she was not planned for lymphadenectomy after MDT (multidisciplinary team discussion because of her comorbidities. The final histology confirmed the diagnosis. Conclusion. According to our knowledge, this is the second case of carcinosarcoma arising in didelphys uterus in the world literature.

  20. Contemporary management of uterine fibroids: focus on emerging medical treatments.

    Science.gov (United States)

    Singh, Sukhbir Sony; Belland, Liane

    2015-01-01

    This review provides an overview of therapeutic options, with a specific focus on the emerging role of medical options for UF management. PubMed, Google Scholar, and Cochrane Systematic Reviews were searched for articles published between 1980 and 2013. Relevant articles were identified using the following terms: 'uterine fibroids', 'leiomyoma', 'heavy menstrual bleeding', and 'menorrhagia'. The reference lists of articles identified were also searched for other relevant publications. Because of the largely benign nature of UFs, the most conservative options that minimize morbidity/risk and optimize outcomes should be considered. Watchful waiting, or no immediate intervention combined with regular follow-up, is an appropriate option for the majority of UF patients who experience no symptoms. For women with symptomatic UFs, the optimal treatment should restore quality of life through rapid relief of UF signs and symptoms, reduce tumor size for a sustained period, and maintain or improve fertility. Invasive surgical treatments, such as hysterectomy, have historically been the mainstay of UF treatment. Less invasive surgical and interventional techniques, such as myomectomy, uterine artery embolization, endometrial ablation, and myolysis provide alternatives to hysterectomy. Until recently, medical management of UFs was characterized by short-term treatments and therapies that provided symptomatic control. In addition to controlling abnormal uterine bleeding, newer medical therapies, including the recently Health-Canada-approved ulipristal acetate, act directly to shrink the tumor. Although no agent is currently approved for such use, emerging evidence suggests the potential for long-term medical management of UFs. The advent of novel medical therapies may diminish the long-held reliance on more invasive surgical UF treatment options.

  1. Coexisting Malignant Melanoma and Blue Nevus of the Uterine Cervix: An Unusual Combination

    Directory of Open Access Journals (Sweden)

    David Parada

    2012-01-01

    Full Text Available Malignant melanoma (MM and blue nevi of the uterine cervix are an extremely rare neoplasm, probably derived from embryologic migration of melanocytes from the neural crest. MM displays aggressive behavior with a poor prognosis. We report the case of a 76-year-old postmenopausal woman abnormal vaginal bleeding. She underwent a hysterectomy and bilateral salpingo-oophorectomy with paraaortic-iliac lymphadenectomy. Histopathological and immunohistochemical studies were consistent with the diagnosis of MM and blue nevi in the uterine cervix. Although it is extremely rare, this case suggests that MM of the uterine cervix should be considered in the differential diagnosis of undifferentiated neoplasm. Early diagnosis is essential in order to warrant a better prognosis, although there are no cases of cure described.

  2. Spontaneous Uterine Rupture in a Twine Pregnancy at 25-26 Weeks Gestation in a Woman with Previous History of Laparoscopy Myomectomy

    Directory of Open Access Journals (Sweden)

    N. Soofizadeh

    2009-07-01

    Full Text Available Introduction: Uterine rupture in pregnancy is rare and often catastrophic with high incidence of fetal and maternal morbidity and mortality. The most common cause of uterine rupture is separation of previous cesarean hysterotomy scar. Other common predisposing factors to uterine rupture are previous traumatizing operations or manipulations such as curettage, perforation, myomectomy and excessive or inappropriate uterine stimulation with oxytocin.Case Report: In this case, spontaneous rupture of uterine at 25-26 weeks gestation (twin pregnancy in a 36 year old woman has been reported(G5P2A2L1. She was hospitalized so that preeclampsia can be rule out for her. She underwent laparoscopic removal of myoma and 3 months later IVF was done for her because of secondary infertility. During hospitalization, suddenly she had mild vaginal bleeding and decreased fetal movement. Emergency sonography reported that the two fetuses died and severe oligohydramnius and myomatosis uterine with the biggest size was 90mm.Conclusion: Try of labor was done for her but she didn't respond to induction and the patient was qualified for cesarean section. During the operation, the rupture of the uterine wall was seen in the site of the previous myomectomy and the two dead fetuses were observed in the abdomen without myoma in the uterin. The myoma that was reported by the sonologist was hematoma and omentoma. Uterine wall was repaired.

  3. Spontaneous Hemoperitoneum due to Rupture of Uterine Varicose Veins during Labor Successfully Treated by Percutaneous Embolization

    Directory of Open Access Journals (Sweden)

    Rebeca Díaz-Murillo

    2014-01-01

    Full Text Available Hemoperitoneum during pregnancy is a rare but potentially lethal clinical condition. Improvements in antenatal and intrapartum care, especially in surgical and anesthetic techniques, have reduced maternal mortality; perinatal mortality remains very high (31%. Treatment is based on the systemic correction of hypovolemia and immediate surgery via laparotomy or laparoscopy in cases in the first trimester of pregnancy for hemostatic purposes. Sometimes, hysterectomy is needed. A 35-year-old Asiatic primigravid woman at 37 weeks’ gestation with otherwise uneventful pregnancy came to the hospital referring abrupt-onset lumbar and abdominal pain. A bleeding uterine superficial varicocele of about 7 cm was found on the left uterine horn during Caesarean section. Interventional radiologic embolization of both uterine arteries was successfully performed. Posterior evolution of the patient was favorable. Percutaneous vascular embolization of the uterine arteries is an effective alternative treatment for many obstetrical and gynecological causes of bleeding. The main advantage of this technique is the low rate of serious complications and the preservation of reproductive function. To our knowledge, this is the first case of spontaneous intrapartum hemoperitoneum treated with this technique. An early diagnosis and a rapid indication of this therapeutic option are essential. Hemodynamic stability is needed to decide this conservative management.

  4. Uterine Conservation During Prolapse Repair: 9-Year Experience at a Single Institution.

    Science.gov (United States)

    Kow, Nathan; Goldman, Howard B; Ridgeway, Beri

    2016-01-01

    The primary aim is to compare safety and long-term outcomes between uterine-sparing prolapse procedures performed using 4 different surgical routes over a 9-year period. This is a retrospective cohort study of women who underwent uterine-sparing prolapse procedures performed by 10 female pelvic medicine and reconstructive surgeons between January 2003 and December 2011. Demographic information, operative characteristics, complications (intraoperative and postoperative), and prolapse recurrence were obtained by chart review. Additional information collected included subsequent uterine or cervical pathology, procedures, and pregnancies. Two hundred forty uterine-sparing prolapse procedures were performed in the 9-year period. One hundred two patients (42.5%) underwent a vaginal procedure, 95 patients (39.6%) underwent a conventional laparoscopic procedure, 28 patients (11.7%) underwent a robotic-assisted laparoscopic procedure, and 15 patients (6.3%) underwent an abdominal procedure. Median follow-up time and interquartile range for abdominal, vaginal, laparoscopic, and robotic surgical routes were 16.4 (3.9-23.9), 14 (3.3-36.4), 22.6 (2.9-64.5), and 6.1 (3-24.4) months, respectively. Prolapse recurrence rates were similar for all groups (abdominal 13.3%, vaginal 14.7%, laparoscopic 11.6%, robotic 3.6%; P = 0.39). Intraoperative, postoperative, and long-term complications rates were similar between all groups (P = 0.63, P = 0.43, P = 0.10). The rate of benign gynecologic conditions encountered after surgery was similar among all groups, with an overall rate of abnormal uterine bleeding/postmenopausal bleeding of 5.4% and overall rate of cervical dysplasia of 0.8%. Two pregnancies were reported, both undergoing cesarean delivery at term. Uterine-sparing prolapse procedures appear to have good long-term safety and a low risk of future gynecologic pathology.

  5. Incidence and clinical characteristics of unexpected uterine sarcoma after hysterectomy and myomectomy for uterine fibroids: a retrospective study of 10,248 cases

    Directory of Open Access Journals (Sweden)

    Zhao WC

    2015-10-01

    Full Text Available Wan-Cheng Zhao,1 Fang-Fang Bi,1 Da Li,2 Qing Yang11Department of Obstetrics and Gynecology, 2Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of ChinaBackground: Uterine fibroids often require a hysterectomy or myomectomy via laparotomy or laparoscopy. Morcellation is often necessary to perform a laparoscopic surgery. The objective of this study is to determine the incidence of unexpected uterine sarcomas (UUSs after hysterectomy and myomectomy for uterine fibroids and to reduce the occurrence and avoid the morcellation of UUSs by analyzing their characteristics.Methods: Women who had a hysterectomy or myomectomy for uterine fibroids in Shengjing Hospital of China Medical University between November 2008 and November 2014 were selected for the study, and their clinical characteristics were analyzed.Results: During the period, 48 UUSs were found in 10,248 cases, and the overall incidence was 0.47%. There was no statistical difference (P=0.449 regarding the incidence (0.50% vs 0.33% between 42 UUSs in 8,456 cases undergoing laparotomy and six UUSs in 1,792 cases undergoing laparoscopy. Most of the UUSs were stage I (89.58%, which occurred more commonly (56.25% in women aged 40–49. Abnormal uterine bleeding (39.58% was the main clinical manifestation. Rapidly growing pelvic masses (12.5%, rich blood flow signals (18.75%, and degeneration of uterine fibroids (18.75% prompted by ultrasonography may suggest the possibility of UUSs. The margins of most UUSs (93.75% were regular, which may cause UUSs to be misdiagnosed as uterine fibroids. Fifteen cases underwent magnetic resonance imaging examinations. Approximately 73.33% showed heterogeneous and hypointense signal intensity on T1-weighted images, and 80% showed intermediate-to-high signal intensity on T2-weighted images, with necrosis and hemorrhage in 40% of cases. After contrast administration, 80% presented early heterogeneous

  6. Bleeding complications in immune thrombocytopenia.

    Science.gov (United States)

    Arnold, Donald M

    2015-01-01

    Bleeding manifestations in patients with immune thrombocytopenia (ITP) range from mild skin bruises to life-threatening intracranial hemorrhage (ICH). Severe bleeding is distinctly uncommon when the platelet count is >30 × 10(9)/L and usually only occurs when the platelet count falls administrative databases, the frequency of ICH in patients with ITP is ~0.5% in children and 1.5% in adults. Estimates of severe (non-ICH) bleeding are difficult to obtain because of the lack of standardized case definitions; the lack of a universally accepted, ITP-specific bleeding assessment tool; and the omission of reporting bleeding outcomes in many clinical studies. In practice, the presence of bleeding should dictate whether or not treatment is needed because many patients, especially children, can be safely managed with observation alone. Guiding principles for the management of ITP, based on the bleeding risk are: (1) Decide when treatment is needed and when it can safely be withheld; (2) for patients with chronic ITP, use the least toxic treatment at the lowest dose; (3) emergency treatment of severe thrombocytopenia-associated bleeding requires combination therapy; and (4) early aggressive therapy may result in durable platelet count responses.

  7. What is abnormal uterine descent on translabial ultrasound?

    Science.gov (United States)

    Shek, Ka Lai; Dietz, Hans Peter

    2015-12-01

    Ultrasound is increasingly used in evaluating women with pelvic floor dysfunction, including quantification of pelvic organ prolapse (POP). The aim of this study was to define the optimal cutoff for uterine descent on translabial ultrasound (TLUS) to predict symptoms of prolapse. This was a retrospective study of patients seen for lower urinary tract symptoms and/or POP at a tertiary urogynecological center. All patients underwent a standardized interview, 4D TLUS and the International Continence Society Pelvic Organ Prolapse Quantification system (ICS POP-Q) assessment. Pelvic organ descent on US was measured relative to the posteroinferior margin of the symphysis pubis (SP) on maximum Valsalva. Receiver operator characteristic (ROC) statistics was used to determine the optimal cutoff. We assessed 538 data sets. Mean patient age was 53 years (range 18-88). Prolapse symptoms were reported by 263 (49 %). Clinically significant POP, i.e., ICS POP-Q  stage ≥2 was found in 74.5 %. This comprised a cystocele in 322, uterine prolapse in 63, enterocele in ten, and rectocele in 280 women. On TLUS, mean uterine position on Valsalva was 14.3 mm above the SP. Prolapse symptoms were strongly associated with uterine descent (20.7 mm vs 7.6 mm, P prolapse in other compartments, +15 mm was found to be the optimal cutoff for predicting symptoms of prolapse, with areas under the curve of 0.68 and 0.74, respectively. An optimal cutoff to predict prolapse symptoms due to uterine descent is a cervix descending to 15 mm above the symphysis pubis on maximum Valsalva.

  8. Performance of upper gastrointestinal bleeding risk assessment scores in variceal bleeding

    DEFF Research Database (Denmark)

    Ngu, Jing H.; Laursen, Stig Borbjerg; Chin, YK

    2017-01-01

    Performance of upper gastrointestinal bleeding risk assessment scores in variceal bleeding: a prospective international multicenter study.......Performance of upper gastrointestinal bleeding risk assessment scores in variceal bleeding: a prospective international multicenter study....

  9. Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Mizuki E-mail: mizuki@mbox.kyoto-inet.or.jpnishinomizuki@hotmail.com; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo

    2005-01-01

    Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

  10. Antiplatelet Drugs: Mechanisms and Risks of Bleeding Following Cardiac Operations

    Science.gov (United States)

    Ferraris, Victor A.; Ferraris, Suellen P.; Saha, Sibu P.

    2011-01-01

    Preoperative antiplatelet drug use is common in patients undergoing coronary artery bypass grafting (CABG). The impact of these drugs on bleeding and blood transfusion varies. We hypothesize that review of available evidence regarding drug-related bleeding risk, underlying mechanisms of platelet dysfunction, and variations in patient response to antiplatelet drugs will aid surgeons as they assess preoperative risk and attempt to limit perioperative bleeding. The purpose of this review is to (1) examine the role that antiplatelet drugs play in excessive postoperative blood transfusion, (2) identify possible mechanisms to explain patient response to antiplatelet drugs, and (3) formulate a strategy to limit excessive blood product usage in these patients. We reviewed available published evidence regarding bleeding risk in patients taking preoperative antiplatelet drugs. In addition, we summarized our previous research into mechanisms of antiplatelet drug-related platelet dysfunction. Aspirin users have a slight but significant increase in blood product usage after CABG (0.5 U of nonautologous blood per treated patient). Platelet adenosine diphosphate (ADP) receptor inhibitors are more potent antiplatelet drugs than aspirin but have a half-life similar to aspirin, around 5 to 10 days. The American Heart Association/American College of Cardiology and the Society of Thoracic Surgeons guidelines recommend discontinuation, if possible, of ADP inhibitors 5 to 7 days before operation because of excessive bleeding risk, whereas aspirin should be continued during the entire perioperative period in most patients. Individual variability in response to aspirin and other antiplatelet drugs is common with both hyper- and hyporesponsiveness seen in 5 to 25% of patients. Use of preoperative antiplatelet drugs is a risk factor for increased perioperative bleeding and blood transfusion. Point-of-care tests can identify patients at high risk for perioperative bleeding and blood

  11. Pregnancy after uterine arterial embolization

    Directory of Open Access Journals (Sweden)

    Cláudio E. Bonduki

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter. Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2, and 87.5% were successful live births (n = 14. The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54. One of the pregnancies resulted in twins. The newborn weights (n = 14 ranged from 2.260 to 3.605 kg (mean, 3.072 kg. One (7.1% was considered to have a low birth weight (2.260 kg. There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%], one case of premature rupture of the membranes (PRM (6.3%, and one case of preeclampsia (6.3%. All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  12. Pregnancy with asymptomatic uterine complete rupture after uterine artery embolization for postpartum hemorrhage

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    Hiroaki Soyama

    2017-08-01

    Conclusion: Many studies have been reported that uterine artery embolization for postpartum hemorrhage did not affect subsequent pregnancy outcomes. However, we report that this procedure contains a potential risk for asymptomatic uterine rupture in a subsequent pregnancy. Although it is difficult to diagnose uterine rupture without symptoms, the obstetrician should be aware of the possibility of uterine rupture.

