#FOAMed of the Week: Acute Menorrhagia via @bitsandbumps

Theres not a lot of #FOAMed Obs & Gynae out there in the blogosphere and even rarer still are #FOAM4GP. So I wanted to highlight this great resource from a GP Obstetrician and GP in Australia.

Authors Dr Penny Wilson and Dr Marlene Pearce produce podcasts on Obs and Gynae topics relevant to GP and EM.

Acute Menorrhagia
Bitsandbumps.org

Take Home Messages: (from bitsandbumps.org)

  • Acute Menorrhagia can be severe enough to create haemodynamic instability, assess for shock first.
  • Always perform a B-hCG to exclude pregnancy/miscarriage
  • Be sure to exclude a pelvic infection in your work-up
  • Consider inherited platelet dysfunction or coagulopathies in the adolescent with new menorrhagia
  • Consider endometrial hyperplasia or cancer in the woman over 35
  • Medical management may include NSAIDs, high-dose Progesterone, Tranexamic Acid
  • Surgical management may include Dilation & Curettage

References & Resources:

Adolescent Gynaecology – Menorrhagia Clinical Practice Guidelines, Royal Children’s Hospital Melbourne (Australia)

Menorrhagia (PDF) Australian Doctor Magazine ‘How To Treat’ (2009)

Heavy Menstrual Bleeding NICE Guideline UK (2007, updated 2013)