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Bleeding - Slide 6 Hormonal Problems • Anovulation •...

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Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 1 Abnormal Bleeding CAPT Mike Hughey, MC, USNR
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Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 2 Causes of Abnormal Bleeding 1. Pregnancy 2. Malignancy 3. Mechanical Problems 4. Hormonal Problems
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Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 3 Rule out Pregnancy Patients of childbearing age with unexplained abnormal bleeding should have a pregnancy test
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Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 4 Rule out Malignancy Cervical cancer (Pap) Vaginal cancer (Exam) Ovarian cancer (Exam) Uterine cancer (Endometrial biopsy, but under age 40, cancer very rare) Invasive Cancer of the Cervix
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Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 5 Mechanical Problems Fibroids Polyps
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Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000
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Unformatted text preview: Slide 6 Hormonal Problems • Anovulation • Ovulatory bleeding • Delayed menses Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 7 Clinical Management: Evaluation 1. Pregnancy Test 2. CBC (anemia) 3. Recent negative Pap smear 4. Pelvic exam Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 8 Clinical Management: Treatment BCPs Bedrest Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 9 Clinical Management: MEDEVAC If BCPs/Bedrest fail to resolve the bleeding and it is heavy, MEDEVAC is the next step. Surgery (D&C, hysteroscopy, etc.) will be needed. This is best undertaken in other than operational settings. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 10...
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