Whether the patient is an expecting mother, a post-menopausal woman, or a young adolescent, abnormal uterine bleeding is distressing for the patient, and often overwhelming for learners. Consider the ‘CAUSES OF bLOOD’ to better tailor your investigations and management.
Urogenital infections (PID, endometritis, salpingitis)
Ovarian cyst rupture
Location of placenta- placenta previa
Onset after delivery – Post-Partum Hemorrhage
Drugs – anticoagulants, antipsychotics, corticosteroids, hormone replacement
This post was copyedited by Dat Nguyen-Dinh (@dat_nd).
Reviewing with the Staff
The above mnemonic provides a reasonable, but not comprehensive, differential for abnormal uterine bleeding. This approach will be helpful to junior learners who want to ensure that they consider various causes of uterine bleeding. Advanced learners should have expanded differentials that are based on categorical clusters such the patient’s reproductive status (e.g. premenarchal, fertile, pregnant, postmenopausal) and/or categories of disease (e.g. reproductive tract disease, iatrogenic causes, systemic causes). Always remember that fertile females presenting to the emergency department with uterine bleeding should be considered pregnant until proven otherwise.