ABNORMAL

UTERINE
BLEEDING
Introduction:
■ Abnormal uterine bleeding is a condition in
which a woman bleeds from her uterus at an
unexpected time or in a way that is unusual
for her.
■ For example: bleeding between periods,a
period that is heavier longer-lasting than
normal
Definition:
■ Abnormal uterine bleeding is bleeding from
the uterus that is longer than usual or that
occurs at an irregular time.Bleeding may be
heavier or lighter than usual and occur often
or randomly.
Types:
1. Menorrhagia
2. Metrorrhagia
1.Menorrhagia:
■ Menorrhagia is the most common type of
abnormal uterine bleeding characterized by
heavy and prolonged menstrual bleeding.
■ A blood loss of greater than 80 ml or lasting
longer than 7 days constitutes menorrhagia
(also called hypermenorrhea).
Causes:
■ In some cases, the cause pf heavy menstrual
bleeding is unknown, but a number of
conditions may cause menorrhagia
 This include;
■ Hormonal imbalance
■ Dysfunction of the ovaries
■ Uterus fibroids
■ Adenomyosis
■ Intrauterine device(IUD)
■ Pregnancy complications
■ Cancer
■ Inherited bleeding disorder
Clinical manifestations:
■ The signs and sympots of menorrhagia may
include:-
■ Menstrual flow that soaks through one or
more sanitary pads or tampones every hour
for several consecutive hours.
Continue……
■ The need to use double sanitary protection
to control menstrual flow.
■ Menstrual periods lasting longer than 7
days.
■ Tiredness,fatigue or shortness of
breath(symptoms of anemia).
Diagnostic evaluation:
■ Pelvic and rectal examination
■ Pap smear
■ Blood tests
■ Sonohysterogram
■ Hysteroscopy
Management:
■ Iron supplements
■ Nonsteroidal anti-inflammatory drugs
■ Oral contraceptives
■ Oral progesterone
■ Hormonal IUD
Treatment options include:

Dilation and ■ Operative

curettage: hysteroscopy:
■ Endometrial ■ Hysterectomy:
ablation:
Metrorrhagia
■ Metrorrhagia is the type of abnormal uterine
bleeding diagnosed when menstruation occurs at
irregular intervals.
 Causes
■ Hormone imbalance
■ Endometrosis
■ Uterine fibroids or cancer of the uterus
■ Intrauterine device
■ Sexualy transmitted disease
Clinical manifestations:
■ Heavy bleeding between her regular
menstrual period
■ Abdominal pain with bleeding
■ Miscarriage or a tubal pregnancy
■ Non cancerous growth of uterine tissue
outside the uterus
Diagnostic evaluation:
■ Doctor will take complete medical history
■ Physical examination
■ Blood tests
■ Ultrasound scan
■ Sonohysterogram
Management:
■ The treatment will depends upon the cause:
■ Hormone replace therapy
■ Antiboitics
■ Radiation or chemotherapy
Nursing management:
■ Encourage patient to comply the medication
to reduce discomfort and pain
■ Explain importance of iron rich food to
supplement iron
■ Assist and teach the patient pain relieving
techniques in managing pain
Nursing assessment:
■ Assess the health condition of the patient
■ Identify patients perception of threat
represented by the situation
■ Encourage the patient to use of relaxation
techniques.
Nursing diagnosis:
■ Pain related to abnormal uterine bleeding
■ Fear related to abnormal health status
■ Risk for deficient fluid volume related to
hyperthermia
■ Fatigue related to blood loss
■ Sexual dysfunction related to altered body
function associated with uterine bleeding
Nursing interventions:
■ Monitor pain characteristics
■ Teach to use of non-pharamacologic
techniques
■ Identify patients perception of threat
represented by the situation
■ Encourage patient to acknowledge and
express fears
Continue…..
■ Monitor and document vital signs
■ Monitor serum electrolytes
■ Teach sexual response cycle
■ Teach about sexual dysfunction
■ Encourage positive self-talk,body
image,exercise to increase self esteem.
Assignment:
1. Define abnormal uterine bleeding? Write
about its types.