Acute vaginal bleeding in women undergoing liver transplantation

Abstract

OBJECTIVES: Our aim was to define the nature of acute vaginal bleeding problems in women undergoing liver transplantation and to determine the efficacy of treatments given. STUDY DESIGN: We performed a retrospective chart review of 24 patients undergoing liver transplantation in whom consultation was requested for vaginal bleeding. RESULTS: Twenty-four liver transplant patients were seen for evaluation of acute vaginal bleeding. Two patients were seen before transplantation, and 16 women were evaluated for bleeding after transplantation (8 within the first 15 postoperative days). In the other eight women abnormal uterine bleeding developed between 2 months and 5 years after transplantation. Five of these women had compromised liver function. In six other women vaginal bleeding originated from extrauterine sources. Six of seven endometrial biopsy specimens revealed proliferative endometrium, and the other showed adenomatous hyperplasia. Three of four patients had a response to progestational agents, bleeding stopped spontaneously in three patients, two required hysterectomy, and three died of other causes. The other five patients were not seen again by us before or after discharge from the hospital. CONCLUSIONS: Medical or surgical therapy can effectively control acute vaginal bleeding in liver transplant patients. (AM J OBSTET GYNECOL 1994;170:733-6.)