  13. Enhanced myometrial autophagy in postpartum uterine involution

    Directory of Open Access Journals (Sweden)

    Keng-Fu Hsu

    2014-09-01

    Conclusion: Autophagy of myocytes may play an important role in uterine involution. These results have implications for our understanding of myometrial functional adaptations during pregnancy and the physiological role of autophagy in the uterine remodeling events in the postpartum period.

  14. Treatment Options by Stage (Uterine Sarcoma)

    Science.gov (United States)

    ... Cancer Prevention Endometrial Cancer Screening Research Uterine Sarcoma Treatment (PDQ®)–Patient Version General Information About Uterine Sarcoma ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  15. Vitamin K deficiency bleeding of the newborn

    Science.gov (United States)

    Vitamin K deficiency bleeding of the newborn (VKDB) is a bleeding disorder in babies. It most often ... A lack of vitamin K may cause severe bleeding in newborn babies. Vitamin K plays an important role in blood clotting. Babies often ...

  16. Infertility and uterine fibroids.

    Science.gov (United States)

    Zepiridis, Leonidas I; Grimbizis, Grigoris F; Tarlatzis, Basil C

    2016-07-01

    Uterine fibroids are the most common tumors in women and their prevalence is higher in patients with infertility. At present, they are classified according to their anatomical location, as no classification system includes additional parameters such as their size or number. There is a general agreement that submucosal fibroids negatively affect fertility, when compared to women without fibroids. Intramural fibroids above a certain size (>4 cm), even without cavity distortion, may also negatively influence fertility. However, the presence of subserosal myomas has little or no effect on fertility. Many possible theories have been proposed to explain how fibroids impair fertility: mechanisms involving alteration of local anatomical location, others involving functional changes of the myometrium and endometrium, and finally endocrine and paracrine molecular mechanisms. Nevertheless, any of the above mentioned mechanisms can cause reduced reproductive potential, thereby leading to impaired gamete transport, reduced ability for embryo implantation, and creation of a hostile environment. The published experience defines the best practice strategy, as not many large, well-designed, and properly powered studies are available. Myomectomy appears to have an effect in fertility improvement in certain cases. Excision of submucosal myomas seems to restore fertility with pregnancy rates after surgery similar to normal controls. Removal of intramural myomas affecting pregnancy outcome seems to be associated with higher pregnancy rates when compared to non-operated controls, although evidence is still nοt sufficient. Treatment of subserosal myomas of reasonable size is not necessary for fertility reasons. The results of endoscopic and open myomectomy are similar; thus, endoscopic treatment is the recommended approach due to its advantages in patient's postoperative course.

  17. Uterine artery embolization for hemorrhage resulting from second-trimester abortion in women with scarred uterus: report of two cases.

    Science.gov (United States)

    Shen, Yunfeng; Liao, Yumei; Feng, Guangsen; Gu, Xiaoli; Wan, Shi

    2015-01-01

    This study was conducted to investigate the effect of uterine artery embolization for the treatment of hemorrhage following second-trimester labor induction for women with scarred uterus. Two cases of second-trimester abortion were retrospectively reviewed, both of which had a history of caesarean delivery and were complicated by gestational anemia. One was at 18 weeks' gestation and presented with persistent vaginal bleeding for two months resulting in relatively large area of blood clot in uterine cavity. The other was at 25 weeks' gestation with partial hydatidiform mole and presented with intermittent vaginal bleeding. Both patients presented with continuous and heavy vaginal bleeding after oral administration of mifepristone for labor induction, with one cervix left unopened, while the other cervix 3 cm left dilatation, yet felt obstructed by pregnant tissue. Both patients were immediately treated with uterine artery embolization (UAE). Both patients presented with alleviated hemorrhage and regular uterine contraction after UAE, followed by smooth induction of labor. No hemorrhage occurred since then during the follow-up. The results suggest that UAE is safe and effective for the treatment of massive hemorrhage of second-trimester abortion in women with scarred uterus. It can reduce time period of labor induction and alleviate hemorrhage, which not only rescues patients but also avoids cesarean sections and retains fertility for the pregnant.

  18. Uterine prolapse in a primigravid woman.

    Science.gov (United States)

    Kim, Jeong Ok; Jang, Shin A; Lee, Ji Yeon; Yun, Nae Ri; Lee, Sang-Hun; Hwang, Sung Ook

    2016-05-01

    Uterine prolapse during pregnancy is an uncommon condition. It can cause preterm labor, spontaneous abortion, fetal demise, maternal urinary complication, maternal sepsis and death. We report the case of uterine prolapse in a 32-year-old healthy primigravid woman. She had no risk factors associated with uterine prolapse. She was conservatively treated, resulting in a successful vaginal delivery. This report is a very rare case of uterine prolapse in a young healthy primigravid woman, resulting in a successful vaginal delivery.

  19. First Trimester Spontaneous Uterine Rupture in a Young Woman with Uterine Anomaly

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    Esra Nur Tola

    2014-01-01

    Full Text Available Spontaneous uterine rupture is a life-threatening obstetrical emergency carrying a high risk for the mother and the fetus. Spontaneous uterine rupture in early pregnancy is very rare complication and it occurs usually in scarred uterus. Uterine anomalies are one of the reasons for spontaneous unscarred uterine rupture in early pregnancy. Obstetricians must consider this diagnosis when a pregnant patient presented with acute abdomen in early pregnancy. We present a case of spontaneous uterine rupture at 12 weeks of gestation in 24-year-old multigravida who had uterine anomaly presenting as an acute abdomen. Our preoperative diagnosis was ectopic pregnancy. Emergency laparotomy confirmed a spontaneous uterine rupture. Uterine anomaly is a risk factor for spontaneous uterine rupture in the early pregnancy. Clinical signs of uterine rupture in early pregnancy are nonspecific and must be distinguished from acute abdominal emergencies.

  20. Recurrent bleeding after perimesencephalic hemorrhage.

    Science.gov (United States)

    Kauw, Frans; Velthuis, Birgitta K; Kizilates, Ufuk; van der Schaaf, Irene C; Rinkel, Gabriel J E; Vergouwen, Mervyn D I

    2017-08-31

    Perimesencephalic hemorrhage (PMH) is a type of subarachnoid hemorrhage with excellent long-term outcomes. Only one well-documented case of in-hospital rebleeding after PMH is described in the literature, which occurred after initiating antithrombotic treatment because of myocardial ischemia. In this case report we describe a patient with PMH without antithrombotic treatment who had two episodes of recurrent bleeding on the day of ictus. In order to validate the radiological findings we conducted a case-control study. Six neuroradiologists and two neuroradiology fellows performed a blinded assessment of serial unenhanced head CT scans of eight patients with a perimesencephalic bleeding pattern (1 index patient, 6 patients with PMH, 1 patient with a perimesencephalic bleeding pattern and basilar artery aneurysm) to investigate a potential increase in amount of subarachnoid blood. A 56-year-old woman with a perimesencephalic bleeding pattern and negative CT angiography had after the onset headache two episodes with a sudden increase of the headache. Blinded assessment of serial head CTs of eight patients with a perimesencephalic bleeding pattern identified the patient who was clinically suspected to have two episodes of recurrent bleeding to have an increased amount of subarachnoid blood on two subsequent CT scans. Recurrent bleeding after PMH may also occur in patients not treated with antithrombotics. Even after early rebleeding, prognosis of PMH is excellent. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Prognosis following upper gastrointestinal bleeding.

    Directory of Open Access Journals (Sweden)

    Stephen E Roberts

    Full Text Available BACKGROUND: Upper gastrointestinal (GI bleeding is one of the most common, high risk emergency disorders in the western world. Almost nothing has been reported on longer term prognosis following upper GI bleeding. The aim of this study was to establish mortality up to three years following hospital admission with upper GI bleeding and its relationship with aetiology, co-morbidities and socio-demographic factors. METHODS: Systematic record linkage of hospital inpatient and mortality data for 14 212 people in Wales, UK, hospitalised with upper GI bleeding between 1999 and 2004 with three year follow-up to 2007. The main outcome measures were mortality rates, standardised mortality ratios (SMRs and relative survival. RESULTS: Mortality at three years was 36.7% overall, based on 5215 fatalities. It was highest for upper GI malignancy (95% died within three years and varices (52%. Compared with the general population, mortality was increased 27-fold during the first month after admission. It fell to 4.3 by month four, but remained significantly elevated during every month throughout the three years following admission. The most important independent prognostic predictors of mortality at three years were older age (mortality increased 53 fold for people aged 85 years and over compared with those under 40 years; oesophageal and gastric/duodenal malignancy (48 and 32 respectively and gastric varices aetiologies (2.8 when compared with other bleeds; non-upper GI malignancy, liver disease and renal failure co-morbidities (15, 7.9 and 3.9; social deprivation (29% increase for quintile V vs I; incident bleeds as an inpatient (31% vs admitted with bleeding and male patients (25% vs female. CONCLUSION: Our study shows a high late as well as early mortality for upper GI bleeding, with very poor longer term prognosis following bleeding due to malignancies and varices. Aetiologies with the worst prognosis were often associated with high levels of social

  2. Antepartum uterine rupture in previous caesarean sections presenting as advanced extrauterine pregnancies: lessons learnt.

    Science.gov (United States)

    Ramphal, Surandhra R; Moodley, Jagidesa

    2009-03-01

    In present day obstetric practice, rupture of a previously scarred uterus should be uncommon. It occurs in uterine pregnancy is made. We present a series of 7 cases, all of whom had one or more previous caesarean sections, were haemodynamically stable and were being managed expectantly, to illustrate the fact that ruptured uterus should be strongly considered in the differential diagnosis, even when the clinical signs and sonography are suggestive of an advanced extra-uterine pregnancy. The lessons in these cases fall into the following categories: 1. Ruptured uteri can occur in non-labouring women with previous lower segment caesarean sections. 2. Absence of signs of peritonism is possibly due to the fact that the pregnancy is extruded through the uterine rupture with the amniotic sac being intact and there is little or no bleeding into the abdominal cavity or vaginally. 3. Imaging techniques should focus on the size of the uterus, as an enlarged uterus in the background of an advanced extra-uterine pregnancy in a previously scarred uterus is highly suggestive of uterine rupture. Clinicians must strongly consider ruptured uteri in non labouring women with previous caesarean sections even when imaging modalities suggest an advanced extrauterine pregnancy. This will lead to earlier surgical treatment and appropriate information being provided to patients.

  3. Papillary Squamotransitional Cell Carcinoma of the Uterine Cervix: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Shomaila Aamir M. Akbar

    2016-01-01

    Full Text Available Introduction. Papillary squamotransitional cell carcinoma (PSTCC is an uncommon histopathological variant of squamous cell carcinoma (SCC of the uterine cervix, which occurs in postmenopausal women. Presentation of Case. Herein, we describe a case of a 63-year-old woman who presented with 4-month history of postmenopausal vaginal bleeding. Vaginal examination revealed a fragile lesion of size 1×1 cm invading left posterior vaginal fornice and parametrium. Biopsy showed the presence of papillae containing fibrovascular cores lined by multilayered atypical epithelial cells resembling squamous and transitional cell epithelium, confirming the diagnosis of PSTCC of the uterine cervix. After staging work-up she was staged according to the International Federation of Gynecology and Obstetrics (FIGO staging system 2009 as FIGO IIB, and she was started on extended field concurrent chemoradiation. Discussion. PSTCC of the uterine cervix is an extremely rare and aggressive entity. PSTCC is often characterized by the presence of papillary structures with prominent fibrovascular cores. PSTCC of the uterine cervix should be differentiated from transitional cell carcinoma, squamous papilloma, papillary adenocarcinoma, and cervical intraepithelial neoplasia with papillary features. Conclusion. PSTCC of the uterine cervix is a diagnostic challenge; further studies regarding the mechanism underlying the development of PSCC are warranted.

  4. Menstrual bleeding after cardiac surgery.

    Science.gov (United States)

    Hjortdal, Vibeke Elisabeth; Larsen, Signe Holm; Wilkens, Helena; Jakobsen, Anja; Pedersen, Thais Almeida Lins

    2014-01-01

    We investigated whether open-heart surgery with the use of extracorporeal circulation has an impact on menstrual bleeding. The menstrual bleeding pattern was registered in fertile women undergoing open-heart surgery in 2010-12. Haematocrit and 24-h postoperative bleeding were compared with those of men undergoing cardiac surgery. Women (n = 22), with mean age of 36 (range 17-60) years, were operated on and hospitalized for 4-5 postoperative days. The mean preoperative haematocrit was 40% (range 32-60%), and mean haematocrit at discharge was 32% (range 26-37%). Mean postoperative bleeding in the first 24 h was 312 (range 50-1442) ml. They underwent surgery for atrial septal defect (n = 5), composite graft/David procedure (n = 4), pulmonary or aortic valve replacement (n = 6), myxoma (n = 2), mitral valvuloplasty (n = 2), ascending aortic aneurysm (n = 1), aortic coarctation (n = 1) and total cavopulmonary connection (n = 1). Unplanned menstrual bleeding (lasting 2-5 days) was detected in 13 (60%) patients. Of them, 4 were 1-7 days early, 4 were 8-14 days early, 3 were 1-7 days late and 2 had menstruation despite having had menstrual bleeding within the last 2 weeks. None had unusually large or long-lasting menstrual bleeding. Ten women took oral contraceptives, 8 of whom had unexpected menstrual bleeding during admission. Men (n = 22), with a mean age of 35 (range 17-54) years, had mean bleeding of 331 (range 160-796) ml postoperatively, which was not statistically significantly different from the women's. The mean preoperative haematocrit was 40% (range 29-49%) among men, while haematocrit at discharge was 32% (28-41), not significantly different from that seen in the female subgroup. Menstrual bleeding patterns are disturbed by open-heart surgery in the majority of fertile women. Nevertheless, the unexpected menstrual bleeding is neither particularly long-lasting nor of large quantity, and the postoperative surgical bleeding is unaffected. We recommend that

  5. Acute variceal bleeding: general management

    Institute of Scientific and Technical Information of China (English)

    David Patch; Lucy Dagher

    2001-01-01

    @@ TREATMENT STRATEGIES FOR ACUTE VARICEAL BLEEDING Backgound Acute variceal bleeding has a significant mortality which ranges form 5% to 50% in patients with cirrhosis[1].Overall survival is probably improving,because of new therapeutic approaches,and improved medical care.However,mortality is still closely related to failure to control hacmorrhage or carly rebleeding,which is a distinct characteristic of portal hypertensive bleeding and occures in as many as 50% of patients in the first days to 6 weeks after admission et al[2].

