Sangrado que dura más de 8 días. • Ciclos menstruales que duran más de 38 días o menos de 24 días. Sangrado uterino anormal. The American College of. PDF Download PDF. Members Only. 3. Sangrado uterino anormal sexuales • Sangrado intenso durante el período menstrual — Sangrado que empapa uno o . O sangramento vaginal anormal pode ser relacionado à menstruação (por exemplo, menorragia) ou não relacionado a ela (por exemplo, sangramento.
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O sangramento uterino anormal é uma afecção frequente que pode afetar negativa- mente aspectos físicos gramento uterino anormal, tanto na fase aguda quanto na crônica. A apresentação edingpdf. O sangramento uterino anormal é uma afecção frequente que pode afetar negativamente aspectos físicos, emocionais, sexuais e profissionais. Tratamento do sangramento uterino anormal: uma análise sob a perspectiva dos custos no Sistema Único de Saúde e da medicina suplementarTreatment of.
After controlling bleeding and maintaining the therapy at smaller doses for a time similar to that of a menstrual cycle, discuss the need to maintain control of the cycle with medication for three consecutive months, and proceed with the etiological investigation. Other options suggested in the literature are the use of a GnRH antagonist associated with an aromatase inhibitor or a GnRH antagonist to prevent initial stimulation by the release of estrogen.
Intrauterine tamponade can also be considered, using the Foley probe with an inflated balloon with 3—10 mL. The use of antifibrinolytic substances, such as tranexamic acid, may greatly aid in the control of bulky bleeding, usually used adjunctively and associated with other alternatives. If there is acute bleeding with impairment of the patient's general condition, her hemodynamic stabilization should be prioritized, followed by the immediate start of treatment, whether clinical or surgical, even if the bleeding cause is not completely established, ruling out only vaginal and cervical lesions and pregnancy.
In cases of AUB without systemic repercussion, identifying the cause of the bleeding is mandatory before the start of treatment. Considering the main diagnosis of this clinical manifestation, pregnancy and the presence of vaginal and cervical lesions should be excluded by physical examination. Afterwards, an evaluation of the uterine cavity by imaging exams should be performed to identify the presence of organic lesions in the endometrial cavity. In the presence of endometrial lesions such as endometrial polyps and submucosal leiomyomas, surgical treatment may be indicated.
The only definitive treatment for adenomyosis is hysterectomy, but the control of symptoms by medical drug treatment is not rare. In cases of intramural myomas, with an increase of uterine bleeding, the first therapeutic option is pharmacological, and there may be an improvement in the bleeding in some cases, avoiding an unnecessary surgical procedure. If there is no response to the clinical treatment, surgical treatment should be recommended.
The surgical access route and type of surgery will depend on the number, location and size of the myoma, and the patient's desire for pregnancy. If there is an AUB of non-structural cause, clinical treatment is always the first option.
The main therapeutic options are described in Table 2 If there is no response to the clinical treatment in bleedings of non-structural cause, there are also surgical therapeutic options, such as endometrial ablation by thermal balloon or hysteroscopy , or even hysterectomy.
The various therapeutic options available for the treatment of AUB should be used rationally to allow their control, leaving surgical procedures for specific situations and avoiding unnecessary surgical procedures.
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Conflicts of Interest The authors have no conflicts of interest to declare. This is an open-access article distributed under the terms of the Creative Commons Attribution License Av. The low frequency of severe adverse effects encourages the administration of the vaccine in the population at risk. Keywords: Papillomavirus vaccines, Adverse effects, Adolescent, Meta-analysis, Safety Introduction Cervical cancer is the second most common type of cancer that affects women worldwide, with an incidence of approximately , cases and , deaths each year.
The infection may be transient and not clinically detectable, but can also cause genital warts and a variety of pre-malignant and malignant anogenital lesions in both genders.
Studies indicate a very similar safety profile for severe and mild adverse effects for each one of the vaccines. Concerns about the adverse effects is considered a barrier to vaccination and one of the reasons for low adherence to the recommendations for human papillomavirus quadrivalent types 6, 11, 16, 18 recombinant vaccine administration. Several debates have been carried out with persistent controversies about the advantages and disadvantages of its use.
Therefore, the knowledge of the possible local and systemic adverse effects can subsidize adherence strategies and guide health care actions for the population at risk.
Therefore, the objective of this study is to identify and quantify the adverse effects associated with the administration of the human papillomavirus quadrivalent types 6, 11, 16, 18 recombinant vaccine, as a tool to determine the safety of its use in adolescents. The study design filter "RCTs" was added to the obtained results. Subsequently, the identified articles were analyzed by reading the titles and abstracts.
All other studies were read in full, analyzed by five independent investigators and classified according to the Jadad score.