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https://www.readbyqxmd.com/read/29201425/heavy-menstrual-bleeding-diagnosis-and-medical-management
#1
REVIEW
Intira Sriprasert, Tarita Pakrashi, Thomas Kimble, David F Archer
Heavy menstrual bleeding (HMB) is a common gynecological problem that has a significant impact on a woman's quality of life and the activities of daily living. Due to the difficulty in accurately describing menstrual bleeding abnormalities using older terminology, the PALM-COEIN classification system of the Federation Internationale de Gynecologie et d'Obstetrique was proposed to describe and identify the etiology of abnormal endometrial bleeding. As there is no single pathway that is associated with HMB, there are several therapeutic interventions involving different molecular pathways to reduce HMB...
2017: Contraception and Reproductive Medicine
https://www.readbyqxmd.com/read/29197944/experience-of-symptoms-and-disease-impact-in-patients-with-adenomyosis
#2
Linda M Nelsen, William R Lenderking, Robin Pokrzywinski, Zaneta Balantac, Libby Black, Shibani Pokras, Mary Beth Enslin, Melisa Cooper, Andrea S Lukes
BACKGROUND: Adenomyosis is a poorly understood, benign disease of the uterus. OBJECTIVE: In this study, patient interviews were conducted to characterize the symptoms and impact of adenomyosis. METHODS: This was a cross-sectional study in which women with adenomyosis were recruited from five US clinics and a health-related social network forum. Participants (aged 18-55 years) were pre-menopausal with a history of regular menstrual cycles...
December 2, 2017: Patient
https://www.readbyqxmd.com/read/29197842/angiomatosis-of-the-uterus-cervix-and-fallopian-tubes-a-rare-and-benign-cause-of-intractable-heavy-menstrual-bleeding
#3
Jennifer C Pontré, Victor Ojedo, Bernadette McElhinney
Angiomatosis of the uterus, cervix and fallopian tubes is a rare and benign entity that has not been reported in the literature previously. We present a case of a 27-year-old patient with severe and intractable heavy menstrual bleeding unresponsive to all conservative and conventional forms of treatment. Following a laparoscopic hysterectomy, the histopathological finding of angiomatosis, a vascular abnormality in the uterus, cervix and fallopian tubes, provided a plausible explanation in this situation.
December 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29179757/lockjaw-from-a-metastatic-uterine-leiomyosarcoma-case-report-and-review-of-the-literature
#4
Isabel Hope, Karen Morton, Carrie Newlands, Simon Butler-Manuel, Thumuluru Kavitha Madhuri
BACKGROUND: Leiomyosarcoma (LMS) is a malignant tumour formed of cells with distinct smooth muscle features. Leiomyosarcomas rarely metastasise to the oral cavity and this literature review details all reported cases of metastasis to the mandible found in the literature. This offers a unique perspective by specifying mandible as the site of metastasis of leiomyosarcoma. CASE PRESENTATION: A 53-year-old female presented to her General Practitioner (GP) with heavy menstrual bleeding and was diagnosed with multiple fibroids...
November 28, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/29170088/simplified-medical-abortion-screening-a-demonstration-project
#5
Elizabeth G Raymond, Yi-Ling Tan, Rodica Comendant, Irina Sagaidac, Stelian Hodorogea, Melissa Grant, Patricio Sanhueza, Emigdio Van Pratt, Ginger Gillespie, Christy Boraas, Mark A Weaver, Ingrida Platais, Manuel Bousieguez, Beverly Winikoff
OBJECTIVES: To evaluate the safety and acceptability of outpatient medical abortion in selected women without a pretreatment ultrasound or pelvic examination. STUDY DESIGN: We conducted a prospective case-series study to estimate the incidence of serious adverse events (death, life-threatening event, hospitalization, transfusion, or any other medical problem that we judged to be significant), surgical completion of the abortion, and satisfaction in women provided with medical abortion without a pretreatment ultrasound or pelvic examination...
November 20, 2017: Contraception
https://www.readbyqxmd.com/read/29166373/pilot-study-of-novel-lab-methodology-and-testing-of-platelet-function-in-adolescent-women-with-heavy-menstrual-bleeding
#6
Anne D Rocheleau, Ayesha Khader, Anh T P Ngo, Colin Boehnlein, Cara McDavitt, Susan Lattimore, Michael Recht, Owen J T McCarty, Kristina M Haley
INTRODUCTION: Approximately 40% of adolescent women experience heavy menstrual bleeding (HMB), and 10-62% of them have an underlying bleeding disorder (BD). Diagnosing BD remains challenging due to limitations of available clinical platelet function assays. AIM: To characterize platelet function in a population of adolescent women with HMB using small-volume whole blood assays. METHODS: Anticoagulated whole blood was used to assess platelet GPIIbIIIa activation, α-granule secretion, and aggregation in response to multiple agonists...
