Postupnik kod nenormalnih krvarenja iz maternice

master's thesis

• Title (english): Algorithm for abnormal uterine bleeding
• Author: Dora Škrljak Šoša
• Mentor: Lana Škrgatić (mentor)
• Committee member: Marina Šprem Goldštajn (predsjednik povjerenstva)
• Committee member: Dinka Pavičić-Baldani (član povjerenstva)
• Committee member: Lana Škrgatić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Nenormalna krvarenja iz maternice (NKM) najčešći su problem u ginekološkoj praksi. Uzroci krvarenja su različiti i ovise o životnoj dobi. Dosadašnje nazivlje i klasifikacija nenormalnih krvarenja je često bilo inkonzistentno što je onemogućavalo znanstvenu analizu i usporedbu. Svjetska udruga ginekologa i opstetričara (FIGO) prihvatila je 2010. godine novu klasifikaciju NKM temeljenu na uzrocima krvarenja nazvanu PALM-COEIN klasifikacija. Akronim PALM-COEIN označava prva slova uzroka nenormalnih krvarenja (polip, adenomioza, leiomiom, malignost i hiperplazija, koagulopatija, poremećaji ovulacije, endometrialni uzroci, jatrogeni i neklasificirani). Dijagnostički postupci kod nenormalnih krvarenja iz maternice sastoje se od anamneze, općeg i ginekološkog statusa, ginekološkog ultrazvučnog pregleda te laboratorijskih nalaza. Anamnezom dobivamo podatke o učestalosti, predvidljivosti i obilnosti krvarenja dok ginekološkim i ultrazvučnim pregledom te laboratorijskom obradom definiramo uzroke nenormalnog krvarenja. Liječenje nenormalnih krvarenja iz maternice ovisi o hitnosti, uzrocima krvarenja, dobi pacijentice, reprodukcijskim željama, mogućim posljedicama, obiteljskim i osobnim rizicima te uspjehu dotadašnjeg liječenja. Liječenje može biti medikamentozno ili kirurško. Prvi izbor pri liječenju nestrukturalnih nenormalnih krvarenja iz maternice je medikamentozan, a kirurški rješavamo simptomatske strukturalne uzroke. Kirurški se rješavaju i sva krvarenja refraktorna na medikamentoznu terapiju.

Abstract (english)

Abnormal uterine bleeding (AUB) is the most common gynecological problem. The causes of bleeding are various and depend on the age of women. The inconsistency of nomenclature and classification of causes limits their effective use in medical communication and researches. In the year 2010. The International Federation of Gynecology and Obstetrics (FIGO) accepted new classification based upon the causes of bleeding and named it „PALM-COEIN classification“. The acronim PALM-COEIN stands for first letters of causes of abnormal bleeding (polyps, adenomyosis, leiomyoma, malignancy and hyperplasia–coagulopathy, ovulatory disorders, endometrial causes, iatrogenic, not classified). The investigation of abnormal uterine bleeding consists of medical history, physical and gynecological examination, gynecological ultrasonographic imaging and laboratory examination. History helps us to determine the frequency, predictability and the volume of bleeding and gynecological, sonographic and laboratory examination helps us define the causes of abnormal uterine bleeding. The therapy of abnormal uterine bleeding depends on emergency, causes of bleeding, the age of women, future reproductive wishes, possible outcomes, family and personal risks and the effectivness of former treatment. Treatment can be conservative medical therapy or surgical. The treatment of nonstrucural causes of abnormal uterine bleeding is usually medical, and surgical treatment is the first option in simptomatic structural causes of bleeding. All bleeding unresponsive to medical therapy is also treated surgically.

• Keywords: nenormalna krvarenja iz maternice; PALM-COEIN klasifikacija; dijagnostički postupci; liječenje
• Keywords (english): abnormal uterine bleeding; PALM-COEIN classification; investigation; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:577492
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-04-12 12:20:00