What is Ectopic pregnancy?

One of the most frequent issues seen in gynaecology OPD is abnormal uterine haemorrhage. It could occur at any age, including youth, perimenopause, and even postmenopausal haemorrhage. 

The most common causes of abnormal uterine bleeding include polyps, fibroids, and submucous fibroids. The usual treatment is hormonal therapy with progestins. Most of the other causes require surgery for removal.

Clinical Parameter:

– Frequency of menses (days) – 2-3

– Duration of menses (days) – 26-56

– Frequency of Menstrual cycle – 28-30 days

– Volume of monthly blood loss (mL)

Abnormal bleeding has been categorised by the PALM-COEIN approach by the International Federation of Gynaecology and Obstetrics (FIGO 2011) to aid in proper diagnosis.

There are four phases of life of a woman that may be affected by menstrual abnormalities:

1. Menarche: age 12-15 years
2. Fertility phase (prime reproductive years): age 16-40 years old
3. Post Menopause: age 40-50+ years old 
4. Infertility (menopause)

The treatment during the first two phases of life is symptomatic. Healthcare providers have a greater ability in treating the irregularities in later phases. However, there are some situations when menorrhagia may be life-threatening and require emergency treatment. 

The case for emergency treatment involves at least three of these criteria:

1. ‘Risk Factor’ (Condition) : 100% chance of death if untreated or very severe bleeding without estimated risk 
2. Significant Future Risk : 5% chance of death if untreated or very severe bleeding with estimated risk 
3. Significant Present Risk : 5% chance of death if treated or 5-30% severe bleeding with estimated risk

A medical emergency specialist should be consulted in cases where these criteria are present.

It has been found that several factors influence the outcome of treatment, including age, haemoglobin-level, presence of other diseases and general health conditions.

Treatment can vary, depending on the underlying disease causing the abnormal uterine bleeding.

Medical conditions that occur during pregnancy :

Preeclampsia :

The main cause of a high-risk pregnancy is preeclampsia which is a hypertensive disorder that occurs late in the pregnancy. It has been defined as hypertension (blood pressure > 140/90 mmHg) with proteinuria (>+1+) and the exclusion of other causes of hypertension.

Gestational diabetes :

It happens when there is non-insulin dependent rise in the blood glucose level during pregnancy, usually in the second or third trimester. The risk of developing preeclampsia is increased with gestational diabetes.

Depression :

According to a study published by the Canadian Medical Association, the risk of premature delivery is markedly increased in women suffering from depression.

These are some of the conditions that occur during pregnancy that may increase the risk of abnormal uterine bleeding and warrant immediate medical attention.