17 ys, severe menorrhagia--treatment

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17 ys, severe menorrhagia--treatment

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14 Posts

lucci
Forum Senior

Topics: 35
Posts: 52

10/12/06 - 04:32 PM

F. 17 years with severe menorrhagia. Investigation reveals Hb 8.0 g\dL. Pulse 110 . BP. 80\60. BhCG (-ve). Initial management. ?

a. -IV Oxytocin

b. -Blood transfusion

c. -D&C

d. -IM. Medroxyprogesteron

e. -IV. Estrogen

zhoufg
Forum Senior

Topics: 15
Posts: 112

10/13/06 - 11:02 AM

yasmeen
Forum Guru

Topics: 67
Posts: 936

10/13/06 - 02:41 PM

HighHopes
Forum Senior

Topics: 12
Posts: 165

10/18/06 - 03:25 AM

Initial managment - Blood transfusion

p00nam
Forum Newbie

Topics: 4
Posts: 13

10/18/06 - 03:09 PM

i remember reading Iv estrogen for severe menorrhagia

p00nam
Forum Newbie

Topics: 4
Posts: 13

10/24/06 - 07:01 PM

yes the answer is IV conjugated estrogen.

After menarche and before menopause heavy bleeding is usually due to anovulation and is treated with estrogen

ashfaque
Forum Newbie

Topics: 0
Posts: 142

10/30/06 - 06:19 PM

pts has features of shock hypotention tachycardia so blood transfusion is definitely the first step of management

dharjma
Forum Senior

Topics: 11
Posts: 182

10/31/06 - 08:14 AM

Agree with transfusion.

causes in the reproductive age group can be Pregnancy (but hCG negative) anatomical lesions or DUB / PCO. either way to find a diagnosis further investigations are neccessary eg USS, pelvic exam, endometrial sampling hysteroscopy. but for management in this patient it should be transfusion? Hb is 8 with tachy and low BP

dharjma
Forum Senior

Topics: 11
Posts: 182

10/31/06 - 08:15 AM

Agree with transfusion.

causes in the reproductive age group can be Pregnancy (but hCG negative) anatomical lesions or DUB / PCO. either way to find a diagnosis further investigations are necessary eg USS, pelvic exam, endometrial sampling hysteroscopy. but for management in this patient it should be transfusion? Hb is 8 with tachy and low BP

goodyear
Forum Guru

Topics: 16
Posts: 409

11/14/06 - 09:39 PM

#10

Menorrhagia is excessive menstrual bleeding ..leads to Fe def. Anemia... For this pt. treat w/ Fe, prostaglandin inhibitors, progesterone , OCP. Of the choices above...
medroxyprogesterone..D

webjeee
Forum Guru

Topics: 99
Posts: 349

05/16/07 - 08:32 PM

#11

so, guys, what's the answer?

NE
Forum Guru
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Topics: 53
Posts: 504

05/17/07 - 07:49 AM

#12

estrogen is the treatment for excessive menstrual bleeding. Guys she is 17 years- no cardiac pathology or what so ever! Why we have to give her blood transfusion FIRST?Why we dont't try to normal saline ( because she is hypovolemic), stop the bleeding and see what is her status after?

Justice
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Topics: 106
Posts: 2,082

05/17/07 - 08:13 AM

#13

e. -IV. Estrogen
Stops unovulatory/dyshormonal bleeding within minutes... Blood transfusion will help to increase Hb only (you won't give the Pt a litter of blood to stabilize PB, right?), and even this volume will take 2-3 to administer... So, immediate action is (e) -IV. Estrogen

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Justice
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05/17/07 - 08:15 AM

#14

NE wrote:
estrogen is the treatment for excessive menstrual bleeding. Guys she is 17 years- no cardiac pathology or what so ever! Why we have to give her blood transfusion FIRST?Why we dont't try to normal saline ( because she is hypovolemic), stop the bleeding and see what is her status after?

Agree... No need for blood transfusion at all. This is not the action of choice to improve/stabilize the hemodynamics... IV saline should be given, but it is not on the list...

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