ABSTRACT
Acute abnormal uterine bleeding (AUB), requiring immediate intervention, may occur in the context of ongoing chronic AUB or as an isolated episode. Decisions regarding investigations and treatments of AUB are influenced by a number of factors, which include the age and reproductive wishes of the individual woman, the pattern and severity of her symptoms and the degree of social disruption that she experiences. Guidelines recommend that transvaginal ultrasound scanning (TVS) should be used, together with endometrial biopsy if indicated, for the initial investigation of AUB, with hysteroscopy as a backup technique. The initial management of AUB should take place within a primary care setting following abdominal and pelvic examination and measurement of full blood count. Abdominal ultrasound is required if the uterus is palpable abdominally. Hysteroscopy provides accurate visualisation of the uterine cavity and greater accuracy than TVS in distinguishing between polyps and submucosal fibroids although it is more invasive and potentially more costly.
