Management

Question 1

What is the management for heavy menstrual bleeding?

Answer 1

Iron supplementation

Non hormonal:
- NSAIDs specifically ibuprofren
- Tranexamic acid

Hormonal:
COCP
Mirena
Oral progesterone

Surgical:
- Polypectomy
- Uterine artery embolization
- Endometrial resection of fibroids
- Endometrial ablation
- Myomectomy
- Hysterectomy

Question 2

What is the management for placenta praevia?

Answer 2

• DRSABCDE if haemodynamically unstable
• Admission >24 weeks
• Deliver > 38 weeks (C section)
• IV access
• Maternal and foetal monitoring
• Consider steroids if <34 weeks

Question 3

What is the management for placental abruption?

Answer 3

• DRSABCDE
• anti D if Rh -ve
• Blood group and hold/crossmatch if necessary
• Delivery if term