Uterine bleeding management

Stenchever MA, Droegemueller W, Herbst AL, Mishell DR. Abnormal uterine bleeding Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In Stenchever MA, ed. Comprehensive Gynecology. 4th ed. St. Louis Mosby 2001 1079-1097. 

SUI. Systemic estrogen therapy also carries numerous short- and long-term side effect risks (mastodynia, uterine bleeding, nausea, thromboembolism, cardiac and cerebrovascular ischemic events, and enhanced breast and endometrial cancer risks). If estrogens are to be used in SUI management, only locally-administered products should be used (Table 50-4). 

High-dose monophasic preparations are indicated for the management of dysfunctional uterine bleedings and when persistent breakthrough bleedings occur with low-dose oral contraceptives. The monophasic combinations are taken in a fixed dose combination once daily over 21 or 22 days, followed by an interval of 7 or 6 days. 

B. Indications and use Oxytocin is widely used for induction and augmentation of labor. It is also indicated for the control of postpartum uterine bleeding and as adjunctive therapy in the management... 

It is indicated in the management of moderate to severe vasomotor symptoms associated with menopause treatment of atrophic vaginitis, kraurosis vulvae, fanale hypogonadism, symptoms of female castration, and primary ovarian failure prevention and treatment of osteoporosis (conjugated estrogens) palliative treatment of metastatic breast or prostate cancer in selected women and men treatment of postpartum breast engorgement and abnormal uterine bleeding. 

A. DeCherney, M.L. Polan (1983). Hysteroscopic management of intrauterine lesions and intractable uterine bleeding. Obstetrics Gynecol., 61(3), 392-397. 

Routine management after delivery of the placenta, uterine atony, and hemorrhage Antepartum to initiate or improve uterine contractions postpartum to produce uterine contractions in third stage of labor, control of postpartum bleeding and hemorrhage... 

The selective transcatheter technique for embolization of uterine and/or internal iliac arteries in the management of intractable bleeding after delivery is safe and effective. In order to create the best hemodynamic and clinical conditions for this therapy, a strong multidisciplinary collaboration is essential to optimize clinical outcomes. 

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