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Management protocol of puberty menorrhagia



 Management protocol of puberty menorrhagia

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🎀 Rest

🎀 Assurance

🎀 Haematinics
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Heavy bleeding continues
🔖
Admit for investigation
🔖
🎀Hb '/,
🎀 Peripheral blood film
🎀 platelet count
🎀 Clotting factors study
🎀 Ultrasonography of any Pelvic pathology
🎀 Thyroid profile in suspected cases
🎀 Blood transfusion, if required
🔖
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●
Primary DUB (Majority)
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Progestin therapy
(Medroxyprogesterone acetate 10-20 mg/day)
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1) Responsive (continue for 2-3 cycles)
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2) Unresponsive
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Conjugated oestrogen
20-40 IV every 6-8 hours
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Responsive
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Replace therapy with combined oral pills containing 50 micrograms of oestrogen

☁️ Unresponsive
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EUA and D + C
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Biopsy

🍓 Secondary to
🎯 Thyroid dysfunction
🎯 I T P
🎯 Leukaemia
🎯 von Willebrand's disease
🎯 Anatomical disorders
🎯 Pregnancy complications
|
Appropriate therapy

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