irregular vaginal bleeding
Introduction
Introduction Irregular menstruation, that is, irregular vaginal bleeding with no obvious organic lesions in the internal and external genitalia. Vaginal bleeding is a common symptom of gynecology. Blood flows out of the vagina, but the bleeding may be in the vagina, cervix or uterus (more in the future), and the amount of bleeding may vary (small drops, many may be life-threatening), bleeding may vary (may be manifested as menstrual disorders, Irregular bleeding or contact bleeding after sexual intercourse, after gynecological examination). Vaginal bleeding must be taken seriously and should not be treated blindly.
Cause
Cause
Common symptoms in obstetrics and gynecology. The bleeding mainly comes from the uterine cavity, but also from the vulva, vagina, cervix, fallopian tubes and other parts.
First, bleeding related to endocrine:
Neonatal vaginal bleeding, bleeding associated with birth control pills, dysfunctional uterine bleeding, intermenstrual bleeding, endocrine disorders, such as menstrual disorders, postmenopausal uterine bleeding.
Second, pregnancy-related bleeding:
Threatened abortion, incomplete abortion, ectopic pregnancy, placenta previa, placental abruption, hydatidiform mole, choriocarcinoma, postpartum placental residue, etc.
Third, bleeding related to inflammation:
1, vulvar bleeding: seen in vulvar ulcers, urethra meat and so on.
2, vaginal bleeding: seen in vaginal ulcers, vaginitis, especially senile vaginitis, trichomonas vaginitis.
3, cervical bleeding: seen in acute and chronic cervicitis, cervical erosion, cervical ulcer, cervical polyps and so on.
4, uterine bleeding: seen in acute and chronic endometritis, chronic uterine myositis, acute and chronic pelvic inflammatory disease.
Fourth, tumor-related bleeding:
Uterine submucosal fibroids, cervical polyps, cervical cancer, endometrial cancer, fallopian tube cancer, etc. are characterized by irregular bleeding. Some ovarian tumors with endocrine function also often cause irregular vaginal bleeding. Postmenopausal bleeding should be especially vigilant against the tumor and should be carefully identified.
5. Bleeding related to contraception. The contraceptive ring is displaced, and the contraceptive is not taken correctly.
Sixth, bleeding related to trauma:
1. Bleeding caused by trauma.
2. What is the vaginal bleeding, bleeding after sexual intercourse: seen in the rupture of the hymen, vaginal wall or rupture of the posterior malleolus.
7. Bleeding associated with systemic diseases:
Found in liver disease, aplastic anemia, thrombocytopenic purpura leukemia and gynecological diseases with diffuse intravascular coagulation.
Examine
an examination
Related inspection
Gynecological routine examination of genital gynecological routine examination electronic colposcopy
Physical examination:
1, pay attention to the general condition, with or without anemia, bleeding tendency, lymphadenopathy and thyroid enlargement.
2, gynecological examination should carefully peep into the vagina and cervix, pay attention to the source of bleeding, double diagnosis and triple repair examination attention to the size of the uterus, hardness, smooth, with or without cervical pain, no lumps and tenderness on both sides of the uterus .
3, for unmarried patients, generally only do anal examination, but highly suspected that there may be tumors, should also be vaginal examination.
Laboratory inspection:
Blood routine examinations are routinely performed and coagulation tests are performed as necessary. Do some related special checks as needed.
1, ovarian function check:
(1) Determination of basal body temperature.
(2) Cervical mucus examination.
(3) endometrial pathology.
(4) Determination of pituitary and ovarian hormones.
2, pregnancy test: In addition to the determination of pregnancy, the diagnosis of hydatidiform mole and choriocarcinoma is also of great significance.
3. Cervical scraping cytology and cervical biopsy.
4. Diagnostic curettage.
Device inspection:
1, hysteroscopy.
2, laparoscopy.
3, colposcopy.
4. Ultrasound examination.
5, uterine fallopian tube iodine angiography.
6, pelvic CT examination.
Diagnosis
Differential diagnosis
Identification:
1. Menorrhagia: Menstrual rules, menstrual extension is greater than 7 days or excessive menstruation is greater than 80ml.
2. Excessive uterine bleeding: irregular period of menstrual period, excessive menstrual flow.
3. Irregular uterine bleeding: irregular cycle, prolonged menstruation and normal menstrual flow.
4. Month frequency: frequent menstruation, shortened cycle, less than 21 days. Irregular cycles, prolonged menstrual period and normal menstrual volume can be diagnosed.
