Management of severe uterine bleeding

Question 0

What are the first steps in management of an unstable patient with heavy uterine bleeding?

What options are then considered?

Answer 0

IV fluids, blood replacement, interuterine tampanode

Uterine curettage
IV Premarin 25 mg, repeat in four hours if needed, transition to orals
UAE
Hysterectomy

Question 1

What options are available for stable women with severe uterine bleeding?

Answer 1

Premarin 2.5 QID tapered to BID. for up to 21 days. Then MPA 10 mg daily for 10 days.
OCP taper: start at 5 or 3
MPA 10–20 mg BID for 10-12 days
Tranexamic acid 1.5 mg TID