  6. Timing and indication for curettage after medical abortion in early pregnant women with prior uterine incision.

    Science.gov (United States)

    Wang, Guoyun; Li, Dong; Manconi, Frank; Dong, Baihua; Zhang, Yuncun; Sun, Bingcui

    2010-01-01

    Termination of pregnancy is an important and necessary back-up method for family planning services in many countries. The combination of mifepristone and misoprostol is a widely used alternative to surgical evacuation of the uterus in early pregnancy; however, there are few reports about medical abortion in women with a prior uterine incision and few studies have described curettage occurring as part of the procedure and an indication for the intervention. Curettage in a prior uterine incision can increase operative complications. The purpose of this study was to investigate whether vaginal bleeding intervals, routine ultrasound scan and serum beta-hCG test after medical abortion could accurately identify women with uterine scars who would require curettage. Six hundred sixty-eight women with a uterine scar and at up to 49 days of gestation underwent a medical abortion with mifepristone and misoprostol. Each woman took 50 mg and 25 mg of mifepristone orally in the morning and in the evening, respectively, for 2 days and 600 mcg of misoprostol orally on the third day. Of the 668 women, 6 (0.9%) were lost to follow-up. The overall complete abortion rate was 91.7%; 55 women underwent curettage, including 2 women with heavy bleeding, 3 women with ongoing pregnancy and 34 women with incomplete abortion. The incomplete abortion rate was significantly greater in women with persistent bleeding lasting 21 days than in women with persistent bleeding lasting 14 days (pabortion rate was also greater in women whose serum beta-hCG was >or=500 IU/L than in women whose serum beta-hCG was or=500 IU/L) were 97.1% and 62.5%, respectively. Moreover, the incomplete abortion rate was greater in women with an endometrial thickness >or=15 mm than in women with an endometrial thickness or=15 mm) were 94.1% and 75%, respectively. No complication occurred. The combination of mifepristone and misoprostol was found to be a safe and effective method to terminate early pregnancy in women with a

  7. Gene expression and immunoreactivity of elastolytic enzymes in the uterosacral ligaments from women with uterine prolapse.

    Science.gov (United States)

    Liang, Ching-Chung; Huang, Hong-Yuan; Chang, Shuenn-Dhy

    2012-04-01

    Altered elastin metabolism has been documented in pelvic tissues from women with pelvic floor dysfunction. This study was conducted to quantify the expression of elastolytic enzymes in uterine cervix and uterosacral ligaments from women with uterine prolapse compared to asymptomatic normal controls. Paired tissues of uterosacral ligament and cervical tissues were obtained from 27 women with uterine prolapse and 14 normal controls. Steady state of matrix metalloproteinase 2 (MMP-2), tissue inhibitor of metalloproteinase 2 (TIMP-2), neutrophil elastase, α-1 antitrypsin immunoreactivity, and messenger RNA (mRNA) expression were analyzed by immunohistochemistry and real-time polymerase chain reaction, respectively. When compared with controls, women with uterine prolapse had a significantly greater level of MMP-2 immunoreactivity and mRNA expression, but less TIMP-2 and α-1 antitrypsin immunoreactivity and mRNA expression in their uterosacral ligaments. However, neutrophil elastase mRNA expression was similar between uterine prolapse and control tissue. Our results showed that there was a close relationship between expressions of MMP-2, TIMP-2, and α-1 antitrypsin in uterosacral ligament and the occurrence of uterine prolapse.

  8. [Sexual dysfunction following pelvic surgery].

    Science.gov (United States)

    Hojo, K

    1997-11-01

    In male, sexual dysfunction was a common complication that occurred after radical pelvic surgery: radical protectomy, radical cysto-, prostatectomy. Upon the recent pelvic neuroanatomical findings and preservation of these nerves, it is now possible to perform successful cancer operation on the rectum, prostate or bladder with preservation of sexual function in the group of early cancer patients. Depending on the location and severity of these nerve injury, this could result in temporary or permanent erectile and ejaculation dysfunction. In female, the total hysterectomy for cervical cancer sacrifices or injuries the faculty of pregnancy or sexual intercourse. The oophorectomies causes a deficiency of female hormones. But recently the numbers of patients with a small or early stages cancer of uterine or ovary are increasing and we have become to be able to save the functions of these organs in many patients well with minimum local excision or partial resection of them.

  9. [Role of imaging in cases of bleeding after spontaneous or induced abortion].

    Science.gov (United States)

    Chassang, M; Baudin, G; Delotte, J; Trastour, C; Bongain, A; Chevallier, Patrick

    2015-05-01

    Post-abortum hemorrhage is a common clinical situation and etiological diagnosis has to be made early to avoid further complications such as persistent bleeding, infection or adhesions that may compromise fertility. Retained products of conception are the most common cause of bleeding. The diagnosis is based on endovaginal color doppler ultrasound showing a thickened and hypervascular endometrial echo-complex extending partly to the myometrium. The main differential diagnosis is uterine arteriovenous malformation, mostly iatrogenic. Diagnosis is based on the presence of myometrial confluent cystic lesions filled with turbulent and high velocity arterial flow on endovaginal color doppler ultrasound. The distinction between these two etiologies of post-abortion bleeding is mandatory because of totally different treatment: typically medical and/or surgical in case of retained products of conception and by selective arterial embolization in case of vascular malformation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Placenta Increta after First-Trimester Dilatation and Curettage Manifesting as an Unusual Uterine Mass: Magnetic Resonance Findings

    Energy Technology Data Exchange (ETDEWEB)

    Ju, W.; Kim, S.C. [Dept. of Obstetrics and Gynecology, and Medical Research Inst., School of Medicine, Ewha Womens Univ., Seoul (Korea)

    2007-10-15

    Placenta increta during the first trimester of pregnancy is extremely rare. Only a few cases of placenta accreta during the latter half of pregnancy manifesting as a uterine mass have been published. This report describes a case of placenta increta that caused prolonged bleeding after a first-trimester abortion, and was identified by magnetic resonance imaging (MRI) as a heterogeneous mass in the myometrium. This is the first report of a placenta increta detected as a uterine mass after first-trimester dilatation and curettage, and its MRI findings.

  11. Side Effects: Bleeding and Bruising

    Science.gov (United States)

    Cancer treatments, such as chemotherapy and targeted therapy, can increase patients’ risk of bleeding and bruising, also called thrombocytopenia. Learn about steps to take if you are at increased risk of a low platelet count.

  12. Fibrinogen concentrate in bleeding patients

    DEFF Research Database (Denmark)

    Wikkelsø, Anne; Lunde, Jens; Johansen, Mathias

    2013-01-01

    Hypofibrinogenaemia is associated with increased morbidity and mortality, but the optimal treatment level, the use of preemptive treatment and the preferred source of fibrinogen remain disputed. Fibrinogen concentrate is increasingly used and recommended for bleeding with acquired haemostatic...

  13. Bleeding in children with cancer

    African Journals Online (AJOL)

    His tory and clinical picture ... Bleeding at presentation is most commonly caused by bone marrow infiltration, whether by ... 7 - 10 days after chemotherapy, except in the case of carboplatinum/ ... adult autologous stem cell transplant patients.

  14. Post-tonsillectomy hemorrhagic outcomes in children with bleeding disorders at a single institution.

    Science.gov (United States)

    Patel, Priyesh N; Arambula, Alexandra M; Wheeler, Allison P; Penn, Edward B

    2017-09-01

    To report on the post-tonsillectomy bleeding outcomes and factors associated with hemorrhage among children with pre- or post-operatively diagnosed bleeding disorders treated with an institutional protocol. Retrospective cohort study of patients with hematologic disorders who underwent tonsillectomy between 2003 and 2016 and were treated with perioperative desmopressin or factor replacement and/or aminocaproic acid. Postoperative outcomes were compared to controls matched for age, sex, and indication for surgery. Analysis of factors associated with hemorrhage was performed in patients with bleeding disorders using Mann-Whitney U or chi-squared tests. 45 patients with hematologic disorders met inclusion criteria. Platelet dysfunction, including von Willebrand Disease (vWD), was the most common diagnosis (77.8%). Most patients had a preoperative diagnosis of a bleeding disorder and received perioperative hematologic medications (86.7%). Compared to matched controls, patients with hematologic disorders experienced more postoperative bleeding (15.5%; 12 bleeds, 7 patients vs. 1.7%; 1 bleed, 1 patient, p = 0.05) and had longer postoperative stays (1.3 days vs. 0.4 days, p bleed were significantly more likely to have a factor deficiency (e.g. Hemophilia over vWD) and have a postoperative diagnosis (compared to preoperative diagnosis) for which they did not receive perioperative hematologic medication. Of patients with a postoperative bleed, all those diagnosed postoperatively required at least one surgical intervention to control bleeding compared to 33% of patients with a preoperative diagnosis. A history of post-surgical bleeding, male sex, age at surgery, and pharyngitis as surgical indication were not associated with higher hemorrhage rates in this group. This study suggests a clinically important magnitude of increased bleeding risk in patients with hematologic disease. This risk appears to decrease with the use of an institutional protocol consisting of

  15. Invasive mole: a rare cause of postmenopausal bleeding

    Directory of Open Access Journals (Sweden)

    Mamour Guèye

    2013-06-01

    Full Text Available Gestational trophoblastic disease (GTD describes a number of gynaecological tumours that originate in the trophoblast layer, including hydatidiform mole (complete or partial, placental site trophoblastic tumour, choriocarcinoma and invasive mole. Invasive moles are responsible of most cases of localized gestational trophoblastic neoplasia (GTN. Invasive mole is a condition where a molar pregnancy, such as a partial hydatidiform mole or complete hydatidiform mole, invades the wall of the uterus. It is an extremely rare condition. As GTN is not considered in the differential diagnosis of postmenopausal uterine malignancies, its preoperative diagnosis is challenging. We report a case of invasive hydatidiform mole in a postmenopausal woman discovered in a context of postmenopausal bleeding. She underwent hysterectomy and followed up till her beta hCG levels were within normal limits. The patient is in complete remission in the first postoperative year. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000: 451-453

  16. Patient-reported prevalence and symptomatic burden of uterine fibroids among women in the United States: findings from a cross-sectional survey analysis

    Directory of Open Access Journals (Sweden)

    Fuldeore MJ

    2017-06-01

    Full Text Available Mahesh J Fuldeore, Ahmed M Soliman Health Economics and Outcomes Research, AbbVie Inc., North Chicago, IL, US Purpose: To estimate the prevalence of women diagnosed with uterine fibroids and the associated symptom burden in the US.Patients and methods: Responses of women aged 18–54 years, who completed an online survey, were analyzed. Data were weighted based on age, education, race, geographic region, income, and propensity score to derive national estimates of the prevalence of women diagnosed with uterine fibroids and associated symptom burden. Weighted means and percentages were reported. Prevalence across age and ethnic groups was examined. Symptom burden among women with and without uterine fibroids was compared using weighted logistic regressions.Results: Of 59,411 respondents who met study inclusion criteria, 7.7% reported receiving a diagnosis of uterine fibroids. Of these, 5,670 women (1,402 in the uterine fibroid group and 4,268 in the control group were excluded from analysis because they had a hysterectomy. Among the non-hysterectomized study participants, 3,031 self-reported a diagnosis of uterine fibroids (prevalence: 5.8%, 95% confidence interval [CI]: 5.5%–6.1%; prevalence increased as women aged and was greatest in the 50–54 age group (11.4%; 95% CI: 10.4%–12.4%. In addition, prevalence was greater in black vs white women (9.8%; 95% CI: 8.7%–11.0% vs 5.4%; 95% CI: 5.1%–5.7%. A greater percentage of women with uterine fibroids (vs those without experienced severe heavy menstrual bleeding (16.7% vs 7.7%, severe constipation/bloating/diarrhea (7.7% vs 4.7%, severe passage of clots (6.7% vs 2.4%, severe spotting/bleeding between periods (1.7% vs 1.0%, and severe pelvic pressure (1.6% vs 0.6%. Among uterine fibroid patients with these typical uterine fibroid-related symptoms, 56.4%, 32.3%, 26.4%, 25.8%, and 20.4% reported heavy menstrual bleeding, passage of clots, spotting/bleeding between periods, constipation

  17. TISSUE-TYPE PLASMINOGEN-ACTIVATOR AND FIBRIN MONOMERS SYNERGISTICALLY CAUSE PLATELET DYSFUNCTION DURING RETRANSFUSION OF SHED BLOOD AFTER CARDIOPULMONARY BYPASS

    NARCIS (Netherlands)

    DEHAAN, J; SCHONBERGER, J; HAAN, J; VANOEVEREN, W; EIJGELAAR, A

    1993-01-01

    Reduced hemostasis and bleeding tendency after cardiopulmonary bypass results from platelet dysfunction induced by the bypass procedure. The causes of this acquired platelet dysfunction are still subject to discussion, although, recently, greater emphasis has been placed on an overstimulated fibrino

  18. Uterine cervical neoplasia prevention in Parque Indigena do Xingu.

    Science.gov (United States)

    Speck, N M de Góis; Pereira, E R; Schaper, M; Tso, F K; de Freitas, V G; Ribalta, J C L

    2009-01-01

    Results of preventive health measures, diagnosis and treatment applied to Parque Indigena do Xingu native women were studied. Thirty-seven cases of uterine cervical intraepithelial lesions and invasive neoplasias were treated in the local villages without referral to an advanced medical center. LEEPs were carried out in 32 women, three cold knife conizations, one vaginal hysterectomy and one Wertheim Meigs procedure. Results of 53.1% of LEEP surgical procedures did not have margin involvement by the lesions. Bleeding complications were seen in 15.6%. Regular follow-up with two or three cytologic and colposcopic tests in 32 women was carried out. All cases were negative for lesions. Five women were not followed-up due mainly to logistical reasons. Health endeavors adopted in the period 2005-2007 brought about a significant reduction of precursor lesions in this native aboriginal population without screening resources.

  19. Uterine leiomyosarcoma manifesting as a tricuspid valve mass.

    Science.gov (United States)

    Marak, Creticus P; Ponea, Ana M; Alappan, Narendrakumar; Shaheen, Shagufta; Guddati, Achuta K

    2013-01-01

    Uterine leiomyosarcoma is a rare malignancy and carries a poorer prognosis when compared to endometrial carcinoma. It has been observed to metastasize to all the major organs. It presents with symptoms of abdominal distension, vaginal bleeding and may pass unnoticed until an advanced stage in patients with leiomyomas. Surgery is a viable option in patients with disease limited to the uterus, but metastasis to the heart may require surgery to prevent acute and catastrophic complications. The case described here involves metastasis to the tricuspid valve, which caused severe tricuspid regurgitation in the setting of acute pulmonary embolism. Surgical resection restored cardiac function and stabilized the patient. This case illustrates a rare site of metastasis of leiomyosarcoma which required immediate intervention and resulted in a favorable outcome.

  20. Spontaneous Rupture of Uterine Vein in Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Emek Doger

    2013-01-01

    Full Text Available Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester. Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear. Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs.

  1. [Diagnosis of uterine vascular malformation using Doppler ultrasound].

