Evaluation/Treatment of Acute Abnormal Uterine Bleeding

Goals and Metrics

Acute Abnormal Uterine Bleeding

Triage
DDX of Abnormal Uterine Bleeding

 Additional Considerations
o Social Work Consult
o Peer Educator

Initial MD/CRNP/RN Assessment

 Assess ABC’s, VS
Orthostatic BP changes
Symptoms of hypovolemia, anemia
Initial Labs  HCG (urine or serum)
 Consider need for
o Hgb
o Type and SCreen

Stable Hemodynamics

HCG⊕
Immediate transfer to HUP ED
Interfacility Transfer Process
Consider Social Work Consult
HCG⊖
Concerning Hemodynamics

 CBC, Type & Screen, PT, PTT

 NS bolus, 2 PIV
 CR monitor, VS q 15 minutes
 Consider need for PRBC's

HCG⊖
HCG⊕

 Actions to consider based

on PE:
 Transfer to HUP if able
 If not stable for transfer
o Consult General or Trauma
o Surgery, and/or SDU

Complete History and Physical

Mild
H&P reassuring
Hgb > 12 mg/dL, if checked
Moderate
Hgb 10-12 mg/dL
Severe
Hgb < 10 mg/dL
Further Diagnostic Testing
Treatment Table
Goals of Treatment
Contraindication to Estrogen Therapy
Indications for Admission
Discharge Considerations
Posted: June 2015
Revised: July 2017
Authors: M. Zucker, MD; R. Hughes, Pharm D; A. Culyba, MD; L. Zinns, MD; J. Boyle, RN;
C. Jacobstein, MD; J. Posner, MD; J. Lavelle, MD

Learn More

 Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged

Women

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clinical pathway please contact us.