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Uterine bleeding that is abnormal in timing, duration, or quantity affects nearly one-third of women and carries a substantial financial and quality-of-life burden. An estimated 5% of ED visits are for vaginal bleeding, and 1% of those patients will have a life-threatening cause that must be identified. Emergency clinicians need to have a comprehensive understanding of the pathophysiology and etiologies of abnormal uterine bleeding to manage and treat these patients. This issue reviews the most recent updates on common causes and the approach to abnormal uterine bleeding in the nonpregnant patient, including vaginal bleeding in prepubescent females.
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J Midwifery Womens Health
September 2025
College of Nursing, Research Institute of Nursing Innovation, Kyungpook National University, Daegu, South Korea.
Introduction: Given the rising number of studies on synthetic osmotic dilators, there is a lack of comprehensive reviews for their use compared with other commonly used cervical ripening methods. This study aimed to examine the maternal and neonatal safety and efficacy in cervical ripening and labor induction using synthetic osmotic dilators compared with pharmacologic agents (prostaglandin E, prostaglandin E, oxytocin) for labor induction.
Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) and cohort studies was conducted, using MEDLINE, Embase, CINAHL, and Cochrane Library databases search.
Cureus
August 2025
Department of Pathology, Saint Savvas Anticancer Hospital of Athens, Athens, GRC.
Small cell neuroendocrine carcinoma of the cervix is an uncommon, aggressive tumor that most often affects women in their 40s and is frequently linked to high-risk human papillomavirus (HPV) infection. It is associated with poor prognosis even in early-stage disease. We report the case of a 36-year-old woman with high-risk HPV who presented with abnormal vaginal bleeding.
View Article and Find Full Text PDFOncoscience
September 2025
Division of Pediatric Hematology and Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Background: Trophoblastic differentiation or beta-human chorionic gonadotropin (β-hCG) secretion in endometrial carcinoma has been associated with poorly differentiated and aggressive tumors; however, the evidence is largely inconclusive. The review aimed to explore the prognostic role of trophoblastic differentiation and β-hCG in non-trophoblastic, primary uterine corpus cancers.
Methodology: A comprehensive electronic search across databases was conducted for all cases of cancers of the uterine corpus that were either associated with elevated levels of β-hCG or showed evidence of trophoblastic differentiation upon microscopy or both.
AJP Rep
July 2025
Departments of Biomedical Informatics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Preeclampsia is a multiorgan vascular disease complicating approximately 8.5 million pregnancies worldwide annually and is a leading cause of maternal and neonatal mortality. The impact is especially severe in Latin America, where maternal deaths attributable to preeclampsia are 2.
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October 2024
Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore.
Massive per vaginal bleeding from ectopic pelvic varices is an exceedingly rare presentation in patients with cirrhosis. A 60-year-old postmenopausal woman presented with massive per vaginal (PV) bleeding. Computerized tomography scan showed extensive portosystemic collaterals with a large collateral vessel from the splenic vein to the region of her previous caesarean scar, on a background of liver cirrhosis.
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