Related Experiment Videos
[Hierarchy for diagnostic and etiological management in menometrorrhagia]
1Hôpital Antoine-Béclère, service de gynécologie obstétrique, 157, avenue de la Porte-de-Trivaux, 92141 Clamart cedex, France. amelie.gervaise@abc.aphp.fr
Abstract:
A strategy to establish the diagnosis and the etiology of menorrhagia is necessary for an adaptated therapeutic care. The cross-examination must endeavour to assess bleedings and their clinical impact, and concentrate on specific pathology (such as hemostasis disorders). Clinical examination may eliminate cervical vaginal pathologies and estimate uterine volume. The diagnosis of pregnancy should always be considered and eliminated and that of iron deficiency anemia will be helpful. Explorations of hemostasis balance will be recommended according to clinical and biological features. Hormonal measurement are not contributive, except in diagnosis of SOPK. Endometrium biopsy with the Pipelle will be systematically performed after 40 years of age or in case of risk factors of endometrial cancer. Transvaginal ultrasonography is the first line exam to recommend in case of proved menorrhagia. Hysteroscopy and hysterosonography will be recommended if ultrasonography is not informative enough, or in case of medical treatment failure. MRI is recommended in an second intention (in case of multiple uterine fibroids, or suspected adenomyosis, and if an arterial embolization is required).
Related Concept Videos
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Mitral Regurgitation III: Medical Management
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Mitral Regurgitation IV: Nursing Management
Mitral Valve Prolapse II: Assessment and Management