This week (after a very long break) we get back to business. We’ll take you through the diagnosis, management and investigation of acute menorrhagia.
Take Home Messages:
- Acute Menorrhagia can be severe enough to create haemodynamic instability, assess for shock first.
- Always perform a B-hCG to exclude pregnancy/miscarriage
- Be sure to exclude a pelvic infection in your work-up
- Consider inherited platelet dysfunction or coagulopathies in the adolescent with new menorrhagia
- Consider endometrial hyperplasia or cancer in the woman over 35
- Medical management may include NSAIDs, high-dose Progesterone, Tranexamic Acid
- Surgical management may include Dilation & Curettage
References & Resources:
Adolescent Gynaecology – Menorrhagia Clinical Practice Guidelines, Royal Children’s Hospital Melbourne (Australia)
Menorrhagia (PDF) Australian Doctor Magazine ‘How To Treat’ (2009)
Heavy Menstrual Bleeding NICE Guideline UK (2007, updated 2013)
Posted In: Gynaecology
Great summary of many important concepts. Big reminder to me to always do a BHCG even if they can’t be pregnant! Our registrars will really find this podcast a useful resource.
Thanks, Erin! Glad you’ve found it useful. 🙂
Hi, I appreciate this is Obs. for doctors, but as a rural midwife practising in a GP-Lead NSW country hospital (< 150 births / year) without 24/7 RMO cover, I've found you guys to be a fantastic resource, esp. the Gynaecological exam & early pregnancy bleeding; have got our present mid. student onto you too. Cheers!
Thank you, David! That’s great to hear.
Excellent podcast. A great resource. Would love to learn more about acute gynaecological and obstetrics emergencies. Much appreciated.