Q; 32 year old female is admitted to ICU due to hypovolemic shock after having a severe uterine bleed. OB-Gyn service has been called to assist in management. Besides other standard treatment Nonsteroidal anti-inflammatory drug (NSAIDs) has been prescribed as an adjuvant treatment. How the NSAIDS directly help in abnormal uterine bleed (AUB)?
Answer: NSAIDs decrease the volume of menstrual blood by causing a decline in the rate of prostaglandin synthesis in the endometrium, leading to vasoconstriction and consequently reduced bleeding. Mostly prescribed NSAIDs are Mefenamic acid, Naproxen, and Ibuprofen.
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References:
1. Rees MC, DiMarzo V, Tippins JR, et al. Leukotriene release by endometrium and myometrium throughout the menstrual cycle in dysmenorrhoea and menorrhagia. J Endocrinol 1987; 113:291.
2. Smith SK, Abel MH, Kelly RW, Baird DT. Prostaglandin synthesis in the endometrium of women with ovular dysfunctional uterine bleeding. Br J Obstet Gynaecol 1981; 88:434.
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