Keywords
How to Cite
Abstract
Pubertal abnormal uterine bleeding requires highly specialized, non-adult-centric intervention strategies to mitigate rapid hemodynamic collapse and preserve pediatric reproductive architecture. This condensed prospective analysis evaluates targeted pharmacological protocols across a rigorously phenotyped cohort of 312 adolescent females (aged 11-17) treated between 2020 and 2024. Diagnostic mapping isolated neuroendocrine immaturity (65.4%) and latent hereditary coagulopathies (19.2%) as the primary etiological drivers. By stratifying 118 acute emergency cases and 194 chronic outpatient cases, the investigation measured the precise kinetic advantages of etiology-specific therapies. Deploying synchronous intravenous tranexamic acid and high-dose progestins secured complete acute hemostasis within 36 hours for 84.6% of hospitalized subjects, bypassing surgical intervention. Extended-cycle monophasic oral contraceptives maintained long-term stabilization in 91.2% of the chronic cohort. The statistical outcomes absolutely invalidate empirical, generalized hormonal suppression, dictating the immediate adoption of step-wise, hematologically verified algorithms for adolescent gynecological care.
References
1. Deligeoroglou E, Karountzos V. Management of abnormal uterine bleeding in adolescents: a comprehensive review. Pediatr Endocrinol Rev. 2021;18(3):234-245.
2. Mullins E, Gurtcheff S, Rebar R. The neuroendocrine regulation of the pubertal transition and its clinical implications. J Pediatr Adolesc Gynecol. 2022;35(2):112-120.
3. James AH. Heavy menstrual bleeding in adolescents with bleeding disorders. Haemophilia. 2020;26(1):15-22.
4. American College of Obstetricians and Gynecologists. Committee Opinion No. 785: Screening and management of bleeding disorders in adolescents with heavy menstrual bleeding. Obstet Gynecol. 2019;134(3):e71-e83.
5. Chi C, Kadir RA. Inherited bleeding disorders in the adolescent female. Best Pract Res Clin Obstet Gynaecol. 2020;63:45-58.
6. O'Brien SH, Zia A. Menorrhagia in adolescents: an algorithmic approach to diagnosis and management. Pediatr Clin North Am. 2022;69(4):725-738.
7. Pecchioli Y, Quint E, Gomez-Lobo V. The utilization of tranexamic acid in pediatric and adolescent gynecology. J Pediatr Adolesc Gynecol. 2023;36(1):14-19.
8. Rimmer E, Rance E, Roberts L. High-dose progestin therapy for acute abnormal uterine bleeding: a clinical analysis. Int J Gynaecol Obstet. 2021;154(2):205-211.
9. Srivaths LV, Minard CG, O'Brien SH. Heavy menstrual bleeding in adolescents: establishing standardized criteria for hospital admission. Blood Adv. 2020;4(15):3677-3684.
10. FIGO Menstrual Disorders Committee. FIGO guidelines on the management of abnormal uterine bleeding. Int J Gynaecol Obstet. 2023;162(2):380-395.