Manejo del sangrado uterino anormal agudo en pacientes entre 15 a 45 años de edad
Palabras clave:
sangrado uterino anormal, manejo agudo, anticonceptivos orales combinados, medroxiprogesterona
Resumen
Objetivo: Evaluar la respuesta de la hemorragia uterina anormal en fase aguda a la terapia con anticonceptivos hormonales orales y acetato de medroxiprogesterona. Material y métodos :Estudio prospectivo, observacional, longitudinal y descriptivo llevado a cabo en un centro de atención terciaria de la ciudad de Villahermosa, Tabasco entre diciembre de 2023 y agosto de 2024. La fuente de información fueron los expedientes clínicos. Criterios de inclusión: Mujeres de 15 a 45 años de edad con hemorragia uterina anormal. Criterios de exclusión: Pacientes que no deseen tratamiento hormonal, pacientes que abandonaron el tratamiento, pacientes que se perdió el expediente. Resultados : Se incluyeron 50 pacientes divididas en dos grupos: grupo A 28 pacientes tratadas con Hormonales Orales Combinados y grupo B 22 pacientes tratadas con acetato de medroxiprogesterona. La evolución del sangrado en el grupo A fue de 1 a 60 meses con promedio de 15 y en el grupo B de 1 a 50 meses con promedio de 12.5. Obteniendo valor de p= 0.5. La respuesta al tratamiento en el grupo A fue de 2 a 15 días con promedio de 9.3 y en el grupo B de 2 a 15 días, con promedio de 8.6. Obteniendo valor de P = 0.5. Conclusiones: Los dos esquemas de manejo tienen la misma efectividad para el control de la hemorragia uterina anormal en fase aguda.
Descargas
La descarga de datos todavía no está disponible.
Citas
1. Khafaga A, Goldstein SR. Abnormal Uterine Bleeding. Obstet Gynecol Clin North Am. 2019 Dec; 46(4):595-605. DOI: https://doi.org/10.1016/j.ogc.2019.07.001
2. Hapangama DK, et al. Pathophysiology of heavy menstrual bleeding. Womens Health 2016; 12 (1):3-13. DOI: https://doi.org/10.2217/whe.15.81
3. Tsolova AO, Aguilar RM, Maybin JA, Critchley HOD. Pre-clinical models to study abnormal uterine bleeding (AUB). EBioMedicine. 2022 Oct; 84:104238. DOI: https://doi.org/10.1016/j.ebiom.2022.104238
4. Critchley HOD, Maybin JA, Armstrong GM, Williams ARW. Physiology of the Endometrium and Regulation of Menstruation. Physiol Rev. 2020 Jul 1; 100(3):1149-1179. DOI: https://doi.org/10.1152/physrev.00031.2019