    Science.gov (United States)

    Deckner, C; Schiesser, M; Bastert, G

    2004-04-01

    We present the case of a 56-year-old woman, who was admitted to our clinic for diagnostic laparoscopy because of a cystic uterine tumour of uncertain dignity. In the patient's history three curettages due to recurrent acyclic premenopausal vaginal bleeding were reported without specific histological findings. The preceding MRI described the structure as a myoma. During preoperative diagnostics an arteriovenous malformation was suspected by transvaginal Doppler sonography. Consequently the procedure was changed and a laparotomy performed. The sonographic findings were confirmed during surgery and by histological examination. This case points out the important role of transvaginal sonography combined with colour-flow-mapping. By confirming the diagnosis preoperatively and changing the management a low-risk procedure could be ensured.

  2. Uterine Leiomyosarcoma Manifesting as a Tricuspid Valve Mass

    Directory of Open Access Journals (Sweden)

    Creticus P. Marak

    2013-02-01

    Full Text Available Uterine leiomyosarcoma is a rare malignancy and carries a poorer prognosis when compared to endometrial carcinoma. It has been observed to metastasize to all the major organs. It presents with symptoms of abdominal distension, vaginal bleeding and may pass unnoticed until an advanced stage in patients with leiomyomas. Surgery is a viable option in patients with disease limited to the uterus, but metastasis to the heart may require surgery to prevent acute and catastrophic complications. The case described here involves metastasis to the tricuspid valve, which caused severe tricuspid regurgitation in the setting of acute pulmonary embolism. Surgical resection restored cardiac function and stabilized the patient. This case illustrates a rare site of metastasis of leiomyosarcoma which required immediate intervention and resulted in a favorable outcome.

  3. [Single-hormone prophylaxis of uterine hemorrhages in the premenopause].

    Science.gov (United States)

    Rachev, E

    1989-01-01

    Single-hormone prophylaxis with gestagen (Primolut nor) was carried out on 62 women with uterine bleedings during the premenopause of climacteric at mean age of 46.8 years. A ten-day scheme with application of 5 mg of gestagen daily from 16 to 25 day of the cycle for a period of 6 months was used. The treatment provided stable clinical characteristic of the successive pseudomenstrual cycles could continue for a considerable time practically till disappearance of pseudo-menstruation and transition of the woman in postmenopause. Primolut nor was a convenient drug also in women under continuous anticoagulant treatment. However it was effective and could not be used for treatment of accompanied climacteric symptoms.

  4. Complete uterine prolapse without uterine mucosal eversion in a queen.

    Science.gov (United States)

    Bigliardi, E; Di Ianni, F; Parmigiani, E; Cantoni, A M; Bresciani, C

    2014-04-01

    A five-year-old female cat weighing 3 kg was presented by the owner after noticing a large pink, bilobed mass protruding through the vulva during labour. The cat was in good condition, with appropriate lactation, and the newborn kittens were nursing normally. The uterus was not reverted or invaginated at examination, and there was rupture of the mesovarium, mesometrium and uterine-vaginal connection around the cervix. Manual reduction of the prolapsed uterus was not possible because of torn ligaments. A coeliotomy was performed to remove the ovaries, and the apex of the uterine horns was passed by the vaginal route. The remaining part of the mesometrium was disconnected, and the prolapsed uterus was removed. The queen and kittens were discharged from the hospital on the second day after surgery. An unusual feature of this case is that the prolapse was complete, without eversion of any part of the uterus through a vaginal tear.

  5. Uterine torsion in term pregnancy

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2007-01-01

    Full Text Available Introduction Uterine torsion has been defined as a rotation of more than 45 degrees of the uterus around its long axis that occurs at the junction between the cervix and the corpus. The extent of the rotation is usually 180 degrees, although cases with torsion from 60 to 720 degrees have been reported. Aetiopathogenesis of this condition is still unclear. Establishing clinical diagnosis of this condition is difficult, but very important for reducing maternal and fetal morbidity and mortality. Clinical symptoms are either absent or nonspecific, and the diagnosis is usually made at laparotomy. Case outlineA 31-year old patient was admitted to the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, as an emergency, seven days upon the established intrauterine fetal demise in the 40th gestation week. On uterine examination, the cervical length of 1.5 cm and dilatation of 3 cm were determined, as well as a palpable soft tissue formation, not resembling placenta praevia. Ultrasound examination confirmed fetal demise and exclusion of the presence of placenta praevia. The labor was completed by caesarean section. During surgery, uterine torsion of 180 degrees to the right was diagnosed. There was a stillborn male baby, and the cause of death was intrauterine asphyxia. A fibrosing and calcified accessory lobe 9x6x2.5 cm in size was observed on placental examination, which is a possible sign of initial gemellary pregnancy. Conclusion The clinical presentation of uterine torsion is variable and clinical examination and ultrasonographic scanning may be insufficient for diagnosis. The method of choice for establishing the diagnosis is magnetic resonance imaging. Once the diagnosis of uterine torsion in pregnancy is established, emergency laparotomy is indicated. Following caesarean delivery, it is necessary to surgically remove all the anatomical causes of torsion, and rotate the uterus back to its normal position. There are some

  6. Bleed Hole Flow Phenomena Studied

    Science.gov (United States)

    1997-01-01

    Boundary-layer bleed is an invaluable tool for controlling the airflow in supersonic aircraft engine inlets. Incoming air is decelerated to subsonic speeds prior to entering the compressor via a series of oblique shocks. The low momentum flow in the boundary layer interacts with these shocks, growing in thickness and, under some conditions, leading to flow separation. To remedy this, bleed holes are strategically located to remove mass from the boundary layer, reducing its thickness and helping to maintain uniform flow to the compressor. The bleed requirements for any inlet design are unique and must be validated by extensive wind tunnel testing to optimize performance and efficiency. To accelerate this process and reduce cost, researchers at the NASA Lewis Research Center initiated an experimental program to study the flow phenomena associated with bleed holes. Knowledge of these flow properties will be incorporated into computational fluid dynamics (CFD) models that will aid engine inlet designers in optimizing bleed configurations before any hardware is fabricated. This ongoing investigation is currently examining two hole geometries, 90 and 20 (both with 5-mm diameters), and various flow features.

  7. Rectal cancer associated with radiation colitis after treatment for cancer of uterine corpus, report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Igari, Tohru; Takizawa, Touichirou; Koike, Morio [Tokyo Medical and Dental Univ. (Japan). School of Medicine; Mori, Takeo; Funada, Nobuaki [Tokyo Metropolitan Komagome General Hospital (Japan)

    2002-07-01

    A 62-year-old woman who had received extended hysterectomy and radium-needle insertion for cancer of the uterine corpus at 32 years of age. Following that episode, rectal bleeding persisted for several years before it spontaneously cleared up. Rectal bleeding recurred 29 years later, and a small ulcer was revealed radiographically and endoscopically. The surgically resected specimen showed well differentiated adenocarcinoma penetrating the proper muscle layer. The effect of former radiotherapy remained as around the lesion intimal thickening and obstruction of small arteries. (author)

  8. Spontaneous intra-abdominal bleeding in twin pregnancy: Case report

    Directory of Open Access Journals (Sweden)

    Berisavac Milica

    2008-01-01

    Full Text Available INTRODUCTION Spontaneous rupture of utero-ovarian vessels is a rare cause of haemoperitoneum in pregnancy, leading to significant maternal and foetal morbidity and mortality. Aetiopathogenesis of this condition is still unclear. Establishing clinical diagnosis of this condition is difficult, but very important. Clinical symptoms are nonspecific, and the diagnosis is usually made at laparotomy. CASE OUTLINE We report a case of spontaneous haematoperitoneum in the third trimester of twin pregnancy. Differential diagnosis included uterine rupture and placental abruption. Due to the deteriorated condition of the patient, it was decided to perform laparotomy which established the diagnosis of ruptured venous varices on the posterior uterine wall. Delivery was performed by caesarean section. The postoperative period was uneventful. CONCLUSION The clinical presentation of spontaneous rupture of utero-ovarian blood vessels is not specific and clinical examination and ultrasonographic scanning may be insufficient for diagnosis. Once the diagnosis of spontaneous haematoperitoneum in pregnancy is established, emergency laparotomy is indicated. Following caesarean delivery, it is necessary to establish surgical haemostasis. There are some authors who suggest leaving the pregnancy intact in cases when the fetus is not viable, although one must have in mind the possibility of recurrent bleeding. The safety of this procedure requires further investigation. It is necessary to have in mind the possibility of blood vessel rupture in all cases of abdominal pain and hypotension of unknown origin during pregnancy.

  9. Thermotolerance of human myometrium: implications for minimally invasive uterine therapies

    Science.gov (United States)

    Thomas, Aaron C.; Grisez, Brian T.; McMillan, Kathleen; Chill, Nicholas; Harclerode, Tyler P.; Radabaugh, Rebecca; Jones, Ryan M.; Coad, James E.

    2013-02-01

    Endometrial ablation has gained significant clinical acceptance over the last decade as a minimally invasive treatment for abnormal uterine bleeding. To improve upon current thermal injury modeling, it is important to better characterize the myometrium's thermotolerance. The extent of myometrial thermal injury was determined across a spectrum of thermal histories/doses (time-temperature combinations). Fresh extirpated human myometrium was obtained from 13 subjects who underwent a previous scheduled benign hysterectomy. Within two hours of hysterectomy, the unfixed myometrium was treated in a stabilized saline bath with temperatures ranging from 45-70 °C and time intervals from 30- 150 seconds. The time-temperature combinations were selected to simulate treatment times under 2.5 minutes. A total of six such thermal matrices, each comprised of 45 time-temperature combinations, were prepared for evaluation. The treated myometrium was cryosectioned for nitro blue tetrazolium (NBT) staining to assess for thermal respiratory enzyme inactivation. Image analysis was subsequently used to quantitatively assess the stained myometrium's capacity to metabolize the tetrazolium at each time-temperature combination. This colorimetric data was then used as marker of cellular viability and determine survival parameters with implications for developing minimally invasive uterine therapies.

  10. Primary choriocarcinoma of uterine cervix treated by uterine artery drug pouring and embolism:one case report%子宫动脉药物灌注及栓塞治疗原发性宫颈绒癌一例

    Institute of Scientific and Technical Information of China (English)

    Yan Wang; Haiyang Jiang; Shaoguang Wang; Xuan Wang; Zhiyun Song

    2009-01-01

    Primary choriocarcinoma of the uterine cervix (PCC) is an extremely rare disease. The conventional treatment of PCC is a combination of hysterectomy and chemotherapy. We present one rare case proved by cervical biopsy. The patient was an 36-year-old Chinese woman with irregular vaginal bleeding for 60 days. A cervical tumoral mass was seen in the pel-vic examination and biopsy revealed active hyperplasia of trophoblastic cell, Because of massive vaginal haemorThage, the patient accepted uterine artery drug pouring and embolism emergently. This management had gained a satisfactory effect. Thus, Uterine artery drug pouring and embolism is one new and effective weapon for PCC, which can preserve the patient's productive abUity.

  11. Clinical Experience of Professor YOU Zhao-ling in Treatment of Gynecological Bleeding Diseases%尤昭玲教授治疗血证临证经验

    Institute of Scientific and Technical Information of China (English)

    李小丹; 曹立幸; 尤昭玲; 袁颂华

    2012-01-01

    崩漏、经间期出血是妇科临床最常见的血证.湖南中医药大学尤昭玲教授指出,出血期应以止血为首要任务,临床常用四草汤(鹿衔草、马鞭草、旱莲草、仙鹤草各15~20g),随证加减,止血理血,疗效显著.%Abnormal uterine bleeding is a common gynecological disease. Professor YOU Zhao-ling who is a famous TCM gynecologist points out that hemostasis is the most important task when bleeding. And she achieved a significant effect by taking Four Herb Decoction to stop abnormal uterine bleeding and recuperate the blood.

  12. Endoscopic management of diverticular bleeding.

    Science.gov (United States)

    Rustagi, Tarun; McCarty, Thomas R

    2014-01-01

    Diverticular hemorrhage is the most common reason for lower gastrointestinal bleeding (LGIB) with substantial cost of hospitalization and a median length of hospital stay of 3 days. Bleeding usually is self-limited in 70-80% of cases but early rebleeding is not an uncommon problem that can be reduced with proper endoscopic therapies. Colonoscopy is recommended as first-line diagnostic and therapeutic approach. In the vast majority of patients diverticular hemorrhage can be readily managed by interventional endotherapy including injection, heat cautery, clip placement, and ligation to achieve endoscopic hemostasis. This review will serve to highlight the various interventions available to endoscopists with specific emphasis on superior modalities in the endoscopic management of diverticular bleeding.

  13. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2012-01-01

    serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  14. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2012-01-01

    serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  15. Endoscopic Management of Diverticular Bleeding

    Directory of Open Access Journals (Sweden)

    Tarun Rustagi

    2014-01-01

    Full Text Available Diverticular hemorrhage is the most common reason for lower gastrointestinal bleeding (LGIB with substantial cost of hospitalization and a median length of hospital stay of 3 days. Bleeding usually is self-limited in 70–80% of cases but early rebleeding is not an uncommon problem that can be reduced with proper endoscopic therapies. Colonoscopy is recommended as first-line diagnostic and therapeutic approach. In the vast majority of patients diverticular hemorrhage can be readily managed by interventional endotherapy including injection, heat cautery, clip placement, and ligation to achieve endoscopic hemostasis. This review will serve to highlight the various interventions available to endoscopists with specific emphasis on superior modalities in the endoscopic management of diverticular bleeding.

  16. Adenocarcinoma of the uterine cervix.

    Science.gov (United States)

    Rutledge, F N; Galakatos, A E; Wharton, J T; Smith, J P

    1975-05-01

    From January 1, 1947, through December 31, 1971, 219 patients with primary adenocarcinoma of the intact uterine cervix were treated at the M.D. Anderson Hospital and Tumor Institute. Two modes of therapy were primarily used, namely, irradiationtherapy alone and irradiation therapy plus operation. The 5 year survival resultsare 83.7 per cent for patients with Stage i disease, 48.0 per cent for patients with Stage ii disease, 29.2 per cent for patients with Stage iii disease, and 0.0 per cent for patients with Stage iv disease. The group with irradiation plus operation had a better over-all survival rate. In addition, the incidence of central and pelvic recurrent disease was remarkably lower (fourfold difference). The urologic and bowel complications are discussed. This review lends support for our practice of preoperative irradiation followed by simple (constructive) hysterectomy for selected patients eith adenocarcinoma of the uterine cervix.

  17. The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse: a review.

    Science.gov (United States)

    Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar; Klarskov, Niels

    2017-01-01

    Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re-intervention rate, complications and operative outcomes. We systematically searched Embase, PubMed, the Cochrane databases, Clinicaltrials and Clinical trials register using the MeSh terms "uterine prolapse", "uterus prolapse", "vaginal prolapse" "pelvic organ prolapse", "prolapsed uterus", "Manchester procedure" and "vaginal hysterectomy". No limitations regarding language, study design or methodology were applied. In total, nine studies published from 1966 to 2014 comparing the MP to VH were included. The anatomical recurrence rate for the middle compartment was 4-7 % after VH, whereas recurrence was very rare after the MP. The re-operation rate because of symptomatic recurrence was higher after VH (9-13.1 %) compared with MP (3.3-9.5 %) and more patients needed conservative re-intervention (14-15 %) than after MP (10-11 %). After VH, postoperative bleeding and blood loss tended to be greater, bladder lesions and infections more frequent and the operating time longer. This review is in favour of the MP, which seems to be an efficient and safe treatment for uterine prolapse. We suggest that the MP might be considered a durable alternative to VH in uterine prolapse repair.

