HEMORRAGIAS UTERINAS ANORMALES NO ORGANICAS

HEMORRAGIAS UTERINAS ANORMALES NO ORGANICAS

(especial para SIIC © Derechos reservados)
Descripción de las principales causas de sangrado uterino anormal y resumen de las nuevas directrices más relevantes para el diagnóstico y el tratamiento del sangrado uterino anormal no orgánico.
castelobranco9_81716.jpg Autor:
Camil Castelo-branco
Columnista Experto de SIIC

Institución:
Universidad de Barcelona


Artículos publicados por Camil Castelo-branco
Coautor
Jose Antonio Lejarcegui Fort* 
Medico, Universidad de Barcelona*
Recepción del artículo
4 de Enero, 2016
Aprobación
12 de Mayo, 2016
Primera edición
18 de Agosto, 2016
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
La hemorragia uterina anormal (HUA) es un trastorno ginecológico muy común, que puede deberse a varias causas. La Federación Internacional de Ginecología y Obstetricia (FIGO) publicó unas directrices en 2011 para establecer una nomenclatura que fuera universalmente aceptada y un sistema de clasificación. El sistema de clasificación de la FIGO (PALM-COEIN) se publicó para intentar estandarizar la terminología que se empleaba en el diagnóstico y en la investigación de las causas de sangrado uterino anormal. Según la nueva clasificación de la FIGO, en ausencia de una patología estructural, debe evitarse el empleo de la antes denominada "hemorragia uterina disfuncional" y los médicos deben indicar si la HUA está ocasionada por trastornos de la coagulación (HUA-C), trastorno de la ovulación (HUA-O), yatrogenia (HUA-I), disfunción primaria del endometrio (AUB-E) o causas no clasificables (HAU-N). Este sistema se basa en el patrón y la etiología de la hemorragia y ha sido adoptado por otras organizaciones. Además, el Colegio Americano de Obstetricia y Ginecología (ACOG) han actualizado recientemente las recomendaciones sobre la evaluación de sangrado uterino anormal, así como las indicaciones para la práctica de biopsias endometriales. En resumen, la HUA es una queja común que puede variar de leve a potencialmente mortal si no se reconoce y trata a tiempo. En esta revisión se describen las principales causas de sangrado uterino anormal y resumimos las nuevas directrices más relevantes para el diagnóstico y el tratamiento del sangrado uterino anormal no orgánico que comprende HUA-C, HUA-O, HUA-E, HUA-I y HUA-N.

Palabras clave
hemorragia uterina anormal, coagulopatías, disfunción ovulatoria, endometrio, yatrogenia, histeroscopia, histerectomia


Artículo completo

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Abstract
Abnormal uterine bleeding (AUB) is a very common gynecological condition, which may have several causes. A new classification system was recently proposed to standardize the terminology used to describe Abnormal Uterine Bleeding. The International Federation of Gynecology and Obstetrics (FIGO) published guidelines in 2011 to develop universally accepted nomenclature and a classification system. The FIGO classification system (PALM-COEIN) was published to standardize the terminology used in the diagnosis and in investigations into the causes of abnormal uterine bleeding. According to the new FIGO classification, in the absence of structural etiology, the former term "dysfunctional uterine bleeding" should be avoided and clinicians should specify whether AUB is caused by coagulation disorders (AUB-C), ovulation disorder (AUB-O), or endometrial primary dysfunction (AUB-E). This system is based on the pattern and etiology of bleeding and has been adopted by other organizations. Additionally, the American College of Obstetrics and Gynecology (ACOG) has recently updated the recommendations on evaluation of abnormal uterine bleeding and the indications for endometrial biopsies. In short, AUB is a common complaint that can vary from mild to life-threatening if not recognized and treated promptly. In this review, we describe the main causes of abnormal uterine bleeding and summarize the most relevant new guidelines for the diagnosis and management of non-organic abnormal uterine bleeding that comprises AUB-C, AUB-O, AUB-E, AUB-I and AUB-N due to other non-classifiable causes.

Key words
abnormal uterine bleeding, coagulation diseases, ovulatory dysfunction, endometrium, hysteroscopy, hysterectomy, iatrogen


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Medicina Reproductiva, Obstetricia y Ginecología
Relacionadas: Anatomía Patológica, Atención Primaria, Cirugía, Diagnóstico por Imágenes, Emergentología, Hematología, Medicina Familiar, Medicina Interna



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Camil Castelo-Branco, Universidad de Barcelona, 08036, Villarroel 170, Barcelona, España
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