5. Wouk N, Helton M. Abnormal Uterine Bleeding in Premenopausal Women. Am Fam Physician. 2019 Apr 1; 99(7):435-443.
https://www.aafp.org/pubs/afp/issues/2019/0401/p435.html
6. Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018 Dec; 143(3):393-408. DOI: https://doi.org/10.1002/ijgo.12666
7. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management (NICE guideline NG88). 2018. https://www.nice.org.uk/guidance/ng88
8. Marnach ML, Laughlin-Tommaso SK. Evaluation and Management of Abnormal Uterine Bleeding. Mayo Clin Proc. 2019 Feb; 94(2):326-335. DOI: https://doi.org/10.1016/j.mayocp.2018.12.012
9. Maybin JA, Critchley HO. Menstrual physiology: implications for endometrial pathology and beyond. Hum Reprod Update. 2015 Nov-Dec; 21(6):748-61. DOI: https://doi.org/10.1093/humupd/dmv038
10. Corbacioglu, A. (2011). The Management of Dysfunctional Uterine Bleeding. InTech. DOI: 10.5772/22764
11. Bradley LD, et al. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol 2016; 214(1):31-44. DOI: https://doi.org/10.1016/j.ajog.2015.07.044
12. Smith RP. The physiology of menstruation. In: Dysmenorrhea and Menorrhagia. Springer, Cham 2018:1-17. DOI: https://doi.org/10.1007/978-3-319-71964-1_1
13. Busby G. Menstrual dysfunction. Obstet Gynaecol Reprod Med 2019; 29(11):320-325. DOI: https://doi.org/10.1016/j.ogrm.2019.08.004
14. Bacon JL. Abnormal Uterine Bleeding: Current Classification and Clinical Management. Obstet Gynecol Clin North Am. 2017; 44 (2): 179-93. DOI: https://doi.org/10.1016/j.ogc.2017.02.012
15. Munro MG. Practical aspects of the two FIGO systems for management of abnormal uterine bleeding in the reproductive years. Best Pract Res Clin Obstet Gynaecol. 2017 Apr; 40:3-22. DOI: https://doi.org/10.1016/j.bpobgyn.2016.09.011
16. Sepúlveda-Agudelo J, Sepúlveda-Sanguino AJ. Sangrado uterino anormal y PALM COEIN. Ginecol Obstet Mex. 2020 enero; 88(1):59-67. DOI: https://doi.org/10.24245/gom.v88i1.3467
17. Kim KR, Peng R, Ro JY, Robboy SJ. A diagnostically useful histopathologic feature of endometrial polyp: the long axis of endometrial glands arranged parallel to surface epithelium. Am J Surg Pathol. 2004 Aug; 28(8):1057-62. DOI: https://doi.org/10.1097/01.pas.0000128659.73944.f3
18. Salem S, Won H, Nesbitt-Hawes E, Campbell N, Abbott J. Diagnosis and management of endometrial polyps: a critical review of the literature. J Minim Invasive Gynecol. 2011 Sep-Oct; 18(5):569-81. DOI: https://doi.org/10.1016/j.jmig.2011.05.018
19. Cunningham RK, Horrow MM, Smith RJ, Springer J. Adenomyosis: A Sonographic Diagnosis. Radiographics. 2018 Sep-Oct; 38(5):1576-1589. DOI: https://doi.org/10.1148/rg.2018180080
20. Sinai Talaulikar V. Medical therapy for fibroids: An overview. Best Pract Res Clin Obstet Gynaecol. 2018 Jan; 46:48-56. DOI: https://doi.org/10.1016/j.bpobgyn.2017.09.007
21. Lasmar RB, Lasmar BP. The role of leiomyomas in the genesis of abnormal uterine bleeding (AUB). Best Pract Res Clin Obstet Gynaecol. 2017 Apr; 40:82-88. DOI: https://doi.org/10.1016/j.bpobgyn.2016.09.008
22. Sobczuk K, Sobczuk A. New classification system of endometrial hyperplasia WHO 2014 and its clinical implications. Prz Menopauzalny. 2017 Sep; 16(3):107-111. DOI: https://doi.org/10.5114%2Fpm.2017.70589
23. Practice Bulletin No. 149: Endometrial cancer. Obstet Gynecol. 2015 Apr; 125(4):1006-1026. DOI: https://doi.org/10.1097/01.aog.0000462977.61229.de
24. van Hanegem N, Prins MM, Bongers MY, Opmeer BC, Sahota DS, Mol BW, Timmermans A. The accuracy of endometrial sampling in women with postmenopausal bleeding: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2016 Feb; 197:147-55. DOI: https://doi.org/10.1016/j.ejogrb.2015.12.008
25. James AH, Kouides PA, Abdul-Kadir R, Edlund M, Federici AB, Halimeh S, Kamphuisen PW, Konkle BA, Martínez-Perez O, McLintock C, Peyvandi F, Winikoff R. Von Willebrand disease and other bleeding disorders in women: consensus on diagnosis and management from an international expert panel. Am J Obstet Gynecol. 2009 Jul; 201(1):12.e1-8. DOI: https://doi.org/10.1016/j.ajog.2009.04.024
26. Lukes AS, Moore KA, Muse KN, Gersten JK, Hecht BR, Edlund M, Richter HE, Eder SE, Attia GR, Patrick DL, Rubin A, Shangold GA. Tranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial. Obstet Gynecol. 2010 Oct; 116(4):865-875. DOI: https://doi.org/10.1097/aog.0b013e3181f20177
27. Hale GE, Hughes CL, Burger HG, Robertson DM, Fraser IS. Atypical estradiol secretion and ovulation patterns caused by luteal out-of-phase (LOOP) events underlying irregular ovulatory menstrual cycles in the menopausal transition. Menopause. 2009 Jan-Feb; 16(1):50-9. DOI: https://doi.org/10.1097/gme.0b013e31817ee0c2
28. Achanna KS, Nanda J. Evaluation and management of abnormal uterine bleeding. Med J Malaysia. 2022 May; 77(3):374-383. PMID: 35638495.
