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Female Patient Cases 3 – Abnormal Uterine Bleeding (AUD)

Frantz Jacob

Female Patient Case 1 – Abnormal Uterine Bleeding (AUD)

Abnormal uterine bleeding (also known as [AUD]), is not regular uterine bleeding that happens in the nonappearance of recognizable pelvic pathology, pregnancy, or general medical disease. It results in an interruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. The bleeding can happen at any time and in many types, such as light or excessive, as well as frequent, extended, or even random (Behera, 2020). AUD occurs in approximately 10 to 35 percent of women (Shaw, 2019).

The symptoms mostly occur when the person has heavy bleeding during a period or between periods. However AUD symptoms consist: if the person gets on period more often than 21 to 35 days; if a period is longer than seven days (usually four to six days); if bleeding is heavier than normal; if have bleeding after menopause; and if have bleeding or spotting after sex (Shaw, 2019).

The differential diagnosis for AUD, (2021, ICD-10-CM) Diagnosis Code N93.9 – Abnormal uterine and vaginal bleeding, unspecified, also can be got by:

Diagnosis Code R58: Hemorrhage, hemorrhagic – uterus, uterine (abnormal) N93.9 or vagina (abnormal) N93.9;

Diagnosis Code Index: Bleeding – uterus, uterine NEC N93.9 or vagina, vaginal (abnormal) N93.9;

Diagnosis Code Index: Menstruation – disorder N93.9.

The patient education is according to the doctor’s instructions and the understanding on which level the AUD is on. After the correct diagnoses and explanation about what measures to be taken the patient education is grounded on what the doctor analyzed. However, it is crucial to be aware of further occasions on which the symptoms could appear again and complications. For more information, the patient should easy to read articles to answer four or five key questions about the given condition.

Management plan

The treatment is typical, by the use of medications (pharmacological) as the first course of action. Usually, the medications prescribed consist of:

Birth control pills: are used because of the hormonal effect to provide a more regular hormonal stability and bleeding cycles well established. They may be used to treat heavy menstrual bleeding and in the prevention of disproportionate growth of the endometrium, so AUD depending on the conditions can be treated with birth control pills.

Nonsteroidal anti-inflammatory drugs (NSAIDS): they are able to help in reducing blood loss and ache (e.g. naproxen sodium and ibuprofen).

Gonadotropin-releasing hormone (GnRH) agonists: these types of drugs can reduce the size of fibroids by causing to happen menopause for a certain time, and they also can stop the current menstrual cycle

Progesterone: Progesterone is normally produced by the body and has the effect to prevent and treat exaggerated bleeding in women who do not have regular ovulation. It is used synthetic forms of progesterone.

Therefore, the option for a non-pharmacological treatment usually is significantly effective by the use of an intrauterine device called IUD (intrauterine contraceptive device, which can combine on (pharmacological) secretes progestin or not (non-pharmacological). The use of IUD is related to decrease pain and stop menstrual bleeding (Shaw, 2019).

References

Behera, M. A. (2020, August 27). Abnormal (Dysfunctional) Uterine Bleeding. Practice Essentials, Background, Pathophysiology. https://emedicine.medscape.com/article/257007-overview#:~:text=Abnormal%20uterine%20bleeding%20(formerly%2C%20dysfunctional,stimulation%20to%20the%20endometrial%20lining.

ICD10Data. (2021). 2021 ICD-10-CM Diagnosis Code N93.9. ICD 10 Data. https://www.icd10data.com/ICD10CM/Codes/N00-N99/N80-N98/N93-/N93.9.

Shaw, F. M. (2019, July 31). Abnormal Uterine Bleeding (AUB). Healthcare Services in New York | Multi-Specialty Practices. https://www.caremountmedical.com/care-and-services/obstetrics-gynecology/abnormal-uterine-bleeding-aub-symptoms-causes-and-treatment/.