ABNORMAL UTERINE BLEEDING

ABNORMAL UTERINE BLEEDING

• is defined as bleeding between monthly periods,
prolonged bleeding, or an extremely heavy flow.
• Normal menstrual flow lasts approximately 5 days and
occurs every 21 to 35 days. Abnormal uterine bleeding
is when you bleed between your monthly periods, or
when you bleed for too long or it is an extremely heavy
flow.
WHAT CAUSES ABNORMAL UTERINE
BLEEDING?
• There are many causes of abnormal uterine bleeding.
One major cause is due to structural abnormalities in
the uterus. This can take the form of fibroids, which are
benign overgrowth of the muscle of the uterus.
• Bleeding disorders or platelet dysfunction can cause
abnormal bleeding. Early pregnancies can have some
bleeding associated with them. Hormonal changes can
also be a cause.
• Polycystic ovary syndrome (PCOS, cysts in the
ovaries) may cause your periods to come at different
times or not at all. It is caused when certain hormones
are out of balance. When this happens, you may have
difficulty getting pregnant. You may grow hair on your
body and face. Also, the hair on your scalp may get
thinner.
• Women who are going into menopause or are in
menopause are more apt to have changes in
hormones. The changes can cause the lining of the
uterus (endometrium) to get thick. This can cause
bleeding.
• Abnormal uterine bleeding due to ovulatory dysfunction
(AUB-O) is abnormal uterine bleeding that, after
examination and ultrasonography, cannot be attributed
to the usual causes (structural gynecologic
abnormalities, cancer, inflammation, systemic
disorders, pregnancy, complications of pregnancy, use
of oral contraceptives or certain drugs). Treatment is
usually with hormone therapy, such as oral
contraceptives, or with NSAIDs.
PATHOPHYSIOLOGY
• During an anovulatory cycle, the corpus luteum does not form.
Thus, the normal cyclical secretion of progesterone does not
occur, and estrogen stimulates the endometrium unopposed.
Without progesterone, the endometrium continues to proliferate,
eventually outgrowing its blood supply; it then sloughs
incompletely and bleeds irregularly and sometimes profusely or
for a long time. When this abnormal process occurs repeatedly,
the endometrium can become hyperplastic, sometimes with
atypical or cancerous cells.
• In ovulatory abnormal uterine
bleeding, progesterone secretion is prolonged;
irregular shedding of the endometrium results, probably
because estrogen levels remain low, near the threshold
for bleeding (as occurs during menses). In obese
women, ovulatory AUB can occur if estrogen levels are
high, resulting in amenorrhea alternating with irregular
or prolonged bleeding.
PATHOPHYSIOLOGY
MANAGEMENT
COMPLICATIONS
• Chronic bleeding may cause iron deficiency anemia.
• If AUB is due to chronic anovulation, infertility may also
be present.
PATIENT’S PROFILE
• NAME: PATIENT X
• AGE: 43
• SEX: Female
• ADDRESS: Santiago Aliaga, Nueva Ecija
• BIRTHDAY: October 15, 1976
• NATIONALITY: Filipino
• RELIGION: Catholic
• CIVIL STATUS: Married
• ADMITING DIAGNOSIS: Abnormal Uterine Bleeding
• FINAL DIAGNOSIS: Endometrial Polyps
• Uterine polyps are growths attached to the inner wall of
the uterus that extend into the uterine cavity.
• Overgrowth of cells in the lining of the uterus leads to
the formation of uterine polyps, also known as
endometrial polyps.
• These polyps are usually noncancerous, although
some can be cancerous or can eventually turn into
cancer (precancerous polyps)
NURSING CARE PLAN
MEDICATION
• Tranexamic Acid IV every 8 hours
• Ascorbic Acid 500 mg BID, PO
• Ferrous sulfate + Vitamin B-Complex BID, PO
TRANEXAMIC ACID
• A medication used to treat or prevent excessive blood
loss from major trauma, postpartum bleeding, surgery,
tooth removal, nosebleeds, and heavy menstruation.
DRUG STUDY
ASCORBIC ACID
• Vitamin C is a vitamin found in various foods and sold
as a dietary supplement. Use to treat scurvy.
DRUG STUDY
FERROUS SULFATE
• Use to treat iron deficiency.
DRUG STUDY