  18. [Gastrointestinal bleeding: the role of radiology].

    Science.gov (United States)

    Quiroga Gómez, S; Pérez Lafuente, M; Abu-Suboh Abadia, M; Castell Conesa, J

    2011-01-01

    Gastrointestinal bleeding represents a diagnostic challenge both in its acute presentation, which requires the point of bleeding to be located quickly, and in its chronic presentation, which requires repeated examinations to determine its etiology. Although the diagnosis and treatment of gastrointestinal bleeding is based on endoscopic examinations, radiological studies like computed tomography (CT) angiography for acute bleeding or CT enterography for chronic bleeding are becoming more and more common in clinical practice, even though they have not yet been included in the clinical guidelines for gastrointestinal bleeding. CT can replace angiography as the diagnostic test of choice in acute massive gastrointestinal bleeding, and CT can complement the endoscopic capsule and scintigraphy in chronic or recurrent bleeding suspected to originate in the small bowel. Angiography is currently used to complement endoscopy for the treatment of gastrointestinal bleeding.

  19. Management of severe perioperative bleeding

    DEFF Research Database (Denmark)

    Kozek-Langenecker, Sibylle A; Afshari, Arash; Albaladejo, Pierre

    2013-01-01

    The aims of severe perioperative bleeding management are three-fold. First, preoperative identification by anamesis and laboratory testing of those patients for whom the perioperative bleeding risk may be increased. Second, implementation of strategies for correcting preoperative anaemia......-sectional surveys were selected. At the suggestion of the ESA Guideline Committee, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was initially used to assess the level of evidence and to grade recommendations. During the process of guideline development, the official position of the ESA...

  20. Use of an Intubating Stylet as a Guide to Complete Uterine Curettage Complicated by Uterine Perforation

    OpenAIRE

    Baum, Jonathan D.; Sherlock, Douglas J.; Atkinson, Andrew L.

    2013-01-01

    Completion of uterine curettage may be challenging following uterine perforation even under sonographic and laparoscopic monitoring. This report illustrates the use of a flexible intubating stylet as a guide to place the suction curette into the uterine cavity when sonography and laparoscopy alone are not successful. Use of a malleable instrument such as an intubating stylet as a guide should be considered an option when insertion of the suction curette into the uterine cavity is complicated ...

  1. Potential Therapeutic Targets in Uterine Sarcomas

    OpenAIRE

    2015-01-01

    Uterine sarcomas are rare tumors accounting for 3,4% of all uterine cancers. Even after radical hysterectomy, most patients relapse or present with distant metastases. The very limited clinical benefit of adjuvant cytotoxic treatments is reflected by high mortality rates, emphasizing the need for new treatment strategies. This review summarizes rising potential targets in four distinct subtypes of uterine sarcomas: leiomyosarcoma, low-grade and high-grade endometrial stromal sarcoma, and undi...

  2. Erectile dysfunction.

    Science.gov (United States)

    Wylie, Kevan

    2008-01-01

    Erectile dysfunction is a common problem affecting sexual function in men. Approximately one in 10 men over the age of 40 is affected by this condition and the incidence is age related. Erectile dysfunction is a sentinel marker for several reversible conditions including peripheral and coronary vascular disease, hypertension and diabetes mellitus. Endothelial dysfunction is a common factor between the disease states. Concurrent conditions such as depression, late-onset hypogonadism, Peyronie's disease and lower urinary tract symptoms may significantly worsen erectile function, other sexual and relationship issues and penis dysmorphophobia. A focused physical examination and baseline laboratory investigations are mandatory. Management consists of initiating modifiable lifestyle changes, psychological and psychosexual/couples interventions and pharmacological and other interventions. In combination and with treatment of concurrent comorbid states, these interventions will often bring about successful resolution of symptoms and avoid the need for surgical interventions.

  3. Underreporting of complete uterine rupture and uterine dehiscence in women with previous cesarean section.

    Science.gov (United States)

    Fogelberg, Maria; Baranov, Anton; Herbst, Andreas; Vikhareva, Olga

    2017-09-01

    To determine the true incidence of complete uterine rupture and uterine dehiscence among women delivered by cesarean section after a previous cesarean section. Medical records of all women who delivered at University Hospital in Malmö, Sweden, during 2005-2009 (n = 21 420) were retrieved from the electronic patient record system (EPRS). After adjustment for inaccuracies, 716 women who had undergone repeat cesarean section were identified and their operation reports were reviewed. Descriptions of complete uterine rupture or uterine dehiscence in operation reports were compared with diagnoses registered in EPRS with International Classification of Diseases codes version 10 (ICD-10). Sensitivity and specificity of complete uterine rupture registration were calculated. There were 13 women with a registered diagnosis of uterine rupture. After reviewing medical records of women with repeat cesarean section, seven additional cases of complete uterine rupture, 33 cases of uterine dehiscence and 39 cases of extremely thin myometrium were identified. The incidence of complete uterine rupture and uterine dehiscence for women who delivered by repeat cesarean section was 2.8% and 10.1%, respectively. Diagnosis of complete uterine rupture was underreported in the EPRS by 35% and diagnosis of uterine dehiscence was missing in 100% of cases.

  4. Spontaneous Uterine Rupture during Pregnancy: Case Report and ...

    African Journals Online (AJOL)

    After ultrasound scan, uterine rupture was diagnosed and an emergency .... Uterine rupture in multiparity occurs usually during labour. We think that our patient may have had uterine scar from ... abdominal pains and signs of shock, at which.

  5. Maternal uterine vascular remodeling during pregnancy.

    Science.gov (United States)

    Osol, George; Mandala, Maurizio

    2009-02-01

    Sufficient uteroplacental blood flow is essential for normal pregnancy outcome and is accomplished by the coordinated growth and remodeling of the entire uterine circulation, as well as the creation of a new fetal vascular organ: the placenta. The process of remodeling involves a number of cellular processes, including hyperplasia and hypertrophy, rearrangement of existing elements, and changes in extracellular matrix. In this review, we provide information on uterine blood flow increases during pregnancy, the influence of placentation type on the distribution of uterine vascular resistance, consideration of the patterns, nature, and extent of maternal uterine vascular remodeling during pregnancy, and what is known about the underlying cellular mechanisms.

  6. [Chronic renal failure secondary to uterine prolapse].

    Science.gov (United States)

    Peces, R; Canora, J; Venegas, J L

    2005-01-01

    Acute and chronic renal failure secondary to bilateral severe hydroureteronephrosis is a rare sequela of uterine prolapse. We report a case of neglected complete uterine prolapse in a 72-year-old patient resulting in bilateral hydroureter, hydronephrosis, and chronic renal failure. In an attempt to diminish the ureteral obstruction a vaginal pessary was used to reduce the uterine prolapse. Finally, surgical repair of prolapse by means of a vaginal hysterectomy was performed. In conclusion, all patients presenting with complete uterine prolapse should be screened to exclude urinary tract obstruction. If present, obstructive uropathy should be relieved by the reduction or repair of the prolapse before irreversible renal damage occurs.

  7. SPONTANEOUS RUPTURE OF RIGHT UTERINE ARTERY IN A PREGNANT WOMEN : A RARE ENTITY

    Directory of Open Access Journals (Sweden)

    Anjum

    2015-06-01

    Full Text Available CASE: A 30 years old female G 4 P 2 L 2 A 1 at 34 wks o f pregnancy with complains of a cute pain abdomen more on right side and constipation, fever on & off & vomiting. After through investigations exploratory laparotomy was done which reveled spontaneous rupture right sided uterine artery with 1000ml of haemoperitoneum. Hysterectomy was performed after delivering the baby due to uncontrolled bleeding & difficult homeostasis. Because of maternal vital signs become unstable & homeostasis was difficult hysterectomy was performe d & blood transfusion administered. Although very rare , hemoperitoneum should be included in the differential diagnosis when a pregnant women experiences acute onset , severe abdominal pain , even without an episode of abdominal trauma . BACKGROUND : Spontaneous rupture of uterine artery during pregnancy is rare, presenting symptom include acute onset abdominal pain & maternal hypovolemic collapse due to hemoperitoneum. A typical case of subculture uterine artery rupture @ 34wks . of gestation occurred in a women. CONCLUSION : Spontaneous rupture of the uterine vessels during pregnancy is a rare complication & may lead to maternal & fetal morbidity & mortality. Diagnosis and treatment are based on the clinical symptoms of actuate abdominal pain & laborato ry test of hypovolemic shock signs.

  8. Does prolapse equal hysterectomy? The role of uterine conservation in women with uterovaginal prolapse.

    Science.gov (United States)

    Ridgeway, Beri M

    2015-12-01

    Hysterectomy has historically been a mainstay in the surgical treatment of uterovaginal prolapse, even in cases in which the removal of the uterus is not indicated. However, uterine-sparing procedures have a long history and are now becoming more popular. Whereas research on these operations is underway, hysteropexy for the treatment of prolapse is not as well studied as hysterectomy-based repairs. Compared with hysterectomy and prolapse repair, hysteropexy is associated with a shorter operative time, less blood loss, and a faster return to work. Other advantages include maintenance of fertility, natural timing of menopause, and patient preference. Disadvantages include the lack of long-term prolapse repair outcomes and the need to continue surveillance for gynecological cancers. Although the rate of unanticipated abnormal pathology in this population is low, women who have uterine abnormalities or postmenopausal bleeding are not good candidates for uterine-sparing procedures. The most studied approaches to hysteropexy are the vaginal sacrospinous ligament hysteropexy and the abdominal sacrohysteropexy, which have similar objective and subjective prolapse outcomes compared with hysterectomy and apical suspension. Pregnancy and delivery have been documented after vaginal and abdominal hysteropexy approaches, although very little is known about outcomes following parturition. Uterine-sparing procedures require more research but remain an acceptable option for most patients with uterovaginal prolapse after a balanced and unbiased discussion reviewing the advantages and disadvantages of this approach. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B.

    2012-01-01

    Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved by the D......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved...... serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  10. Treatment of acute variceal bleeding

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Krag, Aleksander Ahm; Møller, Søren

    2008-01-01

    The management of variceal bleeding remains a clinical challenge with a high mortality. Standardisation in supportive and new therapeutic treatments seems to have improved survival within the last 25 years. Although overall survival has improved in recent years, mortality is still closely related...

  11. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B.

    2012-01-01

    -risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  12. Gastrointestinal Bleeding Secondary to Calciphylaxis.

    Science.gov (United States)

    Gupta, Nancy; Haq, Khwaja F; Mahajan, Sugandhi; Nagpal, Prashant; Doshi, Bijal

    2015-11-17

    BACKGROUND Calciphylaxis is associated with a high mortality that approaches 80%. The diagnosis is usually made when obvious skin lesions (painful violaceous mottling of the skin) are present. However, visceral involvement is rare. We present a case of calciphylaxis leading to lower gastrointestinal (GI) bleeding and rectal ulceration of the GI mucosa. CASE REPORT A 66-year-old woman with past medical history of diabetes mellitus, hypertension, end-stage renal disease (ESRD), recently diagnosed ovarian cancer, and on hemodialysis (HD) presented with painful black necrotic eschar on both legs. The radiograph of the legs demonstrated extensive calcification of the lower extremity arteries. The hospital course was complicated with lower GI bleeding. A CT scan of the abdomen revealed severe circumferential calcification of the abdominal aorta, celiac artery, and superior and inferior mesenteric arteries and their branches. Colonoscopy revealed severe rectal necrosis. She was deemed to be a poor surgical candidate due to comorbidities and presence of extensive vascular calcifications. Recurrent episodes of profuse GI bleeding were managed conservatively with blood transfusion as needed. Following her diagnosis of calciphylaxis, supplementation with vitamin D and calcium containing phosphate binders was stopped. She was started on daily hemodialysis with low calcium dialysate bath as well as intravenous sodium thiosulphate. The clinical condition of the patient deteriorated. The patient died secondary to multiorgan failure. CONCLUSIONS Calciphylaxis leading to intestinal ischemia/perforation should be considered in the differential diagnosis in ESRD on HD presenting with abdominal pain or GI bleeding.

  13. Medroxyprogesterone in Treating Patients With Endometrioid Adenocarcinoma of the Uterine Corpus

    Science.gov (United States)

    2016-03-17

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Recurrent Uterine Corpus Carcinoma; Stage I Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage III Uterine Corpus Cancer; Stage IV Uterine Corpus Cancer

  14. UTERINE INVERSION OF ONE HORN OF BICORNUATE, UNICOLLIS UTERUS. A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rooplekha

    2014-01-01

    Full Text Available Puerperal uterine inversion is rare; inversion of one horn of bicornute unicollis uterus is even rarer. Uterine malformations can make the diagnosis difficult , challenging emergency treatment and could prove potentially life threatening too. In our case the patient after two months of delivery had continuous vaginal bleeding , speculum examination revealed a mass at vaginal vault , reddish colored , about 5 cm in size and cervical rim was felt all around it , but for the colour which was red , it was suspected to be a fibroid polyp as the ultrasound reports had shown a normal uterus. When polypectomy was attempted it was discovered that the mass was probably an inverted uterus. Consequently laparotomy was done which revealed a bicornuate uterus with inversion of one rig ht horn. The inverted horn was reposited with great difficulty but was unsuitable to sustain future pregnancy hence a hemihyterectomy had to be performed. Patient recovered well.

  15. Erectile dysfunction

    African Journals Online (AJOL)

    that increase blood flow to the penis. The blood ... The pressure of the blood in the chambers makes the ... What are the risk factors for erectile dysfunction? The most .... losing excessive weight and increasing physical activity, may improve the ...

  16. The significance of expression changes of MMP-9,TIMP-1 in endometria of women with adult dysfunctional uterine bleeding%MMP-9和TIMP-1在育龄期DUB患者子宫内膜组织中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    康燕华; 张彦芳; 任雁林; 舒丽莎; 李建平; 常丽锦

    2009-01-01

    目的 研究育龄期功能失调性子宫出血(DUB)患者子宫内膜局部基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂(TIMP-1)的表达变化.方法 采用免疫组化S-P法检测35例育龄期DUB患者(病例组)及20例正常月经健康女性排卵后期(对照组)子宫内膜MMP-9、TIMP-1的表达情况.同时用TUNEL原位标记技术精确测定子宫内膜功能层的细胞凋亡指数.结果 育龄期DUB女性以排卵型为主(30/35),其子宫内膜组织中MMP-9在出血部位的表达显著高于正常部位及对照组(P<0.05),TIMP-1在出血部位的表达显著低于正常部位及对照组(P<0.05),且出血部位细胞凋亡指数较正常部位及对照组显著增高(P<0.01),差异均有统计学意义.结论 子宫内膜局部MMP-9与TIMP-1失衡与育龄期DUB的发生有关,细胞凋亡也参与了DUB的发生.

