Heavy Menstrual Bleeding Assessment and Management (NG88)

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What is the estimated prevalence of adenomyosis according to most studies?

20 to 25%

35 to 40%

25 to 30%

30 to 35% (correct)

Why is it important to optimize treatment for adenomyosis?

To complicate patient satisfaction

To reduce unnecessary investigations and treatments (correct)

To avoid studying the impact of adenomyosis

To increase the prevalence of the condition

What type of registry is suggested for recording long-term clinical outcomes in women with adenomyosis?

Prospective clinical registry (correct)

Pharmacological registry

Retrospective clinical registry

Surgical registry

What is the estimated percentage of women in whom submucosal fibroids cause heavy menstrual bleeding?

15% Signup and view all the answers

Which condition is thought to be caused by submucosal fibroids in around 15% of women?

HMB Signup and view all the answers

How can understanding the impact of adenomyosis help in improving patient outcomes?

Improve patient satisfaction and treatment efficacy Signup and view all the answers

Which imaging technique is recommended as the first-line diagnostic tool for women with heavy menstrual bleeding who have significant dysmenorrhea or a bulky, tender uterus on examination?

Transvaginal ultrasound Signup and view all the answers

What is the recommended approach if a woman declines transvaginal ultrasound or it is not suitable for her?

Consider transabdominal ultrasound or MRI, explaining the limitations of these techniques Signup and view all the answers

Which of the following diagnostic tools should NOT be used as a first-line diagnostic tool for heavy menstrual bleeding?

Saline infusion sonography Signup and view all the answers

Which of the following is the LEAST recommended approach for diagnosing heavy menstrual bleeding according to the text?

Performing dilatation and curettage Signup and view all the answers

Which of the following conditions may cause pain associated with heavy menstrual bleeding, according to the text?

All of the above Signup and view all the answers

Which of the following factors may indicate the need for a pelvic ultrasound in women with heavy menstrual bleeding?

All of the above Signup and view all the answers

What should be considered if further information about fibroid position, size, number, and vascularity is needed?

MRI Signup and view all the answers

In what scenario should second-generation endometrial ablation be considered as a treatment option?

For fibroids of 3 cm or more in diameter in women with HMB Signup and view all the answers

What should be considered if initial treatment for heavy menstrual bleeding (HMB) is unsuccessful?

Additional investigations to reassess the cause of HMB Signup and view all the answers

When should pretreatment with a gonadotrophin-releasing hormone analogue be considered?

Before hysterectomy and myomectomy for uterine fibroids causing an enlarged uterus Signup and view all the answers

What should be done when discussing the route of hysterectomy with the woman?

Carry out an individual assessment and consider her preferences Signup and view all the answers

What is recommended if uterine fibroids are causing an enlarged or distorted uterus?

Hysterectomy or myomectomy Signup and view all the answers

What is the primary aim of this guideline?

To help healthcare professionals investigate the cause of heavy periods and offer appropriate treatments based on the woman's preferences. Signup and view all the answers

Who is the intended audience for this guideline?

Both healthcare professionals and women with heavy menstrual bleeding, their families, and carers. Signup and view all the answers

What is the significance of the guideline being the basis for QS47?

QS47 is a quality standard that is derived from the recommendations in this guideline. Signup and view all the answers

What principle is emphasized in the last sentence of the text?

The importance of shared decision-making between healthcare professionals and patients. Signup and view all the answers

What is the significance of the guideline replacing CG44?

CG44 was an outdated guideline, and this new guideline provides updated recommendations. Signup and view all the answers

What is the significance of the Royal College of Obstetricians and Gynaecologists' guidance for gynaecological services during the COVID-19 pandemic?

It is not directly relevant to the guideline on heavy menstrual bleeding and is mentioned as additional context. Signup and view all the answers

Which of the following diagnostic techniques is recommended for detecting submucosal fibroids, polyps, or endometrial pathology in women with heavy menstrual bleeding (HMB)?

Hysteroscopy Signup and view all the answers

What potential impact is mentioned in the text regarding the recommendation for hysteroscopy over pelvic ultrasound?

It will require changes to service organization and training, as hysteroscopy is not as readily available as pelvic ultrasound. Signup and view all the answers

Which of the following strategies could be employed to address the resource impact of the hysteroscopy recommendation?

Specialists could offer more services in the community, or GPs and nurses could be trained to perform hysteroscopy in primary care. Signup and view all the answers

Based on the information provided in the text, which of the following statements is true regarding the potential cost implications of the hysteroscopy recommendation?

The recommendation is expected to result in overall cost savings due to a reduction in unnecessary investigations and more effective treatment. Signup and view all the answers

Which of the following statements is NOT supported by the information provided in the text?

The recommendation for hysteroscopy is expected to lead to an increase in the number of unnecessary investigations. Signup and view all the answers

Which of the following diagnostic techniques can be considered for women with HMB, provided that they understand and accept the limitations of these techniques?

Transabdominal ultrasound and MRI Signup and view all the answers