29. Fernández Parra J, Álvarez López C, Martínez Morales S. Actualización del sangrado menstrual abundante. Prog Obstet Ginecol 2020; 63(2):68-80. https://dialnet.unirioja.es/servlet/articulo?codigo=7766329#
30. Magnay JL, O'Brien S, Gerlinger C, Seitz C. A systematic review of methods to measure menstrual blood loss. BMC Womens Health. 2018 Aug 22; 18(1):142. DOI: https://doi.org/10.1186/s12905-018-0627-8
31. Delamater L, Santoro N. Management of the Perimenopause. Clin Obstet Gynecol. 2018 Sep; 61(3):419-432. DOI: https://doi.org/10.1097%2FGRF.0000000000000389
32. Committee on Practice Bulletins—Gynecology. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012 Jul; 120(1):197-206. DOI: https://doi.org/10.1097/aog.0b013e318262e320
33. Kouides PA, Conard J, Peyvandi F, Lukes A, Kadir R. Hemostasis and menstruation: appropriate investigation for underlying disorders of hemostasis in women with excessive menstrual bleeding. Fertil Steril. 2005 Nov; 84(5):1345-51. DOI: https://doi.org/10.1016/j.fertnstert.2005.05.035
34. Goldstein SR. Modern evaluation of the endometrium. Obstet Gynecol. 2010 Jul; 116(1):168-176. DOI: https://doi.org/10.1097/aog.0b013e3181dfd557
35. MacGregor R, Jain V, Hillman S, Lumsden MA. Investigating abnormal uterine bleeding in reproductive aged women. BMJ. 2022 Sep 16; 378:e070906. DOI: https://doi.org/10.1136/bmj-2022-070906
36. Chacón Campos, N., Pizarro Madrigal, M., & Guerrero Hines, C. (2022). Sangrado uterino anormal en etapa reproductiva. Revista Médica Sinergia, 7(5), e808. DOI: https://doi.org/10.31434/rms.v7i5.808
37. Hernández-Marín I, Villegas-Rodríguez CM, Celis-González C. Anticonceptivos hormonales en pacientes con sangrado uterino disfuncional. Ginecol Obstet Mex. 2020; 88(Supl 1):S163-S177. DOI: https://doi.org/10.24245/gom.v88iSupl1.3855
38. Bradley LD, Gueye NA. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol. 2016 Jan; 214(1):31-44. DOI: https://doi.org/10.1016/j.ajog.2015.07.044
39. Sriprasert I, Pakrashi T, Kimble T, Archer DF. Heavy menstrual bleeding diagnosis and medical management. Contracept Reprod Med. 2017 Jul 24; 2:20. DOI: https://doi.org/10.1186/s40834-017-0047-4
40. Gil JF. Conocimientos, actitudes frente a la aceptación a efectos secundarios del acetato de medroxiprogesterona en usuarias del Servicio de Planificación Familiar del Hospital Nacional Arzobispo Loayza, Lima-Perú, 2005. Rev. Perú. epidemiol. 2010; 14 (3). http://www.redalyc.org/articulo.oa?id=203119676008
41. Olvera-Maldonado AJ, Martínez-Uribe A, Rendón-Macías ME, et al. Tratamiento de los miomas uterinos con medroxiprogesterona en pacientes perimenopáusicas. Ginecol Obstet Mex. 2015; 83(01):41-47.
