Abnormal uterine bleeding may be acute or chronic, and is defined as bleeding from the uterus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy. Acute AUB refers to an episode of heavy bleeding that is of sufficient quantity to require immediate intervention to prevent further blood loss. Acute AUB may occur spontaneously or in association with chronic AUB. Initial screening for an underlying disorder of hemostasis in patients with excessive menstrual bleeding should be structured by the medical history.
Basic workup of abnormal bleeding includes CBC (complete blood count), blood group, Thyroid function tests(TSH), UPT( Urine pregnancy test), coagulation parameters(PT,PTT,INR) and LFT( liver function test). Hormonal management is considered the first line of medical therapy for patients with acute AUB without suspected bleeding disorders.
Antifibrinolytic drugs, such as tranexamic acid, work by preventing fibrin degradation and are effective treatment for patients with recurrent AUB. Surgical options include dilation and curettage, endometrial ablation, uterine artery embolization, and hysterectomy.
The etiologies of acute AUB should be classified based on the PALM–COEIN system: Polyp, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, and Not otherwise classified.
Dr. Ruchi Tandon is a famous gynecologist who specializes in cases of AUB (Abnormal uterine bleeding).She has performed about 1000 hystroscopies and procedures related to AUB.