BHP

Good communication with patient, based on key skills: empathy, attentive listening, expert
knowledge, rapports
Inform consent to perform pelvic exam and curettage (purpose, procedure, risks, etc.), also ask
patient to do certain procedure, such as emptying the bladder before given the treatment.
Risks of curettage:
Complications may arise from either the introduction or spreading of infection, adverse reaction
to general anesthesia required during the surgery or from instrumentation itself, if the procedure
is performed blindly (without the use of any imaging technique such
as ultrasound or hysteroscopy).
One risk of sharp curettage is uterine perforation. Although normally no treatment is required for
uterine perforation, a laparoscopy may be done to verify that bleeding has stopped on its own.
Infection of the uterus or fallopian tubes is also a possible complication, especially if the woman
has an untreated sexually transmitted infection.
Another risk is intrauterine adhesions, or Asherman's syndrome. One study found that in women
who had one or two sharp curettage procedures for miscarriage, 14-16% developed some
adhesions. Women who underwent three sharp curettage procedures for miscarriage had a 32%
risk of developing adhesions. The risk of Asherman's syndrome was found to be 30.9% in women
who had D&C following a missed miscarriage, and 25% in those who had a D&C 14 weeks
postpartum. Untreated Asherman's syndrome, especially if severe, also increases the risk of
complications in future pregnancies, such as ectopic pregnancy, miscarriage, and abnormal
placentation (e.g.placenta previa and placenta accreta). According to recent case reports, use of
vacuum aspiration can also lead to intrauterine adhesions.
The doctor should explain why does he/ she give that particular treatment for the patient and do the
follow up treatment
PHOP
Biasanya DUB terjadi dari perubahan hormone yang tidak dapat diprediksi sehingga tidak dapat
dicegah. Tapi, jika overweight, dapat memengaruhi produksi hormone yang meningkatkan resiko
terjadinya irregular menstrual bleeding. Maka jika overweight, menurunkan berat badan dapat
membantu untuk mencegah terjadinya DUB.
Educate people about menstrual disorder and how to prevent it:
Maintain a healthy weight. Women who are overweight or underweight have more problems
with abnormal vaginal bleeding
If using birth control pills, make sure to take them as directed and at the same time every day
Learn to practice relaxation exercises to reduce and cope with stress. Stress may cause
abnormal vaginal bleeding.
CRP
In the U.S., anovulatory bleeding is the predominant cause of hospital admission (46% of
cases) among adolescent patients presenting with menorrhagia
DUB occurs in approximately 10% to 30% of reproductive-aged women and has a negative
impact on the quality of life of affected women, whether young or old. Twenty-percent of cases of
DUB occur in adolescence, and 40% of cases occur in patients over age 40