MBBS (Hons), FRANZCOG, MPHTM Consultant Gynaecologist, Royal Children@s Hospital, Vic; Consultant Obstetrician and Gynaecologist, Western Health, Vic.
MBBS, FRANZCOG, MD, FFPMANZCA Director, Department of Gynaecology, Royal Children@s Hospital, Vic; Consultant Gynaecologist, Mercy Hospital for Women, Vic; Head of Family Planning Unit, Austin Health, Vic; Head of Plenty Gynaecology Unit, Mercy Hospital for Women, Vic; Clinical Professor, Department of Paediatrics, University of Melbourne, Vic; Research Fellow, Murdoch Children@s Research Institute, Vic; President, International Federation of paediatrics and adolescent gynaecology (FIGIJ), Vic.
Aust J Gen Pract. 2020 Jan-Feb;49(1-2):70-72. doi: 10.31128/AJGP-07-19-4989.
Heavy menstrual bleeding (HMB) in adolecents is predominantly related to an immature hypothalamic-pituitary-ovarian axis. Structural causes in this population are extremely rare; therefore, pelvic ultrasonography is not required as a first-line investigation. Anecdotally, it has been observed that pelvic ultrasounds of adolescents with HMB are normal and do not change clinical care. The aim of this study was to analyse all female patients aged ≤18 years who were referred to a tertiary paediatric hospital for HMB over a 12-month period.
Medical records were reviewed to determine if pelvic ultrasonography was ordered during the diagnostic process and whether the imaging altered management.
No pelvic ultrasounds ordered for adolescents with HMB altered clinical management. General practitioners (GP) were the most likely to refer patients to the tertiary paediatric hospital and to order pelvic ultrasonography, likely reflecting that most female adolescents are seen by a GP within the community.
Providing clinical updates and ongoing education to health professionals managing female adolescent patients is recommended.
青少年月经过多（HMB）主要与未成熟的下丘脑-垂体-卵巢轴有关。该人群中结构原因极为罕见；因此，盆腔超声检查不作为一线检查。据报道，HMB 青少年的盆腔超声通常是正常的，且不会改变临床治疗。本研究的目的是分析在 12 个月内因 HMB 被转诊到三级儿科医院的所有≤18 岁女性患者。
回顾病历以确定在诊断过程中是否开具了盆腔超声检查，以及影像学检查是否改变了治疗方案。
没有因 HMB 而开具盆腔超声检查的青少年改变了临床管理。全科医生（GP）最有可能将患者转介到三级儿科医院并开具盆腔超声检查，这可能反映了大多数青春期女性在社区中由 GP 进行治疗。
建议为管理女性青少年患者的医疗保健专业人员提供临床更新和持续教育。
