| ID | 308 |
|---|---|
| Name | ABNORMAL & EXCESSIVE UTERINE BLEEDING |
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| Introduction | Menstrual cycle: Setting of menstrual cycle or menarche usually occurs between ages 11 & 15 (average 12 years). Normal menstrual cycle lasts an average of 4 days (2-7 days) with a mean blood loss of 40ml. Abnormal & excessive uterine bleeding: In the women of menstrual cycle, there are frequent cases of excessive bleeding in amount (>80ml) and/or duration (>8/28 days). This excessive bleeding may occur at regular menstrual intervals (menorrhagia) or irregular intervals (dysfunctional uterine bleeding). The menstrual bleeding (normal or excessive) in regular interval (>21 days) is ovular, and an irregular or excessive intermenstrual bleeding (interval between the onset of bleeding episodes <21 days) is usually anovular. Therefore, any dysfunctional uterine bleeding (DUB) is anovular. |
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| Types | Clinical types: A. Menorrhagia: It is cyclical bleeding at normal interval which is excessive in amount (>80ml) and/or duration, for example 8/28 days. Causes- 1. Increased surface area of endometrium- e.g, fibroid, uterine polyp, and endometriosis. 2. Infection and inflammation- e.g, endometritis. 3. Active or passive congestion of uterus. 4. Bleeding disorder. B. Epimenorrhoea: It is cyclical bleeding which is normal in amount but which occurs too frequent interval (less than 22 days) for example 4/21 days. Causes-Due to disease or functional disturbance of the ovary. C. Epimenorrhagia: It is cyclical bleeding which is both excessive and too frequent, for example 8/21 days. Causes-It implies a disturbance in both the ovary and the uterus. D. Metrostaxis or metrorrhagia: It is bleeding of any amount which is acyclical and which occurs irregularly or continuously. Causes- 1. Surface lesion of the genital tract. 2. Malignant growth with ulceration. 3. Endometrial polyp. 4. Abortion or ectopic pregnancy. E. Oligomenorrhoea: In this condition the cycle lasts longer than 35 days. Here menstruation may be both infrequent and irregular or may be regularly infrequent. Causes- Error is generally in the ovary and its controlling factors. F. Dysfunctional uterine bleeding (DUB): Dysfunctional uterine bleeding (DUB) is an irregular or excessive intermenstrual bleeding, which includes all forms of abnormal and excessive uterine bleeding for which no orgainc cause in the pelvis can be found Types- 1. Metrophathia hemorrhagica. 2. Threshold bleeding. |
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