November 22, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29141040/medical-therapy-versus-radiofrequency-endometrial-ablation-in-the-initial-treatment-of-heavy-menstrual-bleeding-itom-trial-a-clinical-and-economic-analysis
#7
Abimbola O Famuyide, Shannon K Laughlin-Tommaso, Sherif A Shazly, Kirsten Hall Long, Daniel M Breitkopf, Amy L Weaver, Michaela E McGree, Sherif A El-Nashar, Maureen A Lemens, Matthew R Hopkins
BACKGROUND: Radiofrequency endometrial ablation (REA) is currently a second line treatment in women with heavy menstrual bleeding (MHB) if medical therapy (MTP) is contraindicated or unsatisfactory. Our objective is to compare the effectiveness and cost burden of MTP and REA in the initial treatment of HMB. METHODS: We performed a randomized trial at Mayo Clinic Rochester, Minnesota. The planned sample size was 60 patients per arm. A total of 67 women with HMB were randomly allocated to receive oral contraceptive pills (Nordette ®) or Naproxen (Naprosyn®) (n = 33) or REA (n = 34)...
2017: PloS One
https://www.readbyqxmd.com/read/29139277/tailor-management-to-the-patient-with-fibroids
#8
Marie O'Sullivan, Caroline Overton
Fibroids are benign, hormone-dependent tumours of uterine smooth muscle and connective tissue. They are commonly asymptomatic, but can cause symptoms such as heavy menstrual bleeding and pelvic pressure symptoms. Between 20 to 30% of women with heavy menstrual bleeding have fibroids. Fibroids are most prevalent in women aged 30-50 years and there may be a genetic predisposition. They are more common in black women than white women. Other risk factors include obesity and nulliparity. Asymptomatic women should only be referred if their uterus is palpable abdominally, if fibroids distort the uterine cavity or the uterus is larger than 12 cm in length...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#9
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29128205/endometrial-ablation
#10
REVIEW
Malcolm G Munro
Endometrial ablation (EA) includes a spectrum of procedures performed with or without hysteroscopic direction, designed to destroy the endometrium for the treatment of the symptom of heavy menstrual bleeding (HMB) secondary to a spectrum of causes, but most commonly those that are endometrial in origin (AUB-E) or ovulatory disorders (AUB-O). Resectoscopic endometrial ablation (REA) is often mistakenly referred to as the "first generation" technique, while proprietary devices that do not use the resectoscope (nonresectoscopic EA or NREA) are often misperceived as "second generation" devices...
October 20, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29092828/how-we-treat-heavy-menstrual-bleeding-associated-with-anticoagulants
#11
Kochawan Boonyawat, Sarah H O'Brien, Shannon M Bates
Anticoagulant-associated heavy menstrual bleeding (HMB) is an underrecognized but not uncommon problem in clinical practice. Premenopausal women should be advised of the potential effect of anticoagulant therapy on menstrual bleeding at the time of treatment initiation. Consequences of HMB should be assessed and treated on an ongoing basis. In the acute setting, the decision to withhold anticoagulants is based on an individual patient's risk of thrombosis and the severity of the bleeding. For women who require long-term anticoagulation, the use of levonorgestrel intrauterine system, tranexamic acid (during menstrual flow), high dose progestin-only therapy, and combined hormonal contraceptives are effective for controlling HMB; the risk of thrombosis during anticoagulant therapy with these treatments is not well studied, but is likely to be low...
November 1, 2017: Blood
https://www.readbyqxmd.com/read/29078976/abnormal-uterine-bleeding-including-coagulopathies-and-other-menstrual-disorders
#12
REVIEW
Efthimios Deligeoroglou, Vasileios Karountzos
Abnormal Uterine Bleeding (AUB) is a frequent cause of visits to the emergency department and a major reason for concern among adolescents and their families. The most common cause of AUB, in otherwise healthy adolescents, is ovulatory dysfunction, although 5-36% of adolescents who present with heavy menstrual bleeding, have an underlying bleeding disorder (BD). The most common form of BDs is von Willebrand Disease, reflecting 13% of adolescents with AUB. Management of AUB depends on the underlying etiology, the bleeding severity, as well as the need for hospitalization...
October 9, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29055402/caesarean-section-scar-causes-myometrial-hypertrophy-with-subsequent-heavy-menstrual-flow-and-dysmenorrhoea
#13
Ayman A A Ewies, Ulises Zanetto
In the recent years, maternity statistics world-wide show a continuous rise in the rate of Caesarean Section (CS) operation. Many CS deliveries are conducted despite having no clear obstetric indications. The CS scar is assumed to be related to many adverse clinical gynaecological symptoms such as intermenstrual bleeding, dysmenorrhoea, dyspareunia and chronic pelvic pain; however, the mechanism of this relation is not clear. Further, little is known about the effects of CS scar on uterine wall morphology, function or patho-physiology...
