Management of patients with abnormal uterine bleeding concurrent with severe thrombocytopenia

Spiridonova N.V., Kaganova M.A., Tezikova T.A., Sreselli G.M.

1) Department of Obstetrics and Gynecology, Samara State Medical University, Samara, Russia; 2) Perinatal Center, V.D. Seredavin Samara Regional Clinical Hospital, Samara, Russia
Background. Abnormal uterine bleeding (AUB) is one of the most common symptoms of proliferative processes in the female genital area. AUB is most severe in patients with concomitant pathology of the blood coagulation system.
Description. The given clinical case presented with concomitant pathology: severe idiopathic thrombocytopenic purpura concurrent with multiple large uterine fibroids complicated by uterine bleeding and severe anemia. For treatment, transfemoral angiographic embolization of the uterine arteries, hysteroresectoscopy with endometrial ablation, and the gonadotropin- releasing hormone agonist (GnRH-a) buserelin were used in stages.
Conclusion. The use of GnRH-a in combination with surgical treatment is the optimal treatment of patients with AUB with concomitant blood coagulation system disease.

Keywords

abnormal uterine bleeding
gonadotropin releasing-hormone agonists
idiopathic thrombocytopenic purpura
endometrial ablation
hysteroresectoscopy
uterine artery embolization
buserelin

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Received 07.06.2019

Accepted 21.06.219

About the Authors

Spiridonova Natalia V., Doctor of Medicine, Professor, The Chair of the Department of Obstetrics and Gynecology Obstetrics and Gynaecology of the Institution of Postgraduate Studies of Samara State Medical University Samara, E-mail: nvspiridonova@mail.ru nspiridonova@mail.ru
89 Chapayevskaya St., 443099, Samara, Russian Federation
Kaganova Maria A., PhD, Associate professor, Department Obstetrics and Gynaecology of the Institution of Postgraduate Studies of Samara State Medical University Samara. Е-mail: mkaganova@yandex.ru.89 Chapayevskaya St., 443099, Samara, Russian Federation
Tezikova Tatiana A., Head of the Perinatal Center of the Samara Regional Clinical Hospital named after V.D. Seredavina. E-mail: zgvakush@sokb.ru
159, Tashkentskaya st. 443099, Samara, Russian Federation
Sreselli George M., Head of the Gynecological Department of the Samara Regional Clinical Hospital. V.D. Seredavina. E-mail: zgvakush@sokb.ru
159, Tashkentskaya st. 443099, Samara, Russian Federation

For citation: Spiridonova N.V., Kaganova M.A., Tezikova T.A., Sreselli G.M. Management of patients with abnormal uterine bleeding concurrent with severe thrombocytopenia. Akusherstvo i Ginekologiya. 2019; 8: 174-78 (in Russian)
https://dx.doi.org/10.18565/aig.2019.8.174-178

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