Juvenile uterine bleeding - Bleeding of puberty, do not have an organic nature. Usually occurs after a delay of the next menstrual cycle. Spotting exceed the average amount of blood loss during menstruation, in the case of their profusion and duration of the symptoms of post-hemorrhagic anemia align:. General weakness, dizziness, pale skin and other juvenile uterine bleeding diagnosed based on clinical data and history at the confirmed absence of organic genesis of blood loss. comprehensive treatment. It held a non-hormonal and hormonal hemostasis, anemia treatment and prevention of recurrent dysfunctional bleeding.
uterine bleeding is a serious problem in pediatrics and child gynecology. More than half the cases the delay menstruation in puberty ends bleeding. Frequency of nosology in the structure of gynecological diseases ranges from 10 to 37.5%. However, the true prevalence of juvenile uterine bleeding is much higher, because the condition is often hidden to the girl or her parents underestimated. Many are generally considered normal bleeding during the formation of the menstrual cycle. This view is not only wrong, but also extremely dangerous.
It is important to understand that the juvenile uterine bleeding themselves are stressful for a young girl, and the state of stress increases the risk of recurrent uterine hemorrhage. In addition, the pathology leads to the development of the young age of inflammatory diseases of the reproductive system, which very often have a chronic course. Subsequently, this high incidence is inevitably reflected in the increasing number of pathologies of pregnancy, spontaneous miscarriages, abortions, including medical and so on. D. All of the above contributes to the unfavorable demographic situation in the society as a whole.
intrauterine hypoxia, lack of oxygen as damaging to the brain and can later manifest violation of pituitary hormonal function. Thus, hormonal disorders in juvenile uterine bleeding is often caused by dysfunction is the central link of the regulation.
Against the background of an existing predisposition girls puberty is very often subject to emotional stress. The trigger for the development of juvenile uterine bleeding may be a conflict in the family or with peers, underachievement in school, problems in relationships with the opposite sex and more. Stress leads to disruption of production of follicle stimulating hormone (FSH) and luteinizing hormone (LH), with an excess of more of the former. Consequently, ovulation does not occur for a long time there is a hyperestrogenia, which is the main cause of enhanced proliferation of the endometrium without his timely rejection. The mucous membrane of the uterus at the same time often undergoes abnormal changes with the formation of polyps and cysts. There are areas of ischemia and necrosis, subsequently rejected the endometrium with the development of juvenile uterine bleeding.
Classification of juvenile uterine bleeding
Dysfunctional bleeding puberty are divided according to the degree of blood loss and its relationship to the menstrual cycle phase. There are also differences due to the concentration of estrogen in the blood. The following clinical variants of juvenile uterine bleeding:
It is very important in determining the medical tactics is a correlation between types of juvenile uterine bleeding with the estrogen concentration in the patient's blood. There are three types of bleeding: gipoestrogeniya, normoestrogenny and hyperestrogenia. Gipoestrogeniya type common in women with under-developed secondary sexual characteristics at an accelerated development of intelligence (acceleration). Normoestrogenny type involves the harmonious physical development, but the size of the uterus remain below the age norm. Hyperestrogenia juvenile uterine bleeding to occur in the physical development of girls, often with some psychological immaturity.
dizziness. Noteworthy features of physical development of the girl and her personal characteristics. Some of which are described above, generally there is increased anxiety, mood often reduced may subdepressive condition. The development of secondary sexual characteristics at the juvenile uterine bleeding can correspond to age norm, or keep up with her.
gynecological examination with pap smears, and ultrasound diagnostics. Together, these two methods can not only eliminate an organic cause bleeding, but to conclude that the development of sexual organs. In addition, the ovaries are visualized on ultrasound, which can be seen cysts and preserved the dominant follicle, which normally had to ovulate. The absence of diseases of the uterus and genital tract and confirmed anovulatory cycle are the main diagnostic criteria juvenile uterine bleeding.
Then we conducted a series of laboratory tests, the purpose of which - the discovery of the causes of hemorrhage and differential diagnosis of various hormonal disorders that can cause juvenile uterine bleeding. It is necessary to determine the concentration of thyroid-stimulating hormone and thyroxine to clarify the function of the thyroid gland. X-ray of the skull with the projection of the sella is also mandatory, as it allows to exclude a tumor of the pituitary as the cause of violations of the ratio of FSH and LH. It is also determined by the level of sex hormones, and this must be done several times in different phases of the menstrual cycle. To exclude hyperprolactinemia test is performed on the blood levels of prolactin.
hysteroscopy, ie, diagnostic curettage of the uterus. As a rule, in this case, the cause of juvenile uterine bleeding becomes glandulocystica deformation of the endometrium.
A mandatory stage of therapy is prevention of repeat juvenile uterine bleeding. It is recommended to maintain a healthy weight is assigned to appropriate diet, if necessary, as the excess or deficiency of body weight to a certain extent responsible for the regulation of the menstrual cycle. Clinical supervision is carried out once a month to stabilize the cycle, ultrasound is performed at least once every 6-12 months. In general, in the treatment of juvenile uterine bleeding involved a number of experts, including a pediatrician, endocrinologist, hematologist, neurologist and ophthalmologist. Recommended counseling.
Prediction and prevention of juvenile uterine bleeding
Prognosis depends on the cause of bleeding, and the success of therapy. Unfortunately, very often we have to adjust the cycle of hormones that has a number of negative consequences for women. Furthermore, it does not eliminate the primary cause of any disorder that is a central internal regulation is impaired. In the future, gynecological pathology observed in the majority of women, primary infertility is diagnosed in more than half of the cases. Prevention is possible in part in the antenatal period. The favorable situation in the family and reduces the risk of juvenile uterine bleeding.