Diagnosis of Retroverted uterus
Retroverted uterus Diagnosis: Book Excerpts
Diagnostic Tests for Retroverted uterus: Online Medical Books
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Abnormal Uterine Bleeding:
Differential Diagnosis
(In a Page: Signs and Symptoms)
- Endometrial hyperplasia
–Endogenous estrogen excess (e.g., obesity,
tumor)
–Exogenous estrogen
–DUB is a diagnosis of exclusion (usually
not cyclic, occurs irregularly throughout the menstrual cycle)
-
Polycystic ovarian syndrome
-
Hypo- or hyperthyroidism
-
Endometrial atrophy
–Caused by long-term progestin or oral contraceptive use
-
Anatomic or structural lesions
–Uterine leiomyoma (fibroids)
–Foreign body (often intrauterine device)
–Cervical or uterine polyps
-
Pelvic infection (cervicitis, pelvic inflammatory disease)
-
Hypothalamic lesion
-
Hyperprolactinemia
-
Medications (e.g., exogenous estrogen, phenothiazines, reserpine)
-
Coagulation disorders
–Platelet dysfunction: Thrombocytopenia, leukemia, medications (e.g., aspirin, NSAIDs)
–Clotting factor abnormality: Von Willebrand's disease, hemophilia, hepatic or renal disease, anticoagulant use
-
Complications of pregnancy
–Spontaneous abortion (miscarriage)
–Ectopic pregnancy
–Placenta previa
–Placental abruption
-
Endometrial cancer
–Risk factors include older age, chronic anovulation, obesity, hypertension, DM, and unopposed estrogen
-
Systemic disease (e.g., HIV, hepatic disease, renal disease)
-
Nonuterine bleeding
–Vaginal (tear, trauma, or cancer)
–Cervical (trauma or cancer)
–Urinary (UTI or cancer)
–Rectal (bleeding, trauma, fissure, or cancer)
-
Other malignancy (ovarian or uterine tumor, sarcoma)
-
Endometrioma
Workup and Diagnosis
-
History, physical, pelvic, and rectal examinations
-
Pap smear
-
- Initial labs may include β-hCG (qualitative and, if positive, quantitative); CBC with differential; TSH, LH, FSH, estradiol, testosterone, prolactin, and DHEA-S levels
-
Consider PT/PTT, peripheral smear, clotting factor assays, liver function tests, serum progesterone, and BUN/creatinine to evaluate for coagulopathy, hepatic, or renal disease
-
Pelvic ultrasound may reveal adnexal or uterine masses or other pathology
-
Transvaginal ultrasound is more accurate than pelvic ultrasound in evaluating the endometrium
-
Endometrial biopsy and progesterone challenge test are helpful in the evaluation of estrogen excess
–Administration of medroxyprogesterone for 10 days results in withdrawal bleeding if adequate estrogen is present
-
CT scan may be helpful if malignancy is suspected
-
Hysteroscopy for evaluation of endometrium and uterine cavity
-
Diagnostic dilatation and curettage is more invasive but offers more information than endometrial biopsy
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Dysfunctional uterine bleeding:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Diagnostic studies must rule out other causes of excessive vaginal bleeding, such as organic, systemic, psychogenic, and endocrine causes, including certain cancers, polyps, incomplete abortion, pregnancy, and infection.
Confirming diagnosis Dilatation and curettage (D & C) and biopsy results confirm the diagnosis by revealing endometrial hyperplasia.
Hemoglobin levels and hematocrit determine the need for blood or iron replacement.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
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