REFERAT

DYSFUNCTIONAL UTERINE
BLEEDING

Oleh :
Apriadi
Pembimbing :
dr. H. Sigit Nurfianto, SpOG (K)

KEPANITERAAN KLINIK BAGIAN/SMF ILMU KESEHATAN PEREMPUAN

RSUD DR. DORIS SYLVANUS/FK-UNIVERSITAS PALANGKA RAYA
PALANGKA RAYA
2016

Preliminary
Dysfunctional Uterine Bleeding (DUB)
is the most common cause of
abnormal uterine bleeding in women
of reproductive age.
Reported this disorder occurs in 510% of women. More than 50% occur
during perimenopause,
approximately 20% in adolescence,
and approximately 30% in women of
reproductive age

Definition
Dysfunctional uterine bleeding (DUB)
Standard classification of abnormal bleeding
can be divided into seven patterns:
1.
2.
3.
4.
5.
6.
7.

Menorrhagia (hipermenorea)
Hypomenorrhea (kriptomenorea)
Metrorrhagia (intermenstrual bleeding)
Polimenorea
Menometrorrhagia
Oligomenorrhea
Contact Bleeding (hemorrhage post coitus)

Epidemiology
Reported this disorder occurs in 510% of women. More than 50% occur
during perimenopause,
approximately 20% in adolescence,
and approximately 30% in women of
reproductive age

Pathophysiology
Endometrium is stimulated by
estrogenestrogen is extended or
presence of
progesteroneendometrium blood
supply to herThen will experience
flakingcausing irregular
bleedingIf the bleeding is quite
heavy and frequent, it can cause
anemia.
DUB can occur in ovulatory cycles,

Etiology
Causes of DUB is difficult to know with
certainty
Dysfunctional uterine bleeding is often
found in the state: polycystic ovarian
syndrome (PCO), obesity, hypothalamicpituitary axis immaturitas-ovaries, for
example at the time of menarche,
anovulation late, for example during
perimenopause and psychiatric disorders.

Clinical Manifestations
Perdarahan Ovulatoar (persistent
corpus luteum, insufficiency of the
corpus luteum, apoplexy uteri, Blood
disorders such as anemia)
Bleeding anovulatoar

Diagnosis
Diagnose DUB, a variety of potential
causes organic nature must be
removed. When all organic disorders
related to pregnancy, infections and
tumors (benign or malignant) has
been removed, then a bleeding of
the uterus is considered due to the
dysfunctional uterine bleeding.

Complaints and symptoms

Problem

Pelvic pain

Abortus, Ectopic pregnancy

Nausea, increased frequency of

urination

Pregnancy

Weight gain, fatigue, impaired tolerance Hypothyroid

against the cold
Weight loss, a lot of sweat, palpitations

Hypothyroid

History anticoagulant drug consumption Coagulopathy

Blood clotting disorders
A history of hepatitis, jaundice
Hirsutism, acne, acanthosis nigricans,
obesity
Postcoital bleeding
Galactorrhea, headache, visual field
defects

Heart disease
Polycystic ovary syndrome
Cervical dysplasia, polyps
endocervical
Pituitary tumor

Differensial Diagnosis

Management
The principle of treatment on the DUB is:
1. Make the diagnosis by removing the
possibility of organic pathology
2. Stopping the bleeding
3. Set back to normal so that menstruation
4. When got anemia (Hb <8 g%), transfusion

Stop bleeding, can be done as follows:

.Curette
.Drugs (hormonal or non hormonal)

Prognosis
The results are widely depending on
the medical condition and age of the
patient
Many women, especially teenage
years successfully treated with
hormones
As a last resort, a hysterectomy can
eliminate the source of the problem
to remove the uterus

FINALITY
Dysfunctional uterine bleeding (DUB)
is abnormal uterine bleeding in the
number, frequency, and duration
that occur both inside and outside
the menstrual cycle
The goal of treatment is to control
acute bleeding, bleeding episodes in
the future, and prevent serious
anovulation impact on long-term,
namely endometrial cancer.