The article presents our own clinical observations of cases of abnormal uterine bleeding in postmenopausal women, where the main cause was the pathology of hemostasis: a patient after liver transplantation for cirrhosis with chronic viral hepatitis C, and a patient with primary idiopathic thrombocytopenic purpura which manifested at a later age. Among the most common causes of abnormal uterine bleeding in postmenopausal women are hyperplasia and endometrial cancer, leiomyoma, are adenomyosis are distinguished. Pathology of the hemostasis system as the main cause of abnormal uterine bleeding, prevails in the pubertal and reproductive period. In the literature available we did not find any publications concerning uterine bleeding in postmenopausal patients against the background of the pathology of the blood coagulation system. This article illustrates the significance of hemostasis disorders both secondary and primary in the origin of abnormal bleeding in postmenopausal period. Careful collection of anamnesis, an indication of the occurrence of petechial rash, gingival bleeding should alert the doctor. It should also be remembered that “suddenly arisen” immune cytopenias and late-onset thrombosis are often manifestations of the hematological paraneoplastic syndrome and require the exclusion of neoplasia, first of all, of the hematopoietic system. These clinical observations allow recommending a mandatory examination of the hemostatic system in patients with postmenopausal bleeding.
Pelvic organ prolapse is a pathology that extremely worsens the quality of life of a woman at any age. Usually, this pathology is encountered in patients of the older age group, where the correction of the pathology is reduced to improving the quality of life. Other challenges are pelvic organ prolapse in women of reproductive age, and especially in combination with pregnancy. The task of obstetricians and gynecologists in this situation is not only to preserve and prolong pregnancy, to choose an adequate method of delivery that is optimal for the mother and newborn, but also to correct the anatomical location of the genitals, which requires certain surgical skills. The given clinical observation demonstrates the course of pregnancy and childbirth in a patient with pelvic organ prolapse of stage II according to the POP-Q classification, contains brief judgments on the management of pregnancy at the outpatient stage.
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