Evaluation of patients with abnormal uterine bleeding

Area of Science:

• Gynecology
• Reproductive Medicine
• Diagnostic Medicine

Background:

• Abnormal uterine bleeding (AUB) necessitates a thorough diagnostic process to identify underlying causes.
• Accurate diagnosis is crucial for effective management and improved patient outcomes.

Purpose of the Study:

• To outline a systematic approach for diagnosing abnormal uterine bleeding.
• To highlight the importance of clinical evaluation and judicious use of diagnostic aids.

Main Methods:

• Comprehensive patient history and physical/pelvic examinations.
• Individualized selection of laboratory tests including complete blood count, pregnancy tests, hormone levels, thyroid and liver function tests, and coagulation profiles.
• Utilization of imaging techniques like transvaginal ultrasonography and hysteroscopy for intrauterine pathology evaluation.

Main Results:

• Pregnancy complications and trophoblastic disease must be ruled out in women of reproductive age.
• Advanced imaging (ultrasonography, hysteroscopy) is vital for detecting intrauterine lesions such as polyps, myomas, and retained placental fragments.
• Suspicion of malignancy in women over 35 warrants further investigation with endometrial biopsy, D&C, or hysteroscopy.

Conclusions:

• A systematic diagnostic strategy, beginning with clinical assessment and complemented by selective adjunctive tests, is key to managing abnormal uterine bleeding.
• Diagnostic procedures can offer both accurate diagnosis and immediate therapeutic intervention for identified organic causes.