Abstract
BackgroundAbnormal vaginal bleeding (AVB) in women of reproductive age is a common reason for consulting a general practitioner. Nevertheless, how general practitioners (GPs) choose to initially manage AVB is largely unknown, as is the prevalence of underlying pathology of AVB in primary care.MethodsTo investigate the initial diagnostic procedures and treatment for AVB used in general practice, we performed a descriptive study based on computerised medical records. New consultations for AVB in 2000 and 2001 were selected. Patient characteristics, diagnostic procedures and treatment were analysed.ResultsIn total, 270 new consultations were included. The majority of patients (75%) consulted the GP for AVB only once. GPs performed diagnostic procedures in 54% of all consultations. Overall, additional diagnostic procedures revealed abnormalities in 11% of women. However, the diagnostic procedures implemented by the GPs varied widely per bleeding type and contraceptive use. Anaemia was found in 36% of 45 women tested. Uterine fibroids were found in 41% of 27 women examined by ultrasound. Medication was prescribed in 34% of all consultations. A gynaecological referral was registered in 4% of all contacts.ConclusionInitially, GPs tend to follow a policy of expectant management in women of reproductive age with AVB. However, when additional diagnostic procedures were performed, anaemia and uterine fibroids were found in a considerable number of women.
Highlights
Abnormal vaginal bleeding (AVB) in women of reproductive age is a common reason for consulting a general practitioner
Little is known about which diagnostic procedures are chosen by general practitioners (GPs) to differentiate between causes of AVB and to implement its therapeutic management in general practice [3,4,5]
In this study we found that GPs tend to initially follow a policy of expectative management in women of reproductive age who are seen for abnormal vaginal bleeding
Summary
Abnormal vaginal bleeding (AVB) in women of reproductive age is a common reason for consulting a general practitioner. Abnormal vaginal bleeding (AVB) is a frequent reason for women of reproductive age to consult a general practitioner (GP). Data on causes of AVB in primary care are scarce These guidelines were mostly based on data acquired in secondary care and gave no specific advice on diagnostic methods. To fill this gap, we studied the use and outcome of initial diagnostic procedures and the therapeutic management by GPs of women of reproductive age with AVB
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