Sudhir R Shah MD DGO FICOG
Head Department of Obstetrics and Gynecology Dashashrimali Hospital
Rajkot, Gujarat, India
Beena N Trivedi MD
Senior Gynecologist Dashashrimali Hospital
Rajkot, Gujarat, India
Dipal D Solanki MD
Senior Gynecologist Dashashrimali Hospital
Rajkot, Gujarat, India
Chaitra Sathyanarayana MS
Gynecologist Dashashrimali Hospital
Rajkot, Gujarat, India
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Step by Step® Management of Abnormal Uterine Hemorrhage
© 2011, Jaypee Brothers Medical Publishers (P) Ltd
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition: 2011
9789350250266
Typeset at JPBMP typesetting unit
Printed at
5Preface
Most women experience abnormal uterine bleeding at least once during their reproductive years. The most common times that women experience heavy or prolonged menstrual periods are during the first few years of menstruation at adolescence and during the final two to three years of menstruation just before menopause.
Abnormal uterine bleeding is any type of bleeding from the vagina that is not normal. This may mean bleeding at times of the month other than the regular period, or that the period is unusually heavy. The need to change a pad or tampon more than once every 1–2 hours indicates that the period is unusually heavy. If the period lasts more than 7 days or fewer than 2 days, this is also abnormal uterine bleeding.
Although abnormal uterine bleeding is most common in the pubertal and perimenopausal period, vaginal bleeding in girls before the onset of the menses is abnormal. In postmenopausal women, vaginal bleeding that persists for 12 months after the cessation of the menses is abnormal. Other conditions may also cause abnormal uterine bleeding which will be elaborated in the forthcoming chapters.
Women and abnormal uterine bleeding: some facts and statistics
- A reported 25% of gynecologic surgeries are done for abnormal uterine bleeding.
- In girls who experience abnormal uterine bleeding before the onset of menstruation, many cases involve lesions of the reproductive system, and some of these lesions may be malignant. In these cases, a thorough evaluation must be done.
- Menstrual irregularities are associated with thyroid disease.
Through this book, we have tried to provide an ‘easy-to-understand’ overview of the current and important aspects of abnormal uterine bleeding, one of the most common complaints facing gynecologists and among the leading reasons for hysterectomy. Besides providing an insight into the varied causes of abnormal uterine bleeding and its conventional management, we have also focused on the rapidly evolving field of conservative and noninvasive modalities for the management of abnormal and heavy vaginal bleeding. This book can act as a ready reference in the consulting room for all practicing gynecologists and will also prove helpful to postgraduate and undergraduate medical students.
Sudhir R Shah
Beena N Trivedi
Dipal D Solanki
Chaitra Sathyanarayana
7Acknowledgments
We are thankful to
- Our idols and friends in this fraternity who encouraged us to pen this book.
- M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, for their constant encouragement and provoking us to write this book.
- Our Trustees, Superintendent, Medical Director for supporting us in this endeavor.
- Our family members Mrs Jyoti Shah, Dr Nimish Trivedi (MCh Neurosurgeon), and Dr Dharmesh Solanki (DM Cardiologist) who have provided us constant encouragement to come up with this novel subject.
- A number of other friends who helped us in many ways.