October 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29048917/a-population-based-study-of-the-prevalence-of-abnormal-uterine-bleeding-and-its-related-factors-among-iranian-reproductive-age-women-an-updated-data
#14
Hadigheh Kazemijaliseh, Fahimeh Ramezani Tehrani, Samira Behboudi-Gandevani, Davood Khalili, Farhad Hosseinpanah, Fereidoun Azizi
BACKGROUND: Abnormal uterine bleeding (AUB) is one of the most common gynecologic complaints among reproductive-age women. The purpose of this study was to investigate the prevalence of AUB and its related factors among reproductive age Iranian women. METHODS: A population-based cross-sectional study was conducted on 1393 women aged 15 - 45 years who participated in the Tehran Lipid and Glucose Study in 2009 - 2012. FIGO terminology and previous definitions were used for classification of AUB...
September 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29038072/amenorrhea-rates-and-predictors-during-1-year-of-levonorgestrel-52-mg-intrauterine-system-use
#15
Philip D Darney, Gretchen S Stuart, Michael A Thomas, Carrie Cwiak, Andrea Olariu, Mitchell D Creinin
OBJECTIVE: The objective was to evaluate amenorrhea patterns and predictors of amenorrhea during the first year after levonorgestrel 52 mg intrauterine system (IUS) placement. STUDY DESIGN: This cohort analysis includes 1714 nulliparous and parous women who received a Liletta® levonorgestrel 52 mg IUS in a multicenter trial to evaluate efficacy and safety for up to 8 years. Participants maintained a daily diary with bleeding information. We assessed bleeding patterns in 90-day intervals; amenorrhea was defined as no bleeding or spotting in the preceding 90 days...
October 13, 2017: Contraception
https://www.readbyqxmd.com/read/29030160/mobile-application-vs-paper-pictorial-blood-assessment-chart-to-track-menses-in-young-women-a-randomized-cross-over-design
#16
Amanda E Jacobson, Sara K Vesely, Fareeda Haamid, Myra Christian-Rancy, Sarah H O'Brien
BACKGROUND: /Objectives: Heavy menstrual bleeding is a common complaint reported by approximately 30% of women. The Pictorial Blood Assessment Chart (PBAC) score is often used to quantify severity of menstrual bleeding. However, the traditional PBAC paper diary may be subject to recall bias and compliance issues, especially in adolescents. We developed a mobile application (app) version of the PBAC score and evaluated patient satisfaction and compliance with app reporting vs paper reporting...
October 10, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28984905/meta-analysis-of-bipolar-radiofrequency-endometrial-ablation-versus-thermal-balloon-endometrial-ablation-for-the-treatment-of-heavy-menstrual-bleeding
#17
REVIEW
Yan Zhai, Zihan Zhang, Wei Wang, Tingping Zheng, Huili Zhang
BACKGROUND: Heavy menstrual bleeding is a common problem that can severely affect quality of life. OBJECTIVES: To compare bipolar radiofrequency endometrial ablation and thermal balloon ablation for heavy menstrual bleeding in terms of efficacy and health-related quality of life (HRQoL). SEARCH STRATEGY: Online registries were systematically searched using relevant terms without language restriction from inception to November 24, 2016. SELECTION CRITERIA: Randomized control trials or cohort studies of women with heavy menstrual bleeding comparing the efficacy of two treatments were eligible...
October 6, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28983163/angioleiomyoma-of-uterus-masquerading-as-malignant-ovarian-tumor
#18
Sweta Singh, Monalisha Naik, Narbadyswari Deep Bag, Susama Patra
Uterine angioleiomyoma is rare. A 40-year-old nulliparous woman presented with heavy menstrual bleeding (HMB) for the past 2 years and mass per abdomen with severe dysmenorrhea for three cycles. She had received 8 units of packed cell transfusion outside. Clinical examination revealed a huge 32-week-sized abdominopelvic mass with irregular margins. Ultrasonography (USG) of the abdomen and pelvis showed a large solid cystic mass on the right side of the abdomen with a well-defined hypoechoeic rounded lesion of size 5...
July 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28951427/an-unexpected-complication-following-uterine-artery-embolisation
#19
Sarah Peters, Michelle Wise, Brendan Buckley
A 35-year-old nulliparous woman underwent uterine artery embolisation (UAE) for heavy menstrual bleeding and anaemia due to fibroids, refractive to medical and surgical treatment.Bilateral UAE was performed after cephazolin prophylaxis and analgesia. Postoperatively, pain and abdominal bloating were prominent. Symptoms were initially treated as postembolisation syndrome, and analgesia was escalated. By the third day, pain was worsening and the woman developed marked tachypnoea and tachycardia, with raised inflammatory markers and lactate...
September 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28939480/hysteroscopic-removal-of-retained-products-of-conception-implanted-over-a-focal-area-of-adenomyosis-a-case-report
#20
Luis Alonso, Laura Nieto, Jose Carugno
STUDY OBJECTIVE: To describe a technique for hysteroscopic removal of retained products of conception (RPOC) implanted over an area of adenomyosis. DESIGN: A case report (Canadian Task Force classification III). SETTING: RPOC is an unfortunate complication that may occur after the resolution of a normal pregnancy; it is more common after early pregnancy termination or spontaneous miscarriage [1]. Immediate consequences of RPOC include persistent vaginal bleeding, abdominal pain, pelvic infection, fever, and dilated cervix...
September 20, 2017: Journal of Minimally Invasive Gynecology
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