Aged ; Female ; Humans ; Uterine Hemorrhage/etiology*

The activity of matrix metalloproteinases (MMPs) in the uterine flushing and endometrial tissue of normal adult women wearing FCu-IUD (fixed Cu-IUD) or FICu-IUD (indomethacin-releasing FCu-IUD) was observed by using zymography on SDS-PAGE containing gelatin. The results showed that the activity and kinds of MMPs in FCu-IUD group were increased significantly as compared with themselves before being inserted FCu-IUD. However, compared with the FCu-IUD group, the activity of some kinds of MMPs in the FICu-IUD group was decreased significantly. These data suggest that IUD can enhance the activity of MMPs in human endometrium, intermediated by prostaglandins, and MMPs may have relation to IUD-induced menorrhagia and indomethacin reduces IUD-induced menorrhagia by partly inhibiting MMPs synthesis.
Endometrium/*enzymology ; Indomethacin ; Intrauterine Devices, Copper/*adverse effects ; Intrauterine Devices, Medicated/*adverse effects ; Matrix Metalloproteinases/*metabolism ; Uterine Hemorrhage/etiology ; Uterine Hemorrhage/prevention & control

We present a case of adenomatous polyp with degenerative changes causing abnormal postmenopausal bleeding in a patient who was treated with adjuvant therapy of Tamoxifen for breast cancer after surgery (Modified Radical Mastectomy). The association with prolonged unopposed estrogen--like stimulation with Tamoxifen as a possible factor in this development has been discussed. Until further cases are reported, it would seem imperative to advise all women who are to be treated with Tamoxifen for breast malignancy to have a pelvic examination before such treatment with strict follow up at regular intervals later on. Abnormal bleeding may also be the result of Tamoxifen stimulation and endometrial biopsy may be necessary in these patients should abnormal bleeding occur. Surgical exploration for enlarging leiomyomas or abnormal bleeding will still be necessary to ensure that malignancy is not present, but the pre-operative diagnosis will be less alarming.
Adenomatous Polyps ; complications ; etiology ; Aged ; Breast Neoplasms ; drug therapy ; surgery ; Endometrial Neoplasms ; complications ; etiology ; Female ; Humans ; Mastectomy, Modified Radical ; Postmenopause ; Tamoxifen ; therapeutic use ; Uterine Hemorrhage ; etiology

OBJECTIVE: To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. MATERIALS AND METHODS: We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. RESULTS: The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. CONCLUSION: TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.
Adult ; Aged ; Comparative Study ; *Endosonography/methods ; Female ; Human ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Hemorrhage/etiology/*ultrasonography

Gestational trophoblastic tumors (GTTs) are malignant lesions that often cause abnormal genital bleeding and may present with hemoptysis, intraperitoneal bleeding or acute neurologic deficits. GTTs are generally highly chemosensitive with more favorable outcomes than other comparable malignancies. Here we report a rare case of invasive mole (FIGO stage IV, WHO score16) presenting with renal subcapsular hematoma due to bleeding renal metastasis. The patient had a pretreatment β-human chorionic gonadotrophin (β-HCG) level of 462 047 mIU/ml and received combined chemotherapy with etoposide, methotrexate, actinomycin-D, cyclophosphamide and vincristine with also adjuvant surgeries including hysterectomy and nephrectomy. The patient recovered well and the tumor has remained in complete remission for one year and a half.
Antineoplastic Combined Chemotherapy Protocols ; Female ; Hemorrhage ; etiology ; Humans ; Hydatidiform Mole, Invasive ; complications ; Kidney ; pathology ; Pregnancy ; Uterine Neoplasms ; complications

Child, Preschool ; Diagnosis, Differential ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Hysteroscopy ; Pediatrics ; Puberty, Precocious ; diagnosis ; therapy ; Uterine Hemorrhage ; diagnosis ; etiology ; therapy ; Vaginal Diseases ; diagnosis ; etiology ; therapy