42. Bender RA. Medroxyprogesterone Acetate for Abnormal Uterine Bleeding Due to Ovulatory Dysfunction: The Effect of 2 Different-Duration Regimens. Med Sci Monit. 2022 Jun 24; 28:e936727. DOI: https://doi.org/10.12659%2FMSM.936727
43. Lethaby A, Wise MR, Weterings MA, Bofill Rodríguez M, Brown J. Combined hormonal contraceptives for heavy menstrual bleeding. Cochrane Database Syst Rev. 2019 Feb 11; 2(2):CD000154. DOI: https://doi.org/10.1002/14651858.cd000154.pub3
44. Abdel-Aleem H, d'Arcangues C, Vogelsong KM, Gaffield ML, Gülmezoglu AM. Treatment of vaginal bleeding irregularities induced by progestin only contraceptives. Cochrane Database Syst Rev. 2013 Jul 2;(7):CD003449. DOI: https://doi.org/10.1002/14651858.cd003449.pub4
45. Ramalho I, Leite H, Águas F. Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach. Acta Med Port. 2021 Mar 31; 34(4):291-297. DOI: https://doi.org/10.20344/amp.12829
46. Fonseca-Velázquez SJ, López-Martínez R, Sosa-Bustamante GP, González AP, Paque-Bautista C, Luna-Anguiano JLF, Peralta-Cortázar C. Índice de masa corporal e índice triponderal en sangrado uterino anormal [Body mass index and triponderal index in abnormal uterine bleed]. Rev Med Inst Mex Seguro Soc. 2023 Sep 18;61(Suppl 2):S135-S140. Spanish. PMID: 38011538; PMCID: PMC10764109.
47. Matteson KA, Boardman LA, Munro MG, Clark MA. "Abnormal uterine bleeding: a review of patient-based outcome measures." Fertil Steril. 2019;112(4):684-689. DOI: https://doi.org/10.1016/j.fertnstert.2008.04.023
48. Lethaby A, Hussain M, Rishworth JR, Rees MC. "Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation." Cochrane Database Syst Rev. 2019;8(8). DOI: https://doi.org/10.1002%2F14651858.CD013180.pub2
2. Hapangama DK, et al. Pathophysiology of heavy menstrual bleeding. Womens Health 2016; 12 (1):3-13. DOI: https://doi.org/10.2217/whe.15.81
3. Tsolova AO, Aguilar RM, Maybin JA, Critchley HOD. Pre-clinical models to study abnormal uterine bleeding (AUB). EBioMedicine. 2022 Oct; 84:104238. DOI: https://doi.org/10.1016/j.ebiom.2022.104238
4. Critchley HOD, Maybin JA, Armstrong GM, Williams ARW. Physiology of the Endometrium and Regulation of Menstruation. Physiol Rev. 2020 Jul 1; 100(3):1149-1179. DOI: https://doi.org/10.1152/physrev.00031.2019