  17. Efficacy of combination of estrogen plus progesterone for dysfunctional uterine bleeding at puberty%雌孕激素联合疗法治疗青春期功能失调性子宫出血的疗效分析

    Institute of Scientific and Technical Information of China (English)

    靳新红

    2014-01-01

    目的 探讨雌孕激素联合疗法治疗青春期功能失调性子宫出血(DUB)的疗效.方法 回顾分析2010年1月-2013年7月尉氏县中医院收治的119例青春期DUB患者的临床资料,根据治疗方案将上述患者分为观察组(64例)与对照组(55例),止血分别采用去氧孕烯炔雌醇、戊酸雌二醇.所有患者调节月经周期均采用黄体酮.结果 ①观察组出血控制时间、完全止血时间显著低于对照组,差异有统计学意义(P<0.05).②观察组调经效果显著优于对照组,差异有统计学意义(P<0.05).③两组患者不良反应发生率相比差异无统计学意义(P>0.05).结论 雌孕激素联合疗法治疗青春期DUB的疗效确切、安全性良好,值得临床推广.

  18. 功能障碍性子宫出血患者子宫内膜Ⅷ-RAg和MMP-9的表达%EXPRESSION OF Ⅷ-R AG AND MMP-9 IN THE ENDOMETRIUM OF PATIENTS WITH DYSFUNCTIONAL UTERINE BLEEDING

    Institute of Scientific and Technical Information of China (English)

    郭晓霞; 孙宁宁; 史小林

    2007-01-01

    目的 探讨Ⅷ因子相关抗原(Ⅷ-R Ag)和基质金属蛋白酶-9 (MMP-9)在功能障碍性子宫出血(DUB)患者子宫内膜的表达.方法 采用免疫组织化学方法,对正常妇女与DUB患者的子宫内膜组织中Ⅷ-R Ag和MMP-9进行标记,并应用图像分析技术对其进行定量观察与分析.结果 DUB出血区子宫内膜Ⅷ-R Ag表达显著低于其无出血区内膜和正常内膜,出血区子宫内膜MMP-9表达比其无出血部位内膜和正常内膜明显增多.结论 DUB患者内膜组织异常出血和脱落与Ⅷ-R Ag和MMP-9异常表达有关.

  19. 复方孕二烯酮与去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血的临床疗效比较%Comparing of Clinical Curative Effect between Gestodene-Compound and Gestodene-Ethinylestradiol Used to Treat Dysfunctional Uterine Bleeding in Peri-menopausal Period

    Institute of Scientific and Technical Information of China (English)

    陈梅; 黄丽丽

    2009-01-01

    目的 探讨复方孕二烯酮与去氧孕烯炔雌醇治疗围绝经期功血的临床疗效及安全性.方法 86例围绝经期功血患者随机分为两组.复方孕二烯酮(A组)43例,去氧孕烯炔雌醇(B组)43例,两组患者于流血期分别口服复方孕二烯酮片与去氧孕烯炔雌醇2次·d-1,1片·次-1,待血止后再连续服药20 d,停药.于月经来潮第5天起,再分别口服复方孕二烯酮片与去氧孕烯炔雌醇,1次·d-1,1片·次-1,连服21 d,停药.服药3个周期为1疗程.结果 两组患者均在服药72 h内阴道流血停止,继续服药,无突破性出血.在减量后的周期中,A组突破性出血2例(4.65%),B组突破性出血4例(9.30%),高于A组,但无显著性差异(P0.05).其余A组41例(95.35%),B组39例(90.70%)服药期间月经均规律.其它不良反应两者无显著性差异(P0.05).无严重不良反应发生.结论 复方孕二烯酮与去氧孕烯炔雌醇适用于各种类型的围绝经期功血治疗,疗效相似,止血效果确切,月经周期控制均良好,简便安全,耐受性好.

  20. Use of an Intubating Stylet as a Guide to Complete Uterine Curettage Complicated by Uterine Perforation

    Directory of Open Access Journals (Sweden)

    Jonathan D. Baum

    2013-01-01

    Full Text Available Completion of uterine curettage may be challenging following uterine perforation even under sonographic and laparoscopic monitoring. This report illustrates the use of a flexible intubating stylet as a guide to place the suction curette into the uterine cavity when sonography and laparoscopy alone are not successful. Use of a malleable instrument such as an intubating stylet as a guide should be considered an option when insertion of the suction curette into the uterine cavity is complicated by anatomic variation and uterine perforation.

  1. Gastrointestinal Bleeding: MedlinePlus Health Topic

    Science.gov (United States)

    ... GI Bleeding in Children (North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition) - PDF Patient Handouts Bleeding esophageal varices (Medical Encyclopedia) Also in Spanish Bloody or tarry stools (Medical Encyclopedia) Also in ...

  2. Facts about Vitamin K Deficiency Bleeding

    Science.gov (United States)

    ... this? Submit Button Information For… Media Policy Makers Facts about Vitamin K Deficiency Bleeding Recommend on Facebook ... deficiency and VKDB? Protect Your Baby from Bleeds Fact Sheet   Download and print this fact ...

  3. POSTMENOPAUSAL BLEEDING: HISTOPATHOLOGICAL SPECTRUM AND ASSOCIATION WITH AGE AND CLEAR SPAN: CASE SERIES OF 328 CASES

    Directory of Open Access Journals (Sweden)

    Ruchita

    2014-06-01

    Full Text Available : Introduction: Postmenopausal bleeding is defined as vaginal bleeding occurring after twelve months of amenorrhea in a woman of the age where the menopause can be expected. With increase in life expectancy, a larger proportion of female population will be in postmenopausal age group; hence, the incidence of postmenopausal bleeding is expected to increase. AIM: We studied the prevalence of malignancy as well as the histopathological spectrum of genital tract lesions in cases of postmenopausal bleeding. The association between age, period between cessation of menses and onset of bleeding per vaginum (clear span was also studied. RESULTS: Malignant causes were more common (58.5% than benign causes and included cervical carcinoma, malignant uterine tumors (13.1%, carcinoma vagina (4.3%, malignant ovarian tumors (5.5%, carcinoma vulva (0.9% and carcinoma fallopian tube (0.3%. Squamous cell carcinoma was the commonest among cervical malignancies. The benign causes included polyps (16.5%, endometrial hyperplasia (4.9%, adenomyosis (2.7%, atrophic endometrium (2.4%, cervicitis (2.1%, leiomyoma (1.8%, proliferative endometrium (1.5%, endometritis (1.5%, secretory endometrium (1.2%, retained IUCD (0.9% and uterovaginal prolapse (0.6%. The likelihood of malignancy increased significantly with advancing age (p-value 0.042. The clear span of cases with malignant tumors was significantly longer than the clear span of cases with benign lesions. Hence, the likelihood of malignancy increased with length of clear span (p-value 0.00809. CONCLUSION: Any postmenopausal patient with vaginal bleeding needs to be investigated thoroughly to determine the cause of the bleeding and should be considered to have abnormal histopathology until proved otherwise

  4. Uterine artery pseudoaneurysm: its occurrence after non-traumatic events, and possibility of "without embolization" strategy.

    Science.gov (United States)

    Baba, Yosuke; Takahashi, Hironori; Ohkuchi, Akihide; Suzuki, Hirotada; Kuwata, Tomoyuki; Usui, Rie; Saruyama, Miyuki; Ogoyama, Manabu; Nagayama, Shiho; Nakamura, Hiroyasu; Ugajin, Atsushi; Matsubara, Shigeki

    2016-10-01

    Uterine artery pseudoaneurysm (UAP) has been considered to occur very rarely after traumatic delivery/abortion, and is usually detected after its rupture, yielding massive bleeding. Our hypothesis is: some UAP may be undetected without massive bleeding and may spontaneously resolve, and, thus, may not require transarterial embolization (TAE). We attempted: (1) to detect both ruptured and non-ruptured UAP, thereby characterizing candidates of spontaneously resolving UAP, and (2) to confirm that UAP is not rare and not always associated with traumatic events. This was a retrospective observational study of 50 women with angiographically confirmed UAP and treated by TAE. Angiograms and medical charts were retrieved to examine the associations among symptoms, ultrasound findings, and extravasation. Gray-scale ultrasound was performed for all women after delivery or abortion as our routine practice. UAP occurred in 3-6/1000 deliveries and 40% occurred after non-traumatic deliveries/abortion. While 36% had active vaginal bleeding at admission, 64% did not. While 100% of patients with current active bleeding showed extravasation from the pseudoaneurysmal sac, patients without it showed a varied incidence of extravasation depending on the bleeding pattern/history and ultrasound findings. Interestingly, all patients with current bleeding (-), bleeding history (+), and ultrasound-discernable-intrauterine low echoic mass (-) were devoid of extravasation, suggesting that UAP may show progression to thrombosis and, thus, resolve spontaneously. UAP may not be so rare and not associated with traumatic delivery/abortion. Some UAP may resolve, and, thus, may not require TAE, at least immediately. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Impact single versus double layer uterine closure in caesarean section to uterine rupture

    Directory of Open Access Journals (Sweden)

    Budi Iman Santoso

    2016-07-01

    Full Text Available Caesarean section (CS is one of the most frequent delivery methods in the world whereas the rates of CS were varied according to developing (from 3.5 to 29.2% and developed countries (21.1%. The study aims to known the impact of single versus double layer uterine closure to uterine rupture in the history of cesarean section (CS. In this case report, the clinical question is single versus double-layer uterine closure on the previous CS, gives better outcome to reduce the risk of uterine rupture. To answer this question, we search the evidence from Pub Med and Cochrane database with the keywords: and ldquo;cesarean section" and "uterine rupture" and and ldquo;uterine closure and rdquo;. The inclusion criteria are written in English and focused comparing single and double layer uterine closure to uterine rupture in the previous CS. From the searching literature, we found 3 systematic reviews and 23 articles which were relevant to the topic. After screening the abstract and language, we got 2 systematic reviews and 4 articles. At the end, only 4 articles consisting of 1 systematic review and 3 articles were included to be appraised. Based on evidences, single layer uterine closure did not increase the risk of uterine rupture. Apart from that, shorter operative times and lower estimated blood loss became the superiority of single-layer uterine closure. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2074-2078

  6. Massive upper gastrointestinal bleed from epiphrenic diverticulum.

    Science.gov (United States)

    Garcia, Cesar J; Dias, Ajoy; Hejazi, Reza A; Burgos, Jose D; Huerta, Ana; Zuckerman, Marc J

    2011-05-01

    Epiphrenic diverticula are outpouchings of the esophagus that retain some or all layers of the esophageal wall. Symptoms such as intermittent dysphagia and vomiting may occur. The authors present a case of an elderly woman with a history of dysphagia who presented with a massive upper gastrointestinal bleed because of a bleeding epiphrenic diverticulum seen at endoscopy who responded to conservative management. Bleeding epiphrenic diverticula should be considered as a cause of upper gastrointestinal bleeding.

  7. Abdominal compartment syndrome from bleeding duodenal diverticulum

    Directory of Open Access Journals (Sweden)

    Vakhtang Tchantchaleishvili

    2012-01-01

    Full Text Available Duodenal diverticuli are acquired false diverticuli of unknown etiology. Although mostly asymptomatic, they can occasionally cause upper gastrointestinal hemorrhage, rarely with massive bleeding. In this report, we present (to the best of our knowledge the first reported case of duodenal diverticular bleeding, causing abdominal compartment syndrome. Albeit a rare event, duodenal diverticular bleeding should be included in the differential diagnosis of upper gastrointestinal bleeding. As with our case, a multidisciplinary approach to managing such patients is crucial.

  8. An unusual cause of gastrointestinal bleed

    Directory of Open Access Journals (Sweden)

    C K Adarsh

    2014-01-01

    Full Text Available Gastrointestinal (GI bleed often brings the patient to the emergency medical service with great anxiety. Known common causes of GI bleed include ulcers, varices, Mallory-Weiss among others. All causes of GI bleed should be considered however unusual during the evaluation. Aortoenteric fistula (AEF is one of the unusual causes of GI bleed, which has to be considered especially in patients with a history of abdominal surgery in general and aortic surgery in particular.

  9. Uterine prolapse in 2 dromedary camels.

    OpenAIRE

    Gutierrez, C.; Corbera, J.A.; Morales, I.; Morales, M; Navarro, R.

    2001-01-01

    Two cases of uterine prolapse in dromedary camels in a herd with concomitant cases of white muscle disease are described. Serum selenium and glutathione peroxidase in whole blood were investigated in both patients and showed statistical difference compared with a control group. Results suggest that selenium deficiency could promote uterine prolapse in dromedary camels.

  10. Uterine leiomyoma and its association with menstrual pattern and history of depo-medroxyprogesterone acetate injections

    Directory of Open Access Journals (Sweden)

    Amanati L

    2011-07-01

    Full Text Available L Amanti2, H Sadeghi-Bazargani1, H Abdollahi2, F Ehdaeivand31Statistics and Epidemiology Department, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran; 2Tabriz University of Medical Sciences, Tabriz, Iran; 3Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, IranBackground and aim: Despite the high prevalence of uterine leiomyoma, according to recent review studies there is uncertainty and a paucity of information regarding its predisposing or protective factors. The aim of this study was to assess the possible association between menstrual cycle pattern and occurrence of surgically treated myomas and also to check if depo-medroxyprogesterone acetate (DMPA injection earlier in reproductive life can affect the later occurrence of myomas needing surgical treatment.Methods: In a case–control study in Ardabil, 85 women with definite diagnosis of surgically treated uterine leiomyoma and 154 community controls were enrolled. Possible predictors of myoma including menstrual cycle and menstrual bleeding patterns were assessed. Data were analyzed using SPSS software (SPSS, IBM, Somers, NY. Odds ratios were used as the main statistic in assessing the strength of observed associations.Results: Mean age of the participants was 41.8 ± 8.5 years. Length of menstrual cycle was associated with myoma and a higher likelihood of myoma was observed among those having shorter menstrual cycles (P < 0.05. Number of menstrual bleeding days was also associated with surgically treated myoma and longer bleeding periods increased the likelihood of myoma (P < 0.05. Only one of the eight women who had a history of depo-medroxyprogesterone acetate injections had developed surgically treated uterine leiomyoma and the others belonged to the control group without a history of surgical treatment for uterine leiomyoma.Conclusion: Menstrual cycle pattern is associated with developing leiomyomas requiring surgical treatment

  11. Polyarteritis nodosa with uterine involvement

    Directory of Open Access Journals (Sweden)

    Chihiro Hirai

    2012-12-01

    Full Text Available Polyarteritis nodosa (PAN is characterized by multisystem necrotizing vasculitis, primarily affecting small-to-medium-sized muscular arteries, and it is typically found in middle-aged men. PAN is rarely found in the female genital tract (including the uterus, and imaging of the uterus with PAN has not previously been reported. Reported is a case of a 78-year-old patient with uterus enlargement who was diagnosed with PAN through clinical findings and images. Computed tomography and magnetic resonance imaging findings of a uterus affected by PAN are presented and reviewed, and potential characteristic findings of the uterine with PAN are discussed.

  12. Obscure gastrointestinal bleeding: preoperative CT-guided percutaneous needle localization of the bleeding small bowel segment.

