Evaluation and Management of Heavy Vaginal Bleeding (Noncancerous)

Bridget Kelly; Emily Buttigieg

doi:10.1016/j.ogc.2022.02.021

Evaluation and Management of Heavy Vaginal Bleeding (Noncancerous)

Obstet Gynecol Clin North Am. 2022 Sep;49(3):591-606. doi: 10.1016/j.ogc.2022.02.021.

Authors

Bridget Kelly¹, Emily Buttigieg²

Affiliations

¹ University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; University of Wisconsin Obstetrics and Gynecology Clinic, 2402 Winnebago Street, Madison, WI 53704, USA.
² University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; University of Wisconsin Obstetrics and Gynecology Clinic, 20 South Park, Madison, WI 53715, USA. Electronic address: buttigieg@wisc.edu.

PMID: 36122987
DOI: 10.1016/j.ogc.2022.02.021

Abstract

Heavy vaginal bleeding is a common, life-altering condition affecting around 30% of women at some point in their reproductive lives. Initial evaluation should focus on hemodynamic stability. A thorough history including the patient's menstrual cycle and personal and family bleeding history should be obtained. Causes are stratified using the structural and nonstructural International Federation of Gynecology and Obstetrics classification system. Further consideration of the patient's age is essential because this can help to narrow the differential diagnosis. Work-up includes laboratory and imaging studies. Treatment approach includes acute stabilization and long-term treatment with medical and surgical modalities.

Keywords: Bleeding disorders; Heavy vaginal bleeding; Hormonal management; Hysteroscopy; Saline infusion sonohysterography.

Publication types

Review

MeSH terms

Diagnostic Imaging* / adverse effects
Female
Humans
Uterine Hemorrhage* / diagnosis
Uterine Hemorrhage* / etiology
Uterine Hemorrhage* / therapy