5. Wouk N, Helton M. Abnormal Uterine Bleeding in Premenopausal Women. Am Fam Physician. 2019 Apr 1; 99(7):435-443.
https://www.aafp.org/pubs/afp/issues/2019/0401/p435.html
6. Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018 Dec; 143(3):393-408. DOI: https://doi.org/10.1002/ijgo.12666
7. National Institute for Health and Care Excellence. Heavy menstrual bleeding: assessment and management (NICE guideline NG88). 2018. https://www.nice.org.uk/guidance/ng88
8. Marnach ML, Laughlin-Tommaso SK. Evaluation and Management of Abnormal Uterine Bleeding. Mayo Clin Proc. 2019 Feb; 94(2):326-335. DOI: https://doi.org/10.1016/j.mayocp.2018.12.012
9. Maybin JA, Critchley HO. Menstrual physiology: implications for endometrial pathology and beyond. Hum Reprod Update. 2015 Nov-Dec; 21(6):748-61. DOI: https://doi.org/10.1093/humupd/dmv038
10. Corbacioglu, A. (2011). The Management of Dysfunctional Uterine Bleeding. InTech. DOI: 10.5772/22764
11. Bradley LD, et al. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol 2016; 214(1):31-44. DOI: https://doi.org/10.1016/j.ajog.2015.07.044
12. Smith RP. The physiology of menstruation. In: Dysmenorrhea and Menorrhagia. Springer, Cham 2018:1-17. DOI: https://doi.org/10.1007/978-3-319-71964-1_1
13. Busby G. Menstrual dysfunction. Obstet Gynaecol Reprod Med 2019; 29(11):320-325. DOI: https://doi.org/10.1016/j.ogrm.2019.08.004
14. Bacon JL. Abnormal Uterine Bleeding: Current Classification and Clinical Management. Obstet Gynecol Clin North Am. 2017; 44 (2): 179-93. DOI: https://doi.org/10.1016/j.ogc.2017.02.012
15. Munro MG. Practical aspects of the two FIGO systems for management of abnormal uterine bleeding in the reproductive years. Best Pract Res Clin Obstet Gynaecol. 2017 Apr; 40:3-22. DOI: https://doi.org/10.1016/j.bpobgyn.2016.09.011
16. Sepúlveda-Agudelo J, Sepúlveda-Sanguino AJ. Sangrado uterino anormal y PALM COEIN. Ginecol Obstet Mex. 2020 enero; 88(1):59-67. DOI: https://doi.org/10.24245/gom.v88i1.3467
17. Kim KR, Peng R, Ro JY, Robboy SJ. A diagnostically useful histopathologic feature of endometrial polyp: the long axis of endometrial glands arranged parallel to surface epithelium. Am J Surg Pathol. 2004 Aug; 28(8):1057-62. DOI: https://doi.org/10.1097/01.pas.0000128659.73944.f3
18. Salem S, Won H, Nesbitt-Hawes E, Campbell N, Abbott J. Diagnosis and management of endometrial polyps: a critical review of the literature. J Minim Invasive Gynecol. 2011 Sep-Oct; 18(5):569-81. DOI: https://doi.org/10.1016/j.jmig.2011.05.018
19. Cunningham RK, Horrow MM, Smith RJ, Springer J. Adenomyosis: A Sonographic Diagnosis. Radiographics. 2018 Sep-Oct; 38(5):1576-1589. DOI: https://doi.org/10.1148/rg.2018180080
20. Sinai Talaulikar V. Medical therapy for fibroids: An overview. Best Pract Res Clin Obstet Gynaecol. 2018 Jan; 46:48-56. DOI: https://doi.org/10.1016/j.bpobgyn.2017.09.007
21. Lasmar RB, Lasmar BP. The role of leiomyomas in the genesis of abnormal uterine bleeding (AUB). Best Pract Res Clin Obstet Gynaecol. 2017 Apr; 40:82-88. DOI: https://doi.org/10.1016/j.bpobgyn.2016.09.008
22. Sobczuk K, Sobczuk A. New classification system of endometrial hyperplasia WHO 2014 and its clinical implications. Prz Menopauzalny. 2017 Sep; 16(3):107-111. DOI: https://doi.org/10.5114%2Fpm.2017.70589
23. Practice Bulletin No. 149: Endometrial cancer. Obstet Gynecol. 2015 Apr; 125(4):1006-1026. DOI: https://doi.org/10.1097/01.aog.0000462977.61229.de
24. van Hanegem N, Prins MM, Bongers MY, Opmeer BC, Sahota DS, Mol BW, Timmermans A. The accuracy of endometrial sampling in women with postmenopausal bleeding: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2016 Feb; 197:147-55. DOI: https://doi.org/10.1016/j.ejogrb.2015.12.008
