BACKGROUND: Life-threatening abnormal uterine bleeding can be managed by a variety of techniques, which include intravenous estrogen, dilation and curettage, endometrial ablation, uterine artery embolization, or hysterectomy. Thermal balloon endometrial ablation has been used in the management of chronic dysfunctional uterine bleeding but has not been described in a case of acute uterine hemorrhage.
CASE: A 44-year-old woman with end-stage liver disease presented with vaginal bleeding and fever. She was found to have sepsis, coagulopathy, and anemia. No anatomic uterine pathology was identified. Antibiotics, intravenous estrogen, and blood products were administered, but heavy bleeding persisted. Thermal balloon ablation resulted in abrupt cessation of uterine bleeding.
CONCLUSION: Thermal balloon ablation appears to be an effective method for management of acute uterine hemorrhage.
Reported is a case of acute uterine hemorrhage in a patient with end-stage liver failure and sepsis for which thermal balloon endometrial ablation was therapeutic.
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia
Address reprint requests to: Catherine Matthews Nichols, MD, Medical College of Virginia, Virginia Commonwealth University, Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Box 980034, Richmond, VA 23298; E-mail: firstname.lastname@example.org.
Received January 9, 2002. Received in revised form April 1, 2002. Accepted April 11, 2002.