    Science.gov (United States)

    Heiss, Peter; Feuerbach, Stefan; Iesalnieks, Igors; Rockmann, Felix; Wrede, Christian E; Zorger, Niels; Schlitt, Hans J; Schölmerich, Jürgen; Hamer, Okka W

    2009-04-01

    A 57-year-old woman presented with obscure gastrointestinal bleeding. Double balloon enteroscopy, angiography, and surgery including intraoperative enteroscopy failed to identify the bleeding site. Multidetector computed tomography (CT) depicted active bleeding of a small bowel segment. The bleeding segment was localized by CT-guided percutaneous needle insertion and subsequently removed surgically.

  13. Leiomyosarcoma: a rare complication of uterine fibroid

    Directory of Open Access Journals (Sweden)

    Shazia Parveen

    2014-04-01

    Full Text Available Uterine sarcomas are rare tumours of mesodermal origin. Malignant change occurring in uterine fibroid is termed as leiomyosarcoma. They constitute around 2-6 % uterine malignancies and 25-36% of uterine sarcomas1. The tumour is common in women between the age group 40-50 years. It has an aggressive course and usually metastasis goes to the lungs. The prognosis for women with uterine sarcoma primarily depends on the extent of disease at the time of diagnosis and mitotic index3. Women with tumor size >5 cm in maximum diameter have poor prognosis. These tumours should be diagnosed and managed with no delay and must be followed vigilantly as the rate of recurrence and metastasis is very high. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 486-487

  14. Acute, nonvariceal upper gastrointestinal bleeding.

    Science.gov (United States)

    Klein, Amir; Gralnek, Ian M

    2015-04-01

    Acute, nonvariceal upper gastrointestinal bleeding (UGIB) is a common medical emergency encountered worldwide. Despite medical and technological advances, it remains associated with significant morbidity and mortality. Rapid patient assessment and management are paramount. When indicated, upper endoscopy in patients presenting with acute UGIB is effective for both diagnosis of the bleeding site and provision of endoscopic hemostasis. Endoscopic hemostasis significantly reduces rebleeding rates, blood transfusion requirements, length of hospital stay, surgery, and mortality. Furthermore, early upper endoscopy, defined as being performed within 24 h of patient presentation, improves patient outcomes. A structured approach to the patient with acute UGIB that includes early hemodynamic resuscitation and stabilization, preendoscopic risk stratification using validated instruments, pharmacologic and endoscopic intervention, and postendoscopy therapy is important to optimize patient outcome and assure efficient use of medical resources.

  15. Management of severe perioperative bleeding

    DEFF Research Database (Denmark)

    Kozek-Langenecker, Sibylle A; Ahmed, Aamer B; Afshari, Arash

    2017-01-01

    healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. For this update, electronic databases were searched without language restrictions from 2011 or 2012 (depending on the search) until 2015. These searches produced 18 334 articles. All......: The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia...... articles were assessed and the existing 2013 guidelines were revised to take account of new evidence. This update includes revisions to existing recommendations with respect to the wording, or changes in the grade of recommendation, and also the addition of new recommendations. The final draft guideline...

  16. Oral Dysfunction

    OpenAIRE

    鈴木, 規子; スズキ, ノリコ; Noriko, SUZUKI

    2004-01-01

    The major oral functions can be categorized as mastication, swallowing, speech and respiratory functions. Dysfunction of these results in dysphagia, speech disorders and abnormal respiration (such as Sleep Apnea). These functions relate to dentistry in the occurrence of : (1) oral preparatory and oral phases, (2) articulation disorders and velopharyngeal incompetence (VPI), and (3) mouth breathing, respiratory and blowing disorders. These disorders are related to oral and maxillofacial diseas...

  17. Uterine metrology devices for IUD selection.

    Science.gov (United States)

    1981-11-01

    Accurate measurements of the length of the uterine cavity would make it feasible to select an IUD that is compatible with a given cavity size. Considerable evidence exists to indicate that selecting an IUD on the basis of accurate longitudinal measurements of the uterine cavity improves IUD performance. There are study findings to suggest that as more data are available, specific IUDs can be prescribed for defined ranges of uterine cavity length. Metrology (uterine measuring) devices improve the ability of the clinican to measure accurately longitudinal and, in some instances, lateral dimensions of the uterine cavity. Longitudinal measurements depend on identifying the location of the internal os in order to determine the total length of the cervical canal. Lateral metrology devices also provide a measurement of uterine cavity width. Pain and discomfort associated with the use of the prototype lateral measurement instruments developed thus far is a major deterrent to their wide-scale use. 2 metrology devices -- the Crochet Hook Sound and the Hasson Wing Sound -- are designed to obtain longitudinal measurements of total uterine cavity length and of the length of the cervical canel. 2 new instruments -- the Cavimeter and the Hasson Wing Sound 2 -- designed to obtain both lateral and longitudinal measurements are now available for evaluation. The Hasson Wing Sound appears to be the only uterine metrology device available for service programs that could affect continuation rates of IUD users. It can measure the length of the uterine cavity directly, thus permitting improved IUD selection of individual women or the ability to exclude women who should not be IUD users because of small uterine size. An illustration of the prescriptive approach is included in a table.

  18. Endometrium evaluation with high-field (3-Tesla) magnetic resonance imaging in patients submitted to uterine leiomyoma embolization

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, Monica Amadio Piazza [Post-graduation Program in Abdominal Imaging, Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Nasser, Felipe [Intervention Radiology Department, Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Zlotnik, Eduardo; Messina, Marcos de Lorenzo [Gynecology and Obstetrics Department, Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Baroni, Ronaldo Hueb [Magnetic Resonance Unit, Imaging Department, Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

    2013-07-01

    To evaluate the endometrial alterations related to embolization of uterine arteries for the treatment of symptomatic uterine leiomyomatosis (pelvic pain and/or uterine bleeding) by means of high-field (3-Tesla) magnetic resonance. This is a longitudinal and prospective study that included 94 patients with a clinical and imaging diagnosis of symptomatic uterine leiomyomatosis, all of them treated by embolization of the uterine arteries. The patients were submitted to evaluations by high-field magnetic resonance of the pelvis before and 6 months after the procedure. Specific evaluations were made of the endometrium on the T2-weighted sequences, and on the T1-weighted sequences before and after the intravenous dynamic infusion of the paramagnetic contrast. In face of these measures, statistical analyses were performed using Student's t test for comparison of the results obtained before and after the procedure. An average increase of 20.9% was noted in the endometrial signal on T2-weighted images obtained after the uterine artery embolization procedure when compared to the pre-procedure evaluation (p=0.0004). In the images obtained with the intravenous infusion of paramagnetic contrast, an average increase of 18.7% was noted in the post-embolization intensity of the endometrial signal, compared to the pre-embolization measure (p<0.035). After embolization of the uterine arteries, there was a significant increase of the endometrial signal on the T2-weighted images and on the post-contrast images, inferring possible edema and increased endometrial flow. Future studies are needed to assess the clinical impact of these findings.

  19. A Novel Atraumatic Tourniquet Technique for Excessive Bleeding during Cesarean Sections

    Science.gov (United States)

    Buke, Baris; Akkaya, Hatice; Akercan, Fuat

    2017-01-01

    Objective. Controlling excessive bleeding in cesarean sections which may cause a life-threatening event even under well-prepared conditions. We used a novel atraumatic tourniquet technique to temporary arrest blood flow through the uterine and ovarian vessels and compare with other techniques. Toothless vascular clamps were used as clamp. Methods. Tourniquet technique performed postpartum hemorrhage (PPH) cases (19 out of 37) were compared with 18 other cases with PPH. Results. The difference between preoperative and postoperative hemoglobin values was significantly lower in the study group as well as the number of blood products needed during and after surgery. Conclusions. This technique not only prevented massive bleeding from the uterus but also allowed physicians time to consider the necessity of further interventions.

  20. Role of videocapsule endoscopy for gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Cristina Carretero; Ignacio Fernandez-Urien; Maite Betes; Miguel Mu(n)oz-Navas

    2008-01-01

    Obscure gastrointestinal bleeding (OGIB) is defined as bleeding of an unknown origin that persists or recurs after negative initial upper and lower endoscopies.Several techniques,such as endoscopy,arteriography,scintigraphy and barium radiology are helpful for recognizing the bleeding source;nevertheless,in about 5%-10% of cases the bleeding lesion cannot be determined.The development of videocapsule endoscopy (VCE) has permitted a direct visualization of the small intestine mucosa.We will analyze those techniques in more detail.The diagnostic yield of CE for OGIB varies from 38% to 93%,being in the higher range in those cases with obscure-overt bleeding.

  1. Uterine caliper and depth gauge

    Science.gov (United States)

    King, Loyd L.; Wheeler, Robert G.; Fish, Thomas M.

    1977-01-01

    A uterine caliper and sound consisting of an elongated body having outwardly biased resilient caliper wings and a spring-loaded slidable cervical stop. A slide on the body is operatively connected to the wings by a monofilament and operates with respect to a first scale on the body as a width indicator. A rod extending longitudinally on the body is connected to the cervical stop and cooperates with a second scale on the body as a depth indicator. The instrument can be positioned to measure the distance from the outer cervical ostium to the fundus, as read on said second scale. The wings may be allowed to open by moving the slide, and when the wings engage the utero-tubal junctions, the width may be read on said first scale. By adjustment of the caliper wings the instrument may be retracted until the resistance of the inner ostium of the cervix is felt, enabling the length of the cervical canal to be read directly by the position of the longitudinal indicator rod with respect to said second scale. The instrument may be employed to measure the width of the uterine cavity at any position between the inner ostium of the cervix and the fundus.

  2. 子宫动脉栓塞治疗子宫瘢痕妊娠11例%Clinical application of uterine artery embolization in treating uterine scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    李统怀; 郑红枫

    2011-01-01

    Objective To evaluate uterine artery embolization in treating uterine scar pregnancy. Methods During the period from November 2007 to February 2010, 11 patients with uterine scar pregnancy were encountered in authors' hospital. All the patients had a history of lower uterine segment cesarean section. Four patients had to receive an emergency uterine artery embolization due to acute massive vaginal bleeding. The other 7 patients received intravenous chemotherapy with MTX (0.4 mg/kg/day, every 5 days as a treatment course). Emergency uterine artery embolization had to be carried out in three patients as they developed acute massive vaginal bleeding (blood loss ≥ 100 ml/hour) during the course of chemotherapy, while subsequent uterine artery embolization was performed in the remaining 4 patients after they had completed two courses of treatment when their blood HCG showed no significant decrease. The clinical results were analyzed. Results Remarkable decrease in serum HCG was seen in all 11 patients after interventional management. The vaginal bleeding in 7 patients was significantly reduced within half an hour after uterine artery embolization. The uterus together with intact fertility was successfully preserved in all 11 patients. Conclusion For the treatment of uterine scar pregnancy complicated by massive vaginal bleeding (blood loss ≥ 500 ml/24 h) and/or abnormal elevation of serum HCG (blood β-HCG ≥ 20 000 IU/L), ectopic pregnancy with the mass diameter ≥ 5 cm, uterine artery embolization treatment is very safe and effective. This technique can well preserve female patient's uterus and fertility ability. It is of value to employ this treatment in clinical practice.%目的 探讨子宫动脉栓塞治疗在子宫瘢痕妊娠中的临床应用价值.方法 2007年11月- 2010年2月收治子宫下段剖宫产术后子宫瘢痕妊娠11例,其中4例因阴道大出血入院后急诊行子宫动脉栓塞治疗;另7例患者行MTX静脉化疗(每天剂量为0

  3. Papillary squamotransitional cell carcinoma of the uterine cervix: A histomorphological and immunohistochemical study of nine cases

    Directory of Open Access Journals (Sweden)

    Mani Anand

    2013-01-01

    Full Text Available Background: Papillary squamotransitional cell carcinoma (PSCC is a distinctive subcategory of squamous cell carcinoma of the uterine cervix. It has a propensity for local recurrence and late metastasis. Histologically, it can be misinterpreted as transitional cell carcinoma, or other papillary lesions of the cervix including squamous papilloma, verrucous carcinoma or cervical intraepithelial neoplasia grade 3 with papillary configuration. Materials and Methods: Nine cases of PSCC of the uterine cervix were diagnosed on a cervical biopsy specimen on routine hematoxylin and eosin (H and E stained sections. Their clinic-morphological features were analyzed. The cases were further evaluated immunohistochemically by cytokeratin 7 (CK7, cytokeratin 20 (CK20, p53 and Ki-67. Results: The patients ranged in age from 35 years to 75 years; with abnormal uterine bleeding being the most common clinical presentation. All the cases showed papillary architecture with fibrovascular cores lined by multilayered atypical epithelium. Three cell types were observed: Clear, intermediate and basaloid. Stromal invasion was seen in five cases, whereas in the remaining four cases, the biopsy specimen was too superficial to definitely assess invasion. Immunohistochemically, eight cases were CK7 + /CK20 - and one case was CK7 - /CK20 - . All nine cases showed nuclear accumulation of mutant p53. Moderate and high proliferative activity was observed in two and seven cases, respectively. Five of patients for whom follow-up information was available underwent radical hysterectomy and two of them were disease free 18 months following treatment. Conclusion: PSCC of the uterine cervix are a clinicomorphologically distinct group of cervical lesions that display a morphologic spectrum. They are potentially aggressive malignant tumors that should be distinguished from transitional cell carcinoma and other papillary lesions of the uterine cervix.

  4. [Antithrombotic therapy and nonvariceal upper gastrointestinal bleeding].

    Science.gov (United States)

    Belanová, Veronika; Gřiva, Martin

    2015-12-01

    The incidence of acute upper gastrointestinal bleeding is about 85-108/100,000 inhabitants per year, nonvariceal bleeding accounts for 80-90%. Antiplatelet and anticoagulation treatment are the significant risk factors for upper gastrointestinal bleeding. To evaluate the occurrence of upper gastrointestinal bleeding in the general community of patients in a county hospital. And to compare the role played by antiplatelet and anticoagulation drugs and other risk medication. Retrospective analysis of patients over 18 years of age who underwent endoscopy for acute upper gastrointestinal bleeding or anaemia (haemoglobinupper gastrointestinal tract during a hospital stay in 2013 (from January to June). We included 111 patients of average age 69±15 years, men 60%. Nonvariceal bleeding accounted for 90% of the cases. None of the patients with variceal bleeding (10% of patients) took antiplatelet or anticoagulation therapy. There were 100 patients with nonvariceal bleeding of average age 70±15, 61% men. With the symptoms of acute bleeding (hematemesis, melena) presented in 73% of patients. The most frequent cause of bleeding was gastric and duodenal ulcer (54%). 32% of patients with nonvariceal bleeding had antiplatelets, 19% anticoagulants and 10% used nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors or corticosteroids. 30-days mortality of patients with nonvariceal bleeding was 11%, annual mortality was 23%. There was no significant difference in mortality, blood transfusion requirements or surgical intervention between the patients with antithrombotic agents and without them. 25% of patients (8 patients) using acetylsalicylic acid did not fulfil the indication for this treatment. Among the patients examined by endoscopy for symptomatic nonvariceal bleeding and/or anaemia (haemoglobingastrointestinal bleeding. With regard to that, it is alarming, that there still exists a nonnegligible percentage of patients taking acetylsalicylic acid even

  5. Bleeding

    Science.gov (United States)

    ... Emergency medical services: overview and ground transport. In: Marx JA, Hockberger RS, Walls RM, et al, eds. ... Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et al, eds. ...

