HIPERMENOREA Definsi

servical ectropion/erosion cervical neoplasma/polip trauma cervik/vagina condyloma atropic vaginitis

Perdarahan haid yang lebih banyak dari normal atau lebih lama dari normal (>8 hari). 3) PID (pelvic inflamtory disease) - endometritis Etiologi - tuberculosis Leiomioma 4) hipertiroid Komplikasi kehamilan, ex: aborsi Hiperplasia endometrium Adenomiosis Tatalaksana Keganasan (kanker servik+uterus) identifikasi penyebab Kehamilan ektopik preparat besi : u/cegah+atasi anemia Polip servik/endometrium dll Pharmaceutical treatments Manifestasi klinis menstruasi >8 hari ganti pembalut >5x sehari gejala anemia (sesak nafas, letargi) Faktor risiko - obesitas - anovulasi - estrogen administrasi - gangguan perdarahan herediter

Penegakan diagnosis anamnesis pemeriksaan pelvic dan rectal pap smear USG pelvic : u/ identifikasi abnormalitas struktural Biopsi endometrium: u/ menyingkirkan kanker endometrium/hiperplasia atypikal Hysteroscopi : pemeriksaan servik dan tuba falopi dengan alat seperti teleskop DD 1) Komplikasi kehamilan - kehamilan ektopik - aborsi inkomplit 2) perdarahan non uterin

First line o IntraUterine System insertion Second Line o Tranexamic acid an antifibrinolytic agent o Non-steroidal antiinflammatory drugs (NSAIDs) o Combined oral contraceptive pills to prevent proliferation of the endometrium Third line o Oral progestogen (e.g. norethisterone), to prevent proliferation of the endometrium o Injected progestogen (e.g. Depo provera) Other options o Gonadotrophin-releasing hormone (GnRH) agonists (e.g. Goserelin)

Surgical and radiological treatments

Dilation and curettage (D&C) is no longer performed for cases of simple menorrhagia, having a reserved role

if a spontaneous abortion is incomplete Endometrial ablation Uterine artery embolisation (UAE) Hysteroscopic myomectomy to remove fibroids over 3 cm in diameter Hysterectomy

Komplikasi - tergantung penyakit yang mendasari - anemia Pencegahan - tidak ada pencegahan spesifik, jika dikarenakan obat, hentikan pemakaian