03 xuất huyết tử cung bất thường

VAITRO CUASIEU AM TRONG XUAT

HUYTUECTUNG BAT THUONG KHONG

LIEN QUAN DEN THA |

BS KL Nguyen Thi Thu Trang

BV Vinmec Central Park

be ot ILA

‘ate HƠI Us * HT |

NOI DUNG 1, Dinh nghia, cdc thuat ng, nguyén nhén theo The International

Federationof Gynecologanyd Obstetrics (F1G0)

2, Cd but tgp tận đánh gi uuấthuyết từ tung Hết từntgheo

hai hé thang FGO

3, Hin anh cc én K thug gdp trong wut huyét ti cung bt

thurdng dah gi dt trén siu am

Ket dn

NO DAU

+ Yudt huyet ti cung bt thug abnormal uterine bleding-AUB) la chy mau

ttt cung bat thug vé tinh du dln, th ih, tn sat thoi gan va xay ra
Kh khong co tha

+ Til 3%-30% phy ni trong dtl sinh san, thutng nhieu tu dy hl va

quanh man kinh

+ iện uy t tiều phương tin đánh giá AUB: iu dm, MR, ni soi bud tử
cung.. su Am ngd Am dao a phurong tin đầu ta truy đánh gi AUB

‘Munro MG, Cctey HOO, Fraser 8 FGO MentrulOsordrs Commitee. The two FAG systems for norma and abnormal teri bleeding

symptoms and clsfaton of causes of abnormal uterine bledng nthe reproduce yas 2018 reson

CAC THUAT NGU NGUYEN NHAN THEO FIGO

FO len! Tinwit Bit tng ng at uy i

Cacthuat mpi VaLakmyPe re Kh thug nun (38 ng)

, 4 The gan Bh thug (224 dn 3 gy)
Thtng yen (4 ng)
dinh nga thì AUB oy
inh thu(8 gng)
Toh dtu din
Keo dl pb ng)
(ey
Bnhtdbh(vnhtrchgchu Klng hvhit Sg)
Mui BN gy inh

Xhbun21g0 ny
(ow Volum, putin determined)
k
uit hat la cu
Binh thutng
(ltermenstua bleeding MB)
Mù
Khong

id

Cut (Olu ch ga chu cub chu).

AuthdoeGmadl no ng
as
Sterol thule gadtag wan, dn,
ti
ty

Bang FIGO AUB system 1, Cc thut ng va cdc din nga cla AUB

Mun MG, CichlHOyD, Fasr FC Ment iad Comite, Th two FG tr or oralal abnormal uterine biedng

CAC THUAT NGU, NGUYEN NHAN THEO FIGO

FIGO AUB Sys2 PtALeMCOmEIN

tt yyy utd Kn cu td

p po Iii Coa

Ẻ L Ay | _ tui —
ye = TÍN
\ - | Malig&nhaypnercplaysia Tatrogenc

M " | | Not yet classed

0 ¢] | | fe) 7 2 (0N
p1

E BX

| | \

\ LW fA

Batrgchain dodn bit thn 8 ctu tr PALM cing ng

al chan dod hint anh vd md hoc

‘Munro MG Crtctey HO, Broder MS Fase 10 Working Groon Muensptrual lords FIG clasation ystem PALM

COEIN) for causes ofabnorma uterine been in nongravd women of reproduce agent) Gynaecol Ost. 2011

Ap3{1)343. cel 104086) g02010.1.011, ub 2001 Fb 2. PMO 21345435,

Yh 18D

TheF1GtO sywsteoms fo normaalnd abnormal' TẾ CAN CHAN

iterine bleeding symptoms and classification of B0ÁN AUB

causes of abnormal uterine bleeding inthe

reproductive yeas: 2018 revisions

MacoG Mnunro! 2 Hilary 0D Cty lan Fraser 4: F160Menstal Disorders Commitee

ColtboratorsAfilatons + expand

PMID: 30198563. Ok 10 100g.686

1, Banh gié chung

2, Xa dinh tinh trang phong nodn

3, Tam sodt ch loan dng méu

4, anh gd ni mac tu cung (NMIT

5, Dan pa cdu tric budng noi macti cung

6, Banh id cot cung

TIẾP CAN CHAN DOAN AUB

Dar gi nbimac ti cung va cau tc buon te cun

Sie dm ngd &m dao (TVUS) phe tin quan trong dgu ty dé ddnh id NMTC
va du tric bubng tcung