25. James AH, Kouides PA, Abdul-Kadir R, Edlund M, Federici AB, Halimeh S, Kamphuisen PW, Konkle BA, Martínez-Perez O, McLintock C, Peyvandi F, Winikoff R. Von Willebrand disease and other bleeding disorders in women: consensus on diagnosis and management from an international expert panel. Am J Obstet Gynecol. 2009 Jul; 201(1):12.e1-8. DOI: https://doi.org/10.1016/j.ajog.2009.04.024
26. Lukes AS, Moore KA, Muse KN, Gersten JK, Hecht BR, Edlund M, Richter HE, Eder SE, Attia GR, Patrick DL, Rubin A, Shangold GA. Tranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial. Obstet Gynecol. 2010 Oct; 116(4):865-875. DOI: https://doi.org/10.1097/aog.0b013e3181f20177
27. Hale GE, Hughes CL, Burger HG, Robertson DM, Fraser IS. Atypical estradiol secretion and ovulation patterns caused by luteal out-of-phase (LOOP) events underlying irregular ovulatory menstrual cycles in the menopausal transition. Menopause. 2009 Jan-Feb; 16(1):50-9. DOI: https://doi.org/10.1097/gme.0b013e31817ee0c2
28. Achanna KS, Nanda J. Evaluation and management of abnormal uterine bleeding. Med J Malaysia. 2022 May; 77(3):374-383. PMID: 35638495.
29. Fernández Parra J, Álvarez López C, Martínez Morales S. Actualización del sangrado menstrual abundante. Prog Obstet Ginecol 2020; 63(2):68-80. https://dialnet.unirioja.es/servlet/articulo?codigo=7766329#
30. Magnay JL, O'Brien S, Gerlinger C, Seitz C. A systematic review of methods to measure menstrual blood loss. BMC Womens Health. 2018 Aug 22; 18(1):142. DOI: https://doi.org/10.1186/s12905-018-0627-8
31. Delamater L, Santoro N. Management of the Perimenopause. Clin Obstet Gynecol. 2018 Sep; 61(3):419-432. DOI: https://doi.org/10.1097%2FGRF.0000000000000389
32. Committee on Practice Bulletins—Gynecology. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012 Jul; 120(1):197-206. DOI: https://doi.org/10.1097/aog.0b013e318262e320
33. Kouides PA, Conard J, Peyvandi F, Lukes A, Kadir R. Hemostasis and menstruation: appropriate investigation for underlying disorders of hemostasis in women with excessive menstrual bleeding. Fertil Steril. 2005 Nov; 84(5):1345-51. DOI: https://doi.org/10.1016/j.fertnstert.2005.05.035
34. Goldstein SR. Modern evaluation of the endometrium. Obstet Gynecol. 2010 Jul; 116(1):168-176. DOI: https://doi.org/10.1097/aog.0b013e3181dfd557
35. MacGregor R, Jain V, Hillman S, Lumsden MA. Investigating abnormal uterine bleeding in reproductive aged women. BMJ. 2022 Sep 16; 378:e070906. DOI: https://doi.org/10.1136/bmj-2022-070906
36. Chacón Campos, N., Pizarro Madrigal, M., & Guerrero Hines, C. (2022). Sangrado uterino anormal en etapa reproductiva. Revista Médica Sinergia, 7(5), e808. DOI: https://doi.org/10.31434/rms.v7i5.808
37. Hernández-Marín I, Villegas-Rodríguez CM, Celis-González C. Anticonceptivos hormonales en pacientes con sangrado uterino disfuncional. Ginecol Obstet Mex. 2020; 88(Supl 1):S163-S177. DOI: https://doi.org/10.24245/gom.v88iSupl1.3855
38. Bradley LD, Gueye NA. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol. 2016 Jan; 214(1):31-44. DOI: https://doi.org/10.1016/j.ajog.2015.07.044
39. Sriprasert I, Pakrashi T, Kimble T, Archer DF. Heavy menstrual bleeding diagnosis and medical management. Contracept Reprod Med. 2017 Jul 24; 2:20. DOI: https://doi.org/10.1186/s40834-017-0047-4
40. Gil JF. Conocimientos, actitudes frente a la aceptación a efectos secundarios del acetato de medroxiprogesterona en usuarias del Servicio de Planificación Familiar del Hospital Nacional Arzobispo Loayza, Lima-Perú, 2005. Rev. Perú. epidemiol. 2010; 14 (3). http://www.redalyc.org/articulo.oa?id=203119676008
41. Olvera-Maldonado AJ, Martínez-Uribe A, Rendón-Macías ME, et al. Tratamiento de los miomas uterinos con medroxiprogesterona en pacientes perimenopáusicas. Ginecol Obstet Mex. 2015; 83(01):41-47.
