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US of Abnormal Uterine Bleeding¹

¹ From the Department of Radiological Sciences, University of California, Los Angeles, Center for the Health Sciences. Recipient of a Certificate of Merit award for an education exhibit at the 2001 RSNA scientific assembly. Received October 7, 2002; revision requested October 31 and received December 16; accepted December 16. Address correspondence to P.L.W., 10964 Wellworth Ave #102, Los Angeles, CA 90024 (e-mail: pennalee@hotmail.com).

Any significant deviation from a woman’s established menstrual pattern may be considered abnormal uterine bleeding, and several factors direct evaluation of a patient with such bleeding. Premenopausal disorders that are well evaluated with ultrasound (US) include endometriosis, adenomyosis, and leiomyomas. A positive pregnancy test in a woman of childbearing age prompts a search for an intrauterine pregnancy. Possible complications that may contribute to bleeding include ectopic pregnancy; placental factors including position, trauma, and infection; gestational trophoblastic disease; preterm labor; and postpartum complications. Atrophic changes, hormonal status, and carcinoma are considerations in the postmenopausal patient with abnormal uterine bleeding. Foreign bodies, trauma, infection, polyps, and iatrogenic causes can be observed in all groups. Differential diagnoses for abnormal uterine bleeding in premenopausal, pregnant, and postmenopausal patients are well evaluated with US, and US techniques have greatly facilitated evaluation of pelvic disease. Urgent and emergent conditions such as ectopic pregnancy, placenta previa, and preterm labor are readily identifiable.

© RSNA, 2003

Index Terms: Genitourinary system, infection, 85.217 • Genitourinary system, neoplasms, 85.31, 85.32 • Pregnancy, complications, 85.82 • Uterus, hemorrhage, 854.413

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