Bulky Uterus With Hyperplastic Endometrium.

A 47 yrs/ F. Pt. H/O. PV. Bleeding from 2 yrs ago. Then treatment taken pt. Was stable no any complaints . But. Return PV bleeding after 1 yr. With Anemia. C/O. Abdominal pain/ weakness.. BP. 110 /70 mm of Hg. Pulse. 78 /m. Tem. 99°F. CNS. Consciousness. P/A. Distended. Kindly suggest management.

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? UTERINE PATHOLOGY WITH .. DUB .. NEED'S .. HORMONAL STUDY.. GYNECOLOGICAL EXAMINATION WITH EXPERTS OPINION..

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47/F..case of dysfunctional uterine bleeding. -Reports:bulky uterus with E-12.5mm ECG: WNL. . with normal INR. -Ptn seems to be in perimenopause state. -There is no anaemia as said above. -Advise: -Hysteroscopy with endometrial biopsy test. -progesterone preparations cyclic therapy. -sos plan for hysterectomy. -Refernce to gynaecologist.

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Go for endometrial biopsy with Pap smear. Hormonal assessment to be done. Recommend hysteroscopy to know the cause of bulky uterus ( 7.3 cm) is something that you cannot ignore.

Per vaginal examination Endometrial biopsy Pap smear Start on cyclical progesterone Crina ncr 10 mg bd from day 5 to 25 If biopsy is normal advice to continue medical management or advise LNG IUD insertion

Go for PAP smear, CA 125, endometrial biopsy Per vaginal examination Start norgest 10 mg 21 days xod And antibiotic therapy

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