42. Bender RA. Medroxyprogesterone Acetate for Abnormal Uterine Bleeding Due to Ovulatory Dysfunction: The Effect of 2 Different-Duration Regimens. Med Sci Monit. 2022 Jun 24; 28:e936727. DOI: https://doi.org/10.12659%2FMSM.936727
43. Lethaby A, Wise MR, Weterings MA, Bofill Rodríguez M, Brown J. Combined hormonal contraceptives for heavy menstrual bleeding. Cochrane Database Syst Rev. 2019 Feb 11; 2(2):CD000154. DOI: https://doi.org/10.1002/14651858.cd000154.pub3
44. Abdel-Aleem H, d'Arcangues C, Vogelsong KM, Gaffield ML, Gülmezoglu AM. Treatment of vaginal bleeding irregularities induced by progestin only contraceptives. Cochrane Database Syst Rev. 2013 Jul 2;(7):CD003449. DOI: https://doi.org/10.1002/14651858.cd003449.pub4
45. Ramalho I, Leite H, Águas F. Abnormal Uterine Bleeding in Adolescents: A Multidisciplinary Approach. Acta Med Port. 2021 Mar 31; 34(4):291-297. DOI: https://doi.org/10.20344/amp.12829
46. Fonseca-Velázquez SJ, López-Martínez R, Sosa-Bustamante GP, González AP, Paque-Bautista C, Luna-Anguiano JLF, Peralta-Cortázar C. Índice de masa corporal e índice triponderal en sangrado uterino anormal [Body mass index and triponderal index in abnormal uterine bleed]. Rev Med Inst Mex Seguro Soc. 2023 Sep 18;61(Suppl 2):S135-S140. Spanish. PMID: 38011538; PMCID: PMC10764109.
47. Matteson KA, Boardman LA, Munro MG, Clark MA. "Abnormal uterine bleeding: a review of patient-based outcome measures." Fertil Steril. 2019;112(4):684-689. DOI: https://doi.org/10.1016/j.fertnstert.2008.04.023
48. Lethaby A, Hussain M, Rishworth JR, Rees MC. "Progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation." Cochrane Database Syst Rev. 2019;8(8). DOI: https://doi.org/10.1002%2F14651858.CD013180.pub2
Publicado
2024-11-22
Cómo citar
Gines Montero , N. G., & Soberano Almeida, J. G. (2024). Manejo del sangrado uterino anormal agudo en pacientes entre 15 a 45 años de edad. Ciencia Latina Revista Científica Multidisciplinar, 8(5), 9769-9783. https://doi.org/10.37811/cl_rcm.v8i5.14359
Número
Sección
Ciencias de la Salud
Derechos de autor 2024 Nayib Gerardo Gines Montero , José Guadalupe Soberano Almeida
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
.jpg)
.png)
.png)
1.png)
