Abnormal uterine bleeding causes briefly

Causes od AUB in a brief way

1. ABNORMAL UTERINE BLEEDING CAUSES B.NETHRA LAVANYA

2. INCIDENCE Common in extremes of reproductive age group 10-15% of women experience episodes of abnormal uterine bleeding in reproductive life 56%of adolescence experience abnormal menstural bleeding in first year after onset of puberty In premenopausal ,80%is due to anovulatory cycle

3. CAUSES GENERAL CAUSES PELVIC CAUSES ENDOCRINE IATROGENIC

4. General causes Blood dyscrasia Coagulation disorder Thrombocytopenic purpura Severe anaemia Von willebrand disease Thyroid dysfunction - hypothyroidism and hyperthyroidism Genital TB - menorrhagia and amenorrhea

5. PELVIC CAUSES UTERINE CAUSES- uterine fibroid Fibroid polyp Adenomyosis Endometrial hyperplasia Endometriosis

6. Ovarian causes Chocolate cyst Ovarian feminizing tumours Polycystic ovarian disease

7. OTHERS Salphingo-oophoritis Pelvic inflammatory disease Immediate puerperal and post abortal period uterine arteriovenous fistula Varicose vein in pelvis

8. IATROGENIC Progestrone administration Intrauterine contraceptive device

9. FIGO CLASSIFICATION P olyp A denomyosis L eiomyoma M alignancy and hyperplasia C oagulopathy O vulatory E ndometrial I atrogenic N ot yet classified

10. Uterine fibroid sub classification

11. AUB - PUBERTY CAUSES - hypothalamic pituitary ovarian dysfunction (50%) Blood dyscrasia Hypothyroidism PCOD Genital tuberculosis Liver disorder Feminizing ovarian tumour Adrenal hyperplasia

12. AUB IN REPRODUCTIVE AGE P olyp A denomyosis L eiomyoma M alignancy and hyperplasia

13. C oagulopathy O vulatory - 80%anovulatory 20%ovulatory (LOOP) others

14. E ndometrial - Abnormal secretion of prostaglandins PgE2,pgI2-vasodilator and anti platelet aggregators PgF2alpha ,thromboxane A2- vasoconstrictor and platelet aggregator tissue plasminogen activator endothelin Tubercular endometritis Chlamydia infection

15. I atrogenic- oral contraceptives IUCD(copper-T) Drugs - anticoagulant,phenothiazine,TCAs N ot yet classified AV malformation Varicose vein Myohyperplasia

16. METROPATHIA HAEMORRHAGICA specialised form of anovulatory AUB 40-45 years Continuous painless bleeding May or may not be preceded by 6-8weeks of amenorrhea

17. PATHOLOGY mild degree of myohyperplasia with uterine thickness of 25mm Endometrium - polypoidal Swiss cheese pattern -Cystic glandular hyperplasia and areas of necrosis Absence of secretory endometrium (absence of corkscrew glands ) Ovaries - cyst of size less than 5cm,absent corpus luteum

18. Thank you