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Dysfunctional (Abnormal) Uterine Bleeding, Pediatric

Leonard J. Levine, MD and Jonathan R. Pletcher, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Bleeding that is excessive in flow, outside of regular menstrual cycles, or occurs daily for >8 days

  • Adolescents typically do not establish regular ovulatory cycles until their mid...

DIAGNOSIS

HISTORY

  • A complete history should be obtained both with and without the presence of adolescent’s caregiver.

  • A complete menstrual history includes:

    • Assessment of the amount of bleeding and confi...

TREATMENT

GENERAL MEASURES

  • The initial step in evaluating AUB is to determine pregnancy status and assess hemodynamic stability.

  • Any adolescent who exhibits signs or symptoms of hemodynamic instability ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

When to expect improvement 
  • Bleeding usually tapers after the first few doses of hormone therapy.

  • After 6 to 12 months, if patient does not wish t...

ADDITIONAL READING

  • ACOG Committee Opinion No. 651: menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Obstet Gynecol.  2015;126(6):e143–e146. [View Abstract on Ovid...

CODES

ICD9

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

  • 626.5 Ovulation bleeding

  • 626.9 Unspecified disorders of menstruation and other abnormal bleeding fro...

FAQ

  • Q: If most girls have anovulatory cycles, why do only some present with AUB?

  • A: Most girls do have irregular menstrual cycles during the first 2 years after menarche. However, in most, the negative...

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