  6. Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dreisler, E; Sorensen, S Stampe; Ibsen, P H;

    2009-01-01

    modulators (n = 2). Thus, 375 women without AUB were included (217 pre- and 158 postmenopausal). Receiver-operating characteristics (ROC) curves for endometrial thickness and focal lesion were analyzed. RESULTS: Focal intrauterine pathology was confirmed in 41 women (35 with polyps, five with submucosal...

  7. Multiple organ dysfunction syndrome.

    Science.gov (United States)

    Ramírez, Michelle

    2013-01-01

    Initially known as multiple system organ failure, the term multiple organ dysfunction syndrome (MODS) was first described in the 1960s in adults with bleeding, respiratory failure, and sepsis. It is defined as "the development of potentially reversible physiologic derangement involving two or more organ systems not involved in the disorder that resulted in ICU admission, and arising in the wake of a potentially life threatening physiologic insult."(3) There are many risk factors predisposing to MODS; however, the most common risk factors are shock due to any cause, sepsis, and tissue hypoperfusion. A dysregulated immune response, or immuneparalysis, in which the homeostasis between pro-inflammatory and anti-inflammatory reaction is lost is thought to be key in the development of MODS. The clinical course and evolution of MODS is dependent on a combination of acquired and genetic factors. There are several nonspecific therapies for the prevention and resolution of MODS, mostly care is supportive. Mortality from MODS in septic pediatric patients varies between 11% and 54%. © 2013 Published by Mosby, Inc.

  8. Diffuse uterine leiomyomatosis in a child

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Deepa; Coletti, Monette C.; Ladino-Torres, Maria; Caoili, Elaine [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Elkins, Matthew [University of Michigan Health System, Department of Pathology, Ann Arbor, MI (United States)

    2012-01-15

    Leiomyomas are the most common benign uterine tumor; however, this entity is relatively uncommon in the pediatric population. Although leiomyomas most commonly present as solitary uterine masses, unusual patterns of growth have been described including diffuse leiomyomatosis. In this condition, the myometrium of the uterus is symmetrically expanded by innumerable confluent leiomyomas; this pattern of growth is quite uncommon and has never been reported in a pediatric patient. This case report illustrates the imaging appearance of diffuse uterine leiomyomatosis in an otherwise healthy 16-year-old girl. (orig.)

  9. Neonatal uterine prolapse - a case report.

    Science.gov (United States)

    Saha, D K; Hasan, K M; Rahman, S M; Majumder, S K; Zahid, M K; Chakraborty, A K; Bari, M S

    2014-04-01

    Uterine prolapse is commonly seen in the geriatric age group. Congenital vaginouterine prolapse is a rare condition occurring in neonates and is usually associated with spinal cord malformations in about 85% of cases. Several modalities of treatment have been described for neonatal uterine prolapse. Conservative treatment in the form of simple digital reposition, use of pessary or other self-retaining device is usually sufficient to treat this condition, which is self-limiting and regressive. Here we report our first case of neonatal uterine prolapse, managed successfully with simple digital reposition.

  10. Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient

    Directory of Open Access Journals (Sweden)

    Zhang Qing

    2012-12-01

    Full Text Available Abstract Ultrasound-guided percutaneous renal biopsy is an important technique for diagnosis of glomerular diseases, and the biopsy-induced life-threatening bleeding rarely happens. Primary systemic amyloidosis is a rare disease which may lead to organ dysfunction including arterial stiffness. The accessory renal artery is a kind of renal vascular variation which goes into the renal parenchyma directly or via the renal hilum. Here we reported a rare case of percutaneous renal biopsy-induced accessory renal artery life-threatening bleeding in a renal amyloidosis patient, and our experience of successful rescue in this patient. Virtual Slides http://www.diagnosticpathology.diagnomx.eu/vs/1524207344817819

  11. [The secretion of the main ovarian steroids during bleeding in the premenopause].

    Science.gov (United States)

    Rachev, E; Kŭnchev, L; Stankov, B

    1989-01-01

    The authors study the secretion of the basic ovarian steroids (estradiol, progesterone and testosterone) during dysfunctional bleedings in 46 women at the premenopausal phase of climacteric (mean age of 47.02 years). The results show that the premenopausal bleeding occurs on the background of manifested hypoestradiolemia (2.5 times lower than that at the early follicular phase), hypoprogesteronemia (relatively higher that at the early follicular early follicular phase) and relatively high testosteronemia. Determination of the hormones during three successive days show lack of definite dynamics in the secretion of these ovarian steroids. Considerable individual differences are described.

  12. The management of lower gastrointestinal bleeding.

    Science.gov (United States)

    Marion, Y; Lebreton, G; Le Pennec, V; Hourna, E; Viennot, S; Alves, A

    2014-06-01

    Lower gastrointestinal (LGI) bleeding is generally less severe than upper gastrointestinal (UGI) bleeding with spontaneous cessation of bleeding in 80% of cases and a mortality of 2-4%. However, unlike UGI bleeding, there is no consensual agreement about management. Once the patient has been stabilized, the main objective and greatest difficulty is to identify the location of bleeding in order to provide specific appropriate treatment. While upper endoscopy and colonoscopy remain the essential first-line examinations, the development and availability of angiography have made this an important imaging modality for cases of active bleeding; they allow diagnostic localization of bleeding and guide subsequent therapy, whether therapeutic embolization, interventional colonoscopy or, if other techniques fail or are unavailable, surgery directed at the precise site of bleeding. Furthermore, newly developed endoscopic techniques, particularly video capsule enteroscopy, now allow minimally invasive exploration of the small intestine; if this is positive, it will guide subsequent assisted enteroscopy or surgery. Other small bowel imaging techniques include enteroclysis by CT or magnetic resonance imaging. At the present time, exploratory surgery is no longer a first-line approach. In view of the lesser gravity of LGI bleeding, it is most reasonable to simply stabilize the patient initially for subsequent transfer to a specialized center, if minimally invasive techniques are not available at the local hospital. In all cases, the complexity and diversity of LGI bleeding require a multidisciplinary collaboration involving the gastroenterologist, radiologist, intensivist and surgeon to optimize diagnosis and treatment of the patient.

  13. Uterine Cavity-shaped Device Used in China

    Institute of Scientific and Technical Information of China (English)

    Yan CHE; Ke-juan FANG; Wei-jin ZHOU; Yong-gang DING; Yue-lian SUN; Yao-ling HAN; Olav Merick; Peter Fajans

    2007-01-01

    Objective To assess the effectiveness, side effects, and acceptability of copper uterine cavity - shaped intrauterine devices (UCD) with and without indomethacin.Methods We used electronic search and hand search to identify relevant literatures.Included papers were systematically reviewed according to previous established guidelines.Results A total of 39 related papers were identified. Of them, 9 papers were included in this review: 4 associated with medicated or non-medicated UCD200 (containing copper 200 mm2) and 5 associated with medicated or non-medicated UCD300(containing copper 300 mm2). The contraceptive effectiveness, cumulative one-year and two-year continuation rates were similar between medicated UCD200, non-medicated UCD200 and TCu220C. The effectiveness of non-medicated UCD300 was similar to that of TCu220C and TCu200. The effectiveness of medicated UCD300 was similar to that of MLCu375 and TCu220C but lower than that of TCu380A. The cumulative one-year, three-year and five-year continuation rates were similar between medicated,non-medicated UCD300 and TCu380A or MLCu375. The problem of bleeding was less common among medicated UCD users than among non-medicated devices.Conclusions Uterine cavity-shaped devices should continue to be used in the National Family Planning Proramme. However, priority should be given to the 300 mm2 copper containing device. A large multicenter randomized comparative trial of UCD300 and TCu380A is needed.

  14. Congenital absence of uterine cervix

    Directory of Open Access Journals (Sweden)

    Selvaraj Ravi Lakshmy

    2016-10-01

    Full Text Available Cervical agenesis or dysgenesis is an extremely rare congenital anomaly. Patients with congenital absence of the cervix present with primary amenorrhea and infertility. Though it poses a diagnostic challenge to the clinician, correct diagnosis prior to surgery is possible with the help of ultrasound. Early diagnosis offers significant advantages in patient care and effective presurgical planning. This case report reviews two cases of cervical agenesis diagnosed with the help of ultrasound and later confirmed with the help of MRI. Ultrasonography is the modality of choice to define the internal genital anatomy and helps us to classify the level of obstruction or aplasia in obstructive uterine anomalies. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3634-3636

  15. Associated factors for uterine prolapse.

    Science.gov (United States)

    Gautam, S; Adhikari, R K; Dangol, A

    2012-01-01

    Uterine prolapsed is a significant public health problem in Nepal. The study was conducted in 50 women having second and third degree of uterus prolapse who were admitted in Dhulikhel Hospital for vaginal hysterectomy. A total 200 individual were taken as a control groups who were OPD attendants of Dhulikhel hospital without any sign or had no any sign and symptom of uterus prolapse . Data were collected by structured and semi-structured questionnaires and analysis done by using z test. The occurrence of uterus prolapse had significant difference among ethnicity (p value-prolapse were parity, gravida and age at last birth and work after delivery. Therefore civil society and concerned authority should work to raise awareness on the preventive measure of uterus prolapsed.

  16. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score.

    Science.gov (United States)

    Lip, Gregory Y H; Frison, Lars; Halperin, Jonathan L; Lane, Deirdre A

    2011-01-11

    The purpose of this study was to investigate predictors of bleeding in a cohort of anticoagulated patients and to evaluate the predictive value of several bleeding risk stratification schemas. The risk of bleeding during antithrombotic therapy in patients with atrial fibrillation (AF) is not homogeneous, and several clinical risk factors have been incorporated into clinical bleeding risk stratification schemas. Current risk stratification schemas for bleeding during anticoagulation therapy have been based on complex scoring systems that are difficult to apply in clinical practice, and few have been derived and validated in AF cohorts. We investigated predictors of bleeding in a cohort of 7,329 patients with AF participating in the SPORTIF (Stroke Prevention Using an ORal Thrombin Inhibitor in Atrial Fibrillation) III and V clinical trials and evaluated the predictive value of several risk stratification schemas by multivariate analysis. Patients were anticoagulated orally with either adjusted-dose warfarin (target international normalized ratio 2 to 3) or fixed-dose ximelagatran 36 mg twice daily. Major bleeding was centrally adjudicated, and concurrent aspirin therapy was allowed in patients with clinical atherosclerosis. By multivariate analyses, significant predictors of bleeding were concurrent aspirin use (hazard ratio [HR]: 2.10; 95% confidence interval [CI]: 1.59 to 2.77; p HR: 1.98; 95% CI: 1.42 to 2.76; p HR: 1.63; 95% CI: 1.23 to 2.17; p = 0.0008); diabetes (HR: 1.47; 95% CI: 1.10 to 1.97; p = 0.009), and heart failure or left ventricular dysfunction (HR: 1.32; 95% CI: 1.01 to 1.73; p = 0.041). Of the tested schemas, the new HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score performed best, with a stepwise increase in rates of major bleeding with increasing HAS-BLED score (p(trend) <0.0001). The c statistic for bleeding varied between 0.50 and 0.67 in

  17. ROLE OF MIFEPRISTONE IN MEDICAL MANAGEMENT OF UTERINE FIBROID

    Directory of Open Access Journals (Sweden)

    Shradha

    2015-10-01

    Full Text Available BACKGROUND: Uterine leiomyoma is the most common benign tumour of uterus affecting women of reproductive age group and accounting for most common indication of hysterectomy in India. Effective medical treatment option can prevent hysterectomy related morbidity. MATERIALS AND METHODS: A total of 50 women with symptomatic leiomyoma and asymptomatic with uterine volume >160cc and fibroid size >2.5cm were included in the study. 20mg/day mifepristone was given to them over period of 3 months. Follow up was done at 1, 3 and 6 months of starting treatment. At each visit patients were evaluated for symptomatic improvement of menorrhagia, dysmenorrhoea and ultrasound for myoma volume, haemogram was done. Endometrial biopsy was done at the beginning of therapy, 3rd month and at end of treatment. RESULTS: At the beginning of study, all patients had menorrhagia. At 3 months, 80% developed amenorrhea and 20% scanty menses. At 6 months, 56% had scanty menses and 38% had normal menses but none had menorrhagia. 50% of patients had dysmenorrhoea at the beginning of study with severe dysmenorrhoea in 36% of cases. Only 10% of patients at 3 months and 14% at 6 months had dysmenorrhoea. Improvement in haemoglobin percentage from 9.6 gram% to 10.8 gram% at 3 months of therapy. The reduction in mean uterine volume was 12.28%after 1 month, 26.95% after 3 months and 11.13% at end of 6 months, as compared to pre-treatment level. Fibroid volume decreased by 14.34% after 1 month ,29.8% after 3 months and 24.98% at end of 6 months, as compared to pre-treatment level. At the end of 3 months, 50% of patients experienced no side effect. Rest 50% experienced minor side effects like nausea (8%, hot flushes (4%, liver dysfunction as evidenced by mild increase in transaminase (8% and simple endometrial hyperplasia in 30%. Follow up of these patients at 6 month i.e., 3 months after stopping the drug does not show any evidence of persistence of these effects. CONCLUSION: 20mg

  18. Impact single versus double layer uterine closure in caesarean section to uterine rupture

    OpenAIRE

    Budi Iman Santoso; Raymond Surya; Rima Irwinda

    2016-01-01

    Caesarean section (CS) is one of the most frequent delivery methods in the world whereas the rates of CS were varied according to developing (from 3.5 to 29.2%) and developed countries (21.1%). The study aims to known the impact of single versus double layer uterine closure to uterine rupture in the history of cesarean section (CS). In this case report, the clinical question is single versus double-layer uterine closure on the previous CS, gives better outcome to reduce the risk of uterine ru...

  19. [Obstructive anuria secondary to uterine prolapse].

    Science.gov (United States)

    Rodríguez Alonso, A; González Blanco, A; Cachay Ayala, M E; Bonelli Martín, C i; Porta Vila, A; Lorenzo Franco, J; Cuerpo Pérez, M A; Nieto García, J

    2002-10-01

    The prevalence of obstructive uropathy linked to uterine prolapse ranges between 4% and 80%, depending on the series, probably due to the varying degree of severity of the prolapses under consideration. Renal failure or anuria is an unusual complication. Several etiopathogenic theories regarding obstructive uropathy secondary to prolapse have been put forward: ureteral compression by the uterine vessels, severe urethral angulation, ureteral compression against levator ani muscles and the elongation and narrowing of the distal ureter. The major radiological exploration used in studying the urinary tract of these patients is intravenous urography in bipedestation. Emergency treatment for obstructive anuria resulting from a uterine prolapse consists of manually replacement of the prolapse. Surgery is considered to be the definitive ideal treatment, although in the case of surgical or anaesthetic high risk patients, inserting a permanent pessary may constitute a satisfactory solution. We present a case of obstructive anuria resulting from uterine prolapse, which was successfully treated with the insertion of a ring pessary.

  20. Ovarian function after uterine artery embolisation

    African Journals Online (AJOL)

    2009-08-05

    Aug 5, 2009 ... Uterine artery embolisation (UAE) has been firmly ... Methods. Twenty-nine patients with myomas of the uterus underwent UAE using polyvinyl alcohol (PVA) particles .... that myomectomy may also limit postoperative ovarian.