Néu TVUS cb bd thutng NMC, cu tc bung ti cung
4 Siéu dm dict tuong phan gel /numcui sinh (9
4 NGiso’ bung tcung (kt hop sinh thi

Mri

NG Crt HOO, Fraser F1G0 Menstrual sods Commitee The two FGO sysfotr enormmalsand abnormal uterine bledng symptoms and

ton of aes of abnormal uterine lecing the reproductive yeas: 218 resins.

NAO SINH THIET Khing cin tht pha ngo sinh tit tt cd BN AUB
Nao sinh thet budng te cung Kd yéu 6 nguy coca
ri
tis

(Cac yéut6nguy co di rayén (i ching Lynch)

4Béoph

(Siu dm ng dm dao NMTC dy, bn hon hop

(AUKéoB diva Khdng gai thch dug, khongdue diu tr

day dl.

Munro MG, Cctey HOO, Fraser 8 FGO MentrulOsorders Commute. the two 1G systems for norma and abnormal vere

bleeding symptons and clsication of cases of abnormal uterine lee inthe reproductive yeas: 2018 revs,

hitps/wo/hwmboaruy/tnet/sendnomeata-lopsy

TIEP CAN CHAN DOAANUB

Đánh cot oung

Burd ket hop siéu dm ngôn tâm đạn

Buti 2: vxolién quan dén NMTC (160 0,1,2,3 yy) dn kt hop sium ng

amn dan siéu am cb chat tuong phán tội si bung tử ong va MA
Cacurd conkil,

MRI: pid phn bit xo va lac tuyen trong cot cung,dénh ự đề ép buông

nic, mic dan rdngvé do kch thu tn thyong tot hon

NG Crt HOO, Fraser F1G0 Menstrual sods Commitee The two FGO systemfsor normaanld abnormal uterine bledng symptoms and
ton of aes of abnormal uterine lecig I the reproductive yeas: 218 revsions.

SIFU AM DANH GIA BAT THUONG CAU TRUC

PALM

Polp i

POLYPNOI MAC

"Lastisnd gkh tr qua mit cla cdc tuyén vd md

TUCUNG AUB.P dém vung quanh mt 6 mach tao thành một phần nhô

| fattuốny Mặt ôn tú cudng tt bé mat nd mg i

\ cung

Ddin/da polyp, val mm-em

D Bat kivitendo cla NMITC

D Gap o mola tu thronpgp sau mn Kin (12)
> Theo Dreislr et al 82% hông tổ tiệt ching, SO

AUB, 3546 v0 sinh

htps/inuptodatecomconents/endomeptiohs

POLYP NOIMAC TU? CUNG

SIE AM CHAN DOAN

0 Khoi phn dy, bd, vin phn dy

0 Cc nang abo bén trong, hungmn kin

o Diu ‘bi vin sing (bright ede’
ooh nk dc tm tư nach mu don DN 764

Dù

o Siu bom dich King i cung han od tinh

vac polyp nd mac tt cung

by Nang NP Anderson, Markham 8, Manco. Endometrial pols:
[ Pathogens, sequela and treatment SAGE Open Med. 2019

) Widene oTechcMohiriae, 2020 Ser 18(3}403:415, do: 1.5114/witn 2020379)

Epub 2020 Mar 1

Comparison of diagnostic accuracy of saline infusion

sonohysterography, transvaginal sonography, and

hysteroscopy in evaluating the endometrial polyps in

Women with abnormal uterine bleeding: a systematic

review and meta-analysis

Mania Kaveh ',KambiSadegl 2 Movtza Salar, atm Paroel?

