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Dysfunctional Uterine Bleeding, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Abnormal uterine bleeding is an alteration in pattern or volume of normal menses

    • Typical blood loss during a normal menstrual cycle is 30–80 mL

    • Normal interval between menses 28 (+/− 7...

Diagnosis

Signs and Symptoms

History

  • Abnormal uterine bleeding in the absence of systemic or structural disease

  • Most common in perimenarcheal, perimenopausal women

  • Typically painless

  • Anovulatory presentati...

Treatment

Pre-Hospital

IV crystalloid boluses as needed for hypotension, tachycardia secondary to heavy bleeding 

Initial Stabilization/Therapy

ABCs: 
  • Packed RBCs for significant bleeding unresponsive to ...

Follow-Up

Disposition

Admission Criteria

  • Significant blood loss

  • Continued bleeding

  • Hemodynamic instability requiring aggressive resuscitation and/or operative intervention

Discharge Criteria

Most patients c...

Pearls and Pitfalls

  • DUB is a diagnosis of exclusion

  • Only 2% of endometrial carcinoma occur before age 40 yr

  • If hemodynamic instability, unlikely diagnosis of DUB

Additional Reading

  • Casablanca  Y. Management of dysfunctional uterine bleeding. Obstet Gynecol Clin North Am.  2008;35:219–234.

  • LaCour  DE, Long  DN, Perlman  SE. Dysfunctional uterine bleeding in...

Codes

ICD9

  • 626.2 Excessive or frequent menstruation

  • 626.6 Metrorrhagia

  • 626.8 Other disorders of menstruation and other abnormal bleeding from female genital tract

  • 626.1 Scanty or infrequent menstruation

  • 62...

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