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DUB
- 3. How do hormones work?
- 5. Menstrual Period Characteristics >80 cc 20-80cc 35 cc Volume >8 d 1-8 d 4 d Duration <21 or >35 d 21-35 d 28 d Cycle length Abnormal Normal Average M enses
- 6. Menorrhagia Prolonged (> 7 days) or excessive (> 80mL) uterine bleeding occurring at regular intervals Metrorrhagia Uterine bleeding occurring at irregular intervals or between periods Menometrorrhagia Uterine bleeding occurring at irregular intervals, with heavy (> 80mL) or prolonged (> 7 days) menstrual flow Polymenhorrhea Uterine bleeding occurring at regular intervals of < 21 days Oligomenorrhea Uterine bleeding occurring at intervals of 35 days or longer Amenorrhea Absence of uterine bleeding for 6 months or longer in a non-menopausal woman
- 7. Complications of pregnancy Systemic disease Intrauterine pregnancy Hepatic disease Ectopic pregnancy Renal disease Spontaneous abortion Coagulopathy Gestational trophoblastic disease Thrombocytopenia Placenta previa von Willebrand's disease Leukemia Infection Cervicitis Medications/iatrogenic Endometritis Intrauterine device Hormones (oral contraceptives, Trauma estrogen, progesterone) Laceration, abrasion Foreign body Hormonal imbalance Anovulatory cycles Malignant neoplasm Hypothyroidism Cervical Hyperprolactinemia Endometrial Cushing’s disease Ovarian Polycystic ovarian syndrome Adrenal dysfunction/tumor Benign pelvic lesions Stress Cervical polyp Excessive exercise Endometrial polyp Leiomyoma Adenomyosis
- 14. Enhanced contrast/relief of endometrial lesions: fibroids, polyps CA Sensitivity/Specificity at 93 to 94 % for focal lesions ( vs 75% for TVUS alone) Combined with EB: very high rate of Dx Focal lesions then result in Hysteroscopy
- 15. Evaluation of DUB 4.Endometrial Suction Curette Pippelle : most commonly used, least discomfort Vabra Aspirator and Karman Cannula 5.Endometrial Brush Superior in Post-Menopausal Same as Pipelle in Pre-Menop. (A) Pipelle endometrial suction curette. (B) Vabra aspirator. Tao Endometrial Brush