#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.

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)