OBJECTIVE: To analyze the clinical characteristics of post-traumatic abortion and the relationship between trauma and abortion. METHODS: We collected and analyzed 23 cases of post-traumatic abortion encountered in the department of clinical forensic medicine, faculty of forensic medicine, China Medical University in recent years. RESULTS: All 23 post-traumatic abort inns were early abortions. Their traumata were mild and external only. Vagina bleeding and abortion occurred shortly after trauma. Most patients were older, from countryside, or unemployed. CONCLUSION The causes of abortion are complex. Post-traumatic abortion can only be diagnosed after excluding non-traumatic factors. For those cases abortion occur shortly after injuries and non-traumatic factors can not be excluded, trauma should be assessed for its role in abortions as primary, secondary or induction factors correlated with clinical symptoms and pre-
Abdominal Injuries/complications* ; Abortion, Spontaneous/etiology* ; Adult ; Brain Injuries/complications* ; Diagnosis, Differential ; Female ; Forensic Medicine ; Gestational Age ; Humans ; Pregnancy ; Retrospective Studies ; Uterine Hemorrhage/etiology* ; Young Adult

In order to explore the effect of Yaoliuan capsule in the prevention and treatment of vaginal bleeding after drug-induced abortion and menses recovery after drug-induced abortion, 323 cases of gestation period < or = 49 days and without contraindication, were divided randomly into study group (168 cases, taking Yaoliuan capsule) and control group (155 cases, taking placebo capsule). The results showed that in the study group, there were 161 cases (95.8%) of complete abortion, 7 cases (4.2%) of incomplete abortion; In the control group, there were 146 cases (94.2%) of complete abortion, 6 cases (3.9%) of incomplete abortion, 3 cases (1.9%) of abortion failure. The vaginal bleeding time was 5-25 days (mean 10.8 days) in study group, while that was 6-62 days (mean 19.1 days) in control group. The menstrual cycle was 30.5+/-5. 2 days and 33.8 d+/-8.6 days respectively in study and control groups. The menstrual period was 6.1+/-3. 5 days and 9.9+/-5.1 days respectively in study and control groups. Yaoliuan capsule is an effective drug to prevent and treat vaginal bleeding following drug-induced abortion, promote menstruation recovery and prevent pelvic infection.
Abortifacient Agents, Nonsteroidal/adverse effects ; Abortion, Induced/*adverse effects ; Capsules ; Drugs, Chinese Herbal/*therapeutic use ; Menstruation/*drug effects ; Phytotherapy ; Pregnancy Trimester, First ; Uterine Hemorrhage/etiology ; Uterine Hemorrhage/*prevention & control

Arteriovenous malformations of the uterus are extremely rare and they occur either in congenital or acquired forms. The most common clinical presentation is abnormal uterine bleeding, which may be aggravated by therapeutic curettage. Because of their rare incidence and clinical importance in management of patients, we report a case of arteriovenous malformation causing serious bleeding during a hysterectomy for uterine leiomyoma. The patient was a 47-year-old multiparous woman who had a history of chronic vaginal bleeding for one year. Numerous anomalous blood vessels draining into the right and left uterine arteries were found on the anterior wall of the uterus and parametrium.
Arteriovenous Malformations/*complications ; Female ; Humans ; Hysterectomy/adverse effects ; Intraoperative Complications/etiology ; Leiomyoma/blood supply/surgery ; Middle Aged ; Uterine Hemorrhage/*etiology ; Uterine Neoplasms/blood supply/surgery ; Uterus/*abnormalities/*blood supply

OBJECTIVETo discuss the diagnosis of and conservative management for lower uterine segment pregnancy with placenta increta complicating first trimester abortion.

METHODSFour patients with previous caesarean section and severe hemorrhage in induced abortion in the first trimester were studied. Uterine artery embolization (UAE) was used to control bleeding and preserve the uterus.

RESULTSUAE controlled heavy uterine bleeding satisfactorily. One of the four patients asked for a hysterectomy after UAE, and her pathology report confirmed "lower uterine segment pregnancy with placenta increta".

CONCLUSIONPrevious caesarean section is a risk factor for lower uterine segment pregnancy with placenta increta. UAE is one of the best conservative management methods for heavy hemorrhage, especially for women who desire future fertility.

Abortion, Induced ; adverse effects ; Adult ; Embolization, Therapeutic ; Female ; Humans ; Placenta Accreta ; diagnosis ; therapy ; Pregnancy ; Pregnancy Trimester, First ; Uterine Hemorrhage ; etiology ; therapy ; Uterus ; pathology