Da'san Trainig and Coaching Center

:- Strategic Approaches for Clinical Teaching Skills During Hospital Attachment
:- Turning Everyday Hospital Work into Powerful Learning Experiences
:
~Clinical mentors & preceptors
~Ward supervisors & team leaders
~Skill lab instructors
~Nursing, Midwifery, Laboratory, Nutrition & Public Health educators
:- during clinical attachment

waxaan todobaadkan dhexdiisa soo gabagabaynay tababar ay qaadanayeen macalimiinta mihnada caafiimaadka(clinical supervisor of Faculty of health sciences) oo ku saabsanaa sidii ay u gudbin lahaayeen Aqoonta inta lagu jiro wareegga bukaanka(Clinical rotation) iyo waxbarashada sariirta agteeda(bedside learning) ama kor ugu qaadilahayeen Fursadaha baris-barasho marka ay joogaan goobaha Caafimaadka ee bukaanka loogu adeego.

Tababarkan oo socday mudo laba habeen ah ayaa waxaa ka faa'iidaystay barayaal sare
Kasoo Ku baxayay qaabka

'san Trainig and Coaching Center

✨ 𝐅𝐫𝐞𝐞 𝐒𝐞𝐦𝐢𝐧𝐚𝐫: STRATEGY OF CLINICAL TEACHING SKILLS

🚀 Ku soo biir group-ka tababarka:
https://chat.whatsapp.com/LLijz0qnEdGEJpF2BHYWI8

𝐗𝐨𝐠𝐭𝐚 𝐓𝐚𝐛𝐚𝐛𝐚𝐫𝐤𝐚:
🕒 Duration: 2 Night
📆 Date: 01-02 January 2026
⏰ Time: 8:00 -10:00 PM
📍 Place: Google Meeting
🎖️ Certificate: Yes / optional – $5

📞 Wixii faahfaahin ah, la soo xiriir:
⁨Whatssapp:±252637423353

ABNORMAL UTERINE BLEEDING
A. DEFINITIONS
1. Clinical Medicine Definition

• Abnormal Uterine Bleeding is any deviation in a woman’s menstrual blood loss—whether in volume, frequency, regularity, or duration—that falls outside the limits of normal cyclic menstruation and cannot be explained by pregnancy.

2. Gynecology Textbook Definition

• AUB is a symptom characterized by uterine bleeding that is unpredictable in timing or excessive in amount, arising from structural or functional disturbances of the female reproductive system.

3. Pathophysiological Definition

• AUB refers to menstrual bleeding that results from alterations in the normal hormonal regulation of the menstrual cycle or from pathologies affecting the uterus, endometrium, or ovulatory mechanisms.

4. Reproductive Endocrinology Definition

• AUB is a manifestation of disrupted endocrine signaling or endometrial responsiveness, leading to bleeding that is heavier, prolonged, irregular, or occurring between normal menstrual periods.

5. Research / Scientific Definition

• Abnormal Uterine Bleeding is a clinical entity in which menstrual bleeding patterns differ from the established norms (24–38-day cycle, 4.5–8-day duration, 5–80 mL blood loss), indicating potential underlying systemic, structural, or hormonal abnormalities.

6. Public Health / Women's Health Definition

• AUB is a common women’s health concern where menstrual bleeding occurs in ways that affect physical wellbeing, emotional health, or daily functioning, often requiring medical evaluation to determine the cause.

6. World Health Organization (WHO) Definition of AUB

The WHO defines Abnormal Uterine Bleeding as:

“Any bleeding from the uterus that is abnormal in volume, regularity, frequency, or duration and occurs in the absence of pregnancy.”

B.CAUSES OF AUB
1. Pregnancy-Related Causes

 Implantation bleeding

 Threatened abortion

 Inevitable/incomplete/complete abortion

 Ectopic pregnancy

 Molar pregnancy

 Placenta previa

 Abruptio placentae

 Vasa previa

2. Hormonal Causes

 Anovulation (PCOS, thyroid disorders, hyperprolactinemia, perimenopause, POI)

 Luteal phase defect

 Obesity (increased estrogen)

 Stress, extreme weight changes

 Medications (hormonal contraception, antipsychotics)

3. Trauma-Related Causes

 Sexual assault / in*******se injury

 Unsafe abortion

 Pelvic trauma

 Uterine rupture

 Cervical laceration during childbirth

 Iatrogenic trauma (IUD, D&C, biopsies)

4. Malignancy-Related Causes

 Endometrial: hyperplasia, carcinoma

 Cervical: dysplasia, cancer

 Vaginal/vulvar cancer

 Uterine sarcoma

C.AUB MANAGEMENT PROTOCOL

• Divided into Emergency (unstable patient) and Chronic (stable patient).

A. EMERGENCY MANAGEMENT OF AUB

1. Assess ABCs

 Airway, breathing, circulation

 IV access (2 large-bore lines), O₂, monitor vitals

2. Determine hemodynamic stability

• If unstable → immediate resuscitation & gynecology referral

3. Labs

 CBC, RFT, LFT

 β-hCG (pregnancy test mandatory)

 Coagulation profile

 Type & crossmatch

4. Medical Management

A. If severe bleeding but patient stable:

 High-dose IV estrogen

 OR high dose combined OCPs

 OR High dose progestins (if estrogen is contraindicated)

 Tranexamic acid (TXA)

 NSAIDs (reduce prostaglandins)

B. If medical therapy fails:

 Uterine tamponade (Bakri balloon, Foley)

 D&C (diagnostic + therapeutic)

 Uterine artery embolization

 Surgical options (hysterectomy)

B. CHRONIC AUB MANAGEMENT

• (For stable patient)

Step 1: Identify the Cause

 Pregnancy?

 According the above classification

 Labs: CBC, TSH, prolactin

 Pelvic ultrasound

 Endometrial biopsy if >45 years or cancer risk

Step 2: Medical Treatment

1. Hormonal

 Combined oral contraceptives

 Progestin pills (cyclic or continuous)

 Depot medroxyprogesterone (DMPA)

 LNG-IUS (Mirena) → most effective long-term management

2. Non-Hormonal

 Tranexamic acid

 NSAIDs

 Iron supplementation for anemia

3. Treat underlying cause

 PCOS → weight loss, metformin, OCP

 Thyroid disease → treat thyroid disorder

 Hyperprolactinemia → dopamine agonists

 Fibroids → myomectomy, embolization

 Polyps → removal

 Malignancy → oncology referral

Contacts
Email: Nour Mahamoud [email protected]
Whatssapp: +252637423353

Ramadaan kariim to All f&f
Nour Mahamoud Ahmed
and founder
Da'san Trainig and Coaching Center

Areas improving student experience

Benefits of Concept Maps health sciences education

:

Concept maps are powerful visual tools used in education.

They help students and educators organize and integrate knowledge effectively.

Design of the office coming soon inshaa allah