Atflations + evpand

PMID; 32404826. PMCID: PMCT4S7193. Ok 10.51 14/itm2020.93791

TL ee LL khung

0.462 (057-067) 073 (068-077) ay

tú

$6 0.8) (82-091) 0.86(083+0488) 9 082

Hysterocopy — 092(089+0.94) 0.85(081-088) 0M 045

BN 39, PARA 2012

Ndioi bung TC ct pohyp

III(IIL|V(00I0V

BN 40k, PID 200534680

NGI sol bud cng ct polyp,

ngo sinh thitlong tl cung

SIFU AM DANGHIA BAT THUCING CAU TRUC

PALM

i

Adenomyosis i

, neyand hy

LAC TUYEN TRONG CO TU’ CUNG (AUBA}

DCéctuyén nbimgvcd md dm lac cd ao trong ct cng, lam hi dai co tcung

kung quanh

D Corchésnh bh dpa thuyét

Sy xdm in vdo co Demovo from
tcucnlagni 4
millerian remnants Q

mac te cung Hinh than cd sang
Vichin thug d giao
thong dy tn

sign! neve mau kinh d tát

tébaondmaic

‘Andres MP Borel GM, ibe, Baraat Abdo MS, Kho RM Transvaginal Ursound forthe Dagnodsof Adenomyoss th

Review and Metana}ys, Minnlvsve Gynec 2018 et2$2}257-26, dl 10.1mg021017608)653 Epub 201? Aug30, IO

ido,

LAC TUYEN TRONG CO TH CuNG
MetasAnais > J Min col, 20F2eb0 (2408418

Ws 10.100))mig 019 11,00, Eu 2019 Nov

Rin eh HH Noninvasive Diagnosis of Adenomyosis; A Structured

md bnh hgc nung cb phdu. Review and Meta-analysis of Diagnostic Accuracy in
" `.
thudt nén chan dodn da vao
TT Sk gud? eg?
Siu dn/ Mc | rr lịiit

Ms wh wh

OTS Wh m

Mi 1 ih

Theo FGO AUB Syte2md nghi cn dod lac tytronég cont cung

dua trén Morphological Uterus Sonographic Assessment (MUSA)

Dt ans Ld as ch phe pit Tl lrip.

Ñ és 1, Cc nang trong ct cung

i wags | 2 CAcvng ting dm trong ot cng
km km

L4 Ậ | Ậ Ñ 3, Cc dt vac ting dt ni mac un

| (ivi wot | CACOACGONVETEMP

ay

mẠ n Ñ ‘ 1.1cung hh cu

vale jwocw! | 2. Thanh te cung day king di xing

cin rn vin Mrates, Hubing g nga gat

Sonographic Assessment (MUSA) |, Mach mu uyén in hung

§, Vg nl Khong du

6, ing nd bi gin doan

‘Harms A Vand BT, a aban MA, Dube M,xaous Valet, tray WK, Grn De rut, nu Caza, bane, , ata

1 onium, a Coan road ts capil a raph es NK ao ames
wd 6 pd at Oba Go 2) 18131

`7 a | / = 1 okt

ị / Wis

rUIiTsRASOOUtND \t

Thanh trv sou tri ph dey

pŠyr 4) et td, hn hp?

Cpa ree Dang nang khong dang nang?

Sonographic classication and eprtsnysgte fr dagnosing as Â
adenomyosis

1, Vee dan Bosch AV. de Brin, A, Ge Le, Mehl acoso, Boum,

an) AF Hur)

tle 21) yayMD | Cato “@ '

Lop (tý lị anhlưng

"—Ặ..., 4 lỆ lanrong

\ Nhe 25%, trung bn 25-50%, nding 250%

\\ ‘ Kich thtoun tdhong

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