Not otherwise classified
DEFINITION
- This includes cases where abnormal uterine bleeding is not related to pregnancy, structural pelvic alterations, hormonal imbalance, hormonal contraception or chronic disease1,5
- Conditions might include myometrial hypertrophy and arteriovenous malformations, or uterine ischiocele related to the uterine scar from a previous cesarean section2,3,4
SYMPTOMS
- Abnormal uterine bleeding in a woman in whom other causes were excluded
DIAGNOSIS
- Exclude other potential causes of abnormal uterine bleeding: detailed patient history, gynecological examination, blood tests, transvaginal ultrasound1
- Endometrial biopsy can identify a previously non diagnosed structural cause (i.e. endometrial polyps or hyperplasia)1
TREATMENT
- Medical treatment should be considered as a first-line option in the absence of structural abnormalities5,6
- Non-hormonal treatments: NSAIDs (like mefenamic acid) and tranexamic acid5
- Hormonal treatments: cyclical progestins, combined oral
Not otherwise classified HMB Library
Find more information and download materials on not otherwise classified HMB in the teaching and resources library.
References
- Grzechocinska B, et al. J Womens Health Issues Care 2017;6:1.
- Munro MG, et al. Int J Gynaecol Obstet 2018; 143,393–406.
- Munro MG, et al. BJOG 2017;124:185–9.
- Munro MG, et al. Int J Gynaecol Obstet 2011;113:3–13.
- Singh S, et al. J Obstet Gynaecol Can 2013;35(5_eSuppl):S1–S28.
- Bradley LD & Gueye NA. Am J Obstet Gynecol 2016;214:31–44.
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