Dysfunctional Uterine Bleeding in Pediatrics Follow-up

  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Andrea L Zuckerman, MD   more...
 
Updated: Jul 13, 2011
 

Further Inpatient Care

  • Patients require admission for acute poorly controlled bleeding that results in severe symptomatic anemia. Consider transfusion of packed red blood cells for these patients.
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Further Outpatient Care

  • Consider long-term (6 mo minimum) suppression of the HPO axis in patients with bleeding that results in significant anemia. Mild anemia responds rapidly to once-a-day oral iron supplementation. Iron supplements taken orally 2 or 3 times per day can cause constipation with subsequent noncompliance and should try to be avoided in most patients.
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Deterrence/Prevention

  • Place patients with a history of dysfunctional uterine bleeding (DUB) and no desire for attempting conception on oral contraceptive pills or cyclic progestins for cycle control.
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Complications

  • Complications are related to acute or chronic blood loss and the resulting anemia. Observe patients who receive blood products for the usual transfusion-related complications of acute hemolytic reactions, bacterial sepsis, and viral infections.
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Prognosis

  • Adolescents with DUB have an excellent prognosis and most outgrow the problem within 3-5 years of menarche.
  • Compliant patients prescribed OCPs rarely have recurrent episodes of DUB.
  • For patients with DUB related to systemic disease, prognosis depends upon the underlying illness.
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Patient Education

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Contributor Information and Disclosures
Author

Germaine L Defendi, MD, MS, FAAP  Associate Clinical Professor, Department of Pediatrics, Olive View-UCLA Medical Center

Germaine L Defendi, MD, MS, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Elizabeth Alderman, MD  Director of Fellowship Training Program, Director of Adolescent Ambulatory Service, Professor of Clinical Pediatrics, Department of Pediatrics, Division of Adolescent Medicine, Albert Einstein College of Medicine and Children's Hospital at Montefiore

Elizabeth Alderman, MD is a member of the following medical societies: American Academy of Pediatrics, American Pediatric Society, North American Society for Pediatric and Adolescent Gynecology, and Society for Adolescent Medicine

Disclosure: Merck Honoraria Speaking and teaching

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Wayne Wolfram, MD, MPH  Associate Professor, Department of Emergency Medicine, Mercy St Vincent Medical Center

Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Paul D Petry, DO, FACOP, FAAP  Consulting Staff, Freeman Pediatric Care, Freeman Health System

Paul D Petry, DO, FACOP, FAAP is a member of the following medical societies: American Academy of Osteopathy, American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Chief Editor

Andrea L Zuckerman, MD  Assistant Professor of Obstetrics/Gynecology and Pediatrics, Tufts University School of Medicine; Division Director, Pediatric and Adolescent Gynecology, Tufts Medical Center

Andrea L Zuckerman, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, North American Society for Pediatric and Adolescent Gynecology, and Society for Adolescent Medicine

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Tod C Aeby, MD, and LeighAnn C Frattarelli, MD, MPH,to the development and writing of this article.

References

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  14. Rajput R, Dhuan J, Agarwal S, Gahlaut PS. Central venous sinus thrombosis in a young woman taking norethindrone acetate for dysfunctional uterine bleeding: case report and review of literature. J Obstet Gynaecol Can. Aug 2008;30(8):680-3. [Medline].

  15. Gultekin M, Diribas K, Buru E, Gökçeoglu MA. Role of a non-hormonal oral anti-fibrinolytic hemostatic agent (tranexamic acid) for management of patients with dysfunctional uterine bleeding. Clin Exp Obstet Gynecol. 2009;36(3):163-5. [Medline].

 
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