Onm-1: Imaging in Abnormal Uterine Bleeding

Abnormal uterine bleeding is any bleeding from the uterus other than normal monthly period. Having extremely heavy bleeding during period can also be considered abnormal uterine bleeding. Dysfunctional uterine bleeding (DUB) is heavy or irregular menstrual bleeding that is not caused by an underlying anatomical abnormality, such as a fibroid, lesion, or tumor. DUB is the most common type of abnormal uterine bleeding. Abnormal uterine bleeding acounts for up to 20% of gynecologic visits.In AUB any pregnancy event must be excluded. If pregnancyhas been excluded: the most likely cause of bleeding is dysfunctional anovulatory bleeding (hormone imbalance). As women get older, organic pathology such as polyp,submocus myomas, hyperplasiaand even frank carcinoma become more likely. In postmenopausal women on no hormonal replacement therapy any bleeding is considered cancer until proven otherwise,although the incidence of malignancy in such patients ranges from 2 to10%, depending on risk factors. In AUB differential diagnosis: first pregnancy should be considered. If beta hCG is negative, other cuases are: structural, hormonal, malignancy and bleeding disorders. The imaging workup in detection of pelvic organ utilizes several techniques: Abdominal Sonography, Vaginal Sonography, 3-D Sonography, Hysterosonography, Hysterosalpingography, MRI and CT scan.