[Abnormal uterine bleedings in premenopausal women--diagnosis, treatment and prevention].
OBJECTIVE
To reveal the reasons for the haemorrhages such as pregnancy, iatrogenic factors, systemic diseases and evident genital tract pathology among the cases with abnormal uterine bleedings (AUB) in premenopausal women by the way of elimination as well as to establish the histomorphological status of the endometrium in the cases with dysfunctional uterine bleedings (DUB) aiming at defining the necessity and the type of treatment.


METHODS
The study covered 224 females with AUB. The following diagnostic methods were made use of: general and special history of the disease, inspection with valves and bimanual vaginal examination, vaginal ultrasonography, microbiological examination including diagnosis by using polymerase chain reaction (PCR), biopsy as well as abrasio probatoria separata.


RESULTS
A total of 96 patients (42,86 per cent of the cases) presented with AUB of true organic origin. In 9 of them (4,02 per cent) the histomorphological examinations proved either a carcinoma, or atypical morphological findings. DUB that were pathogenetically related with disturbed rhythm of ovarian steroidogenesis were diagnosed in the rest 128 patients (57, 14 per cent). These females were administered a monohormonal gestagen treatment as a prevention measure against eventual relapses as well.


CONCLUSIONS
A diagnostic distinguishing between the organic AUB and DUB in the premenopausal women with AUB is needed in order to sufficiently motivate both therapy and prevention.
Tsvetkov
K
K
Koleva
P
P
Petkova
U
U
Kis'ov
S
S
D000328:Adult; D003937:Diagnosis, Differential; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D008796:Metrorrhagia / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D008875:Middle Aged; D017697:Premenopause