Successful management of abnormal uterine bleeding from uterine arteriovenous malformations with progesterone in postabortal patients

Taneja, Ashima; Chopra, Isha; Kaur, Harmeet; Ss, Naik; Aggarwal, Reetika; Sachdeva, Eshani; Kaur, Poonampreet

doi:10.1111/jog.13939

Cited by 25 publications

(25 citation statements)

References 18 publications

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“…The mean age of the study participants was 33.8 years, which aligned with a similar Indian study assessing the effectiveness of norethisterone in the management of AUB. 12 Other studies have reported a relatively higher mean age of women with AUB, ranging from 36 to 39 years. 10,13,14 This could be explained by the better health status of younger women as compared to women in later years of life.…”

Section: Discussionmentioning

confidence: 93%

“…2 The present real-world study in addition to other reports establishes the effectiveness of norethisterone in the management of AUB. 2,12,16 Even in women with warfarin-induced AUB, 5 mg thrice-daily dose of norethisterone effectively and safely controls AUB. 17 Further, a doctor-centric survey from India revealed that 43.85% of physicians prescribe hormonal therapy for the management of AUB.…”

Section: Discussionmentioning

confidence: 99%

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Real-world Safety and Effectiveness Analysis of Norethisterone in the Management of Abnormal Uterine Bleeding

Jaiswal¹,

Boruah²,

Jaiswal³

et al. 2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective: To assess the real-world safety and effectiveness of norethisterone 10 mg-controlled release (CR) formulation in the management of abnormal uterine bleeding (AUB). Methods: This was a retrospective analysis of real-world data collected between January 2021 and March 2021 across 40 centers in India. A total of 308 women in the reproductive age-group (18-45 years) with ovulatory AUB were treated with norethisterone CR 10 mg once a day for 10 days. The data from women with a confirmed diagnosis of AUB were included in the study. The clinical records that were analyzed for the primary objectives included the time required for arresting heavy menstrual bleeding after initiating medication, the incidence of breakthrough bleeding, safety and tolerability, and the secondary objectives included the timing of withdrawal bleeding after the last tablet was taken, assessment of heaviness of bleeding, and treatment compliance. Results:The mean age [± standard deviation (SD)] was 33.8 ± 8.3 years. Out of the 308 women with AUB, the majority of women (n = 193, 63%) experienced styptic action of norethisterone 10 mg CR within 4 hours of administration of the medication, 61% of the women (n = 187) did not report any incidence of breakthrough bleeding, and 70% of the women (n = 216) reported withdrawal bleeding within 24-72 hours of administration of the last medication dose. No adverse events were reported. Heavy bleeding was noted in only 7% of the women. More than 80% of compliance with therapy was observed in 94% of women (n = 290). Conclusion: Our analyses of the retrospective data suggested that norethisterone 10 mg CR was safe and effective for the treatment of AUB in Indian women. Clinical significance: To the best of our knowledge, this is the first real-world study to show that norethisterone 10 mg CR effectively treats AUB, is safe, and is associated with a high compliance rate in Indian women of reproductive age-group (18-45 years).

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Real-world Safety and Effectiveness Analysis of Norethisterone in the Management of Abnormal Uterine Bleeding

Jaiswal¹,

Boruah²,

Jaiswal³

et al. 2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…Except uterine artery embolization, the treatment methods still consisted of expectant management [20,21] and surgical therapy.When applying conservative management, a global assessment should be made including the number of involved blood vessels, the presence of retained pregnant products as well as Doppler indices [22].There were two cases(8 and 14) applying this method in present paper. Case 8 had D&G for cervix pregnancy after uterine artery embolization and succeeded in expectant management.…”

Section: Resultsmentioning

confidence: 99%

Uterine Arteriovenous Fistula:Rare Cause of Vaginal Bleeding and Experience from 14 Case Series in a Single Center

fei

Wu²,

Jian-hong

2020

Preprint

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Background: This study aimed to summarize the characteristics of uterine arteriovenous fistul for proper treatment.Methods: This was a retrospective study of fourteen women diagnosed with uterine arteriovenous fistul and eventually proved by pelvic angiography at our department,. Results: Six women presented with late postpartum hemorrhage and the other seven had abnormal uterine bleeding while only one was asymptomatic.The majority of them had uterine manipulation with the most common being repeated dilation and curettage but the time interval ranged from more than ten days to months even several years. they could originate from ovarian artery or internal iliac artery in rare cases and even some cases showed uterine artery- ovarian vein fistul. Most of them had a good outcome with bleeding resolved or mild bleeding after arterial embolization with controllable fever and pain, and only three cases had surgery unsuitable for embolization or formation of traffic branch after embolization.Conclusions: uterine arteriovenous fistul were rare but easy to be diagnosed with characteristic ultrasound findings along medical history such as D&G and feature of vaginal bleeding. A successful treatment for artery embolization was based on careful evaluated vessels mapped by angiography while a comprehensive assessment with color and spectral flow Doppler was very necessary to exclude retained products of conception or placenta and avert unnecessary D&G after embolization. Surgical therapy was the last choice in women difficult to embolism or failed with UAE.

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“…We used oral progesterone Dydrogesterone in our patients, and that led to complete resolution of their AVMs. Recently Taneja et al 17 published a study where they successfully treated 27 out of 30 patients with postabortal symptomatic uterine AVM. Progesterone use results in stromal decidualization and subsequent thinning of endometrium, thus preventing exposure of AVM.…”

Section: Discussionmentioning

confidence: 99%

Uterine arteriovenous malformation: A rare yet perilous entity.

Mannan

Niaz

Hayat³

et al. 2021

Int. j. endorsing health sci. res.

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Background: Uterine Arteriovenous Malformation (AVM) is a rare diagnosis. Although rare, it can cause massive and life-threatening hemorrhage, eventually leading to considerable morbidity and mortality. Healthcare professionals need to have a high index of suspicion in order to avoid the morbidity associated with Uterine Arteriovenous Malformation. We shed light on this relatively under-researched gynecologic diagnosis. Case Presentation: We describe the presentation, workup, including radiological studies, and subsequent management of Uterine Arteriovenous Malformation in two reproductive-age females who presented to our hospital with abnormal vaginal bleeding. Both patients had a history of primary hemorrhage after abortion, requiring blood transfusion. Both patients underwent Magnetic resonance imaging (MRI) and showed a tortuous serpentine tangle of mixed signals extending from the deep myometrium into the endometrium. Management & Results: Diagnosis of Uterine AVM was established months later when they presented with continuous abnormal vaginal bleeding. The diagnosis was established based on clinical examination and imaging studies. Patients were managed with hormonal treatment and responded well; one of them eventually got a successful pregnancy. Conclusion: Uterine arteriovenous malformation, causing significant vaginal bleeding, can be managed timely with accurate diagnosis and prompt management, with an array of modalities including conservative, medical or surgical methods. The modality of treatment depends upon the patient’s clinical condition and fertility wishes.

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Successful management of abnormal uterine bleeding from uterine arteriovenous malformations with progesterone in postabortal patients

Cited by 25 publications

References 18 publications

Real-world Safety and Effectiveness Analysis of Norethisterone in the Management of Abnormal Uterine Bleeding

Real-world Safety and Effectiveness Analysis of Norethisterone in the Management of Abnormal Uterine Bleeding

Uterine Arteriovenous Fistula:Rare Cause of Vaginal Bleeding and Experience from 14 Case Series in a Single Center

Uterine arteriovenous malformation: A rare yet perilous entity.

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