Ludwig H
MMW Munch Med Wochenschr. 1978 Sep 15;120(37):1187-92.
Uterine hemorrhages are dependent on the vascular architecture of the endometrium: the endometrial spiral arteries supply sectors strictly separated from each other at intervals of about 1.4 mm. Their function is so closely coupled with the endocrine regulation of the cycle that the presence of hormonal receptors in the vessel wall must be assumed. Menstrual bleeding is an instructive example of morphologically detectable endocrine controlled processes. Endometrial hemorrhage in adenocarcinoma appears early, but it is not an early symptom because the surface epithelium remains intact at first. The diagnosis of precancerous changes in the endometrium (adenomatous hyperplasia--carcinoma in situ) is based on the condition of the surface epithelial cells. Extrauterine pregnancies, miscarriages and trophoblastic diseases are usually diagnosed from the uterine hemorrhage. The quality of the hemorrhage in early pregnancy has less diagnostic importance than, for example, in dyshormonal hemorrhagic disorders.
子宫内膜螺旋动脉供应的区域相互严格分隔，间隔约为1.4毫米。它们的功能与月经周期的内分泌调节紧密相关，因此必须假定血管壁中存在激素受体。月经出血是形态学上可检测到的内分泌控制过程的一个典型例子。腺癌中的子宫内膜出血出现较早，但它不是早期症状，因为起初表面上皮仍保持完整。子宫内膜癌前病变（腺瘤样增生——原位癌）的诊断基于表面上皮细胞的状况。宫外孕、流产和滋养细胞疾病通常根据子宫出血来诊断。早期妊娠出血的特征相比例如激素失调性出血性疾病，其诊断重要性较低。
