Abnormal Uterine Bleeding: American College of Nurse-Midwives.

Variations in uterine bleeding, termed abnormal uterine bleeding, occur commonly among women and often are physiologic in nature with no significant consequences. However, abnormal uterine bleeding can cause significant distress to women or may signify an underlying pathologic condition. Most women experience variations in menstrual and perimenstrual bleeding in their lifetimes; therefore, the ability of the midwife to differentiate between normal and abnormal bleeding is a key diagnostic skill. A comprehensive history and use of the PALM-COEIN classification system will provide clear guidelines for clinical management, evidence-based treatment, and an individualized plan of care. The purpose of this Clinical Bulletin is to define and describe classifications of abnormal uterine bleeding, review updated terminology, and identify methods of assessment and treatment using a woman-centered approach.

Factors affecting the use of emergency obstetric care among pregnant women with antenatal bleeding.

OBJECTIVE: to investigate the factors that affect the use of emergency obstetric care services among pregnant women in Turkey with antenatal bleeding. DESIGN: descriptive, cross-sectional study. SETTING: Mersin Maternity and Child Hospital, Mersin, Turkey. PARTICIPANTS: 125 pregnant women who had been admitted to the emergency department for antenatal bleeding. FINDINGS: advanced age, high level of education, lack of health insurance, receiving antenatal care, nuclear family structure and knowledge of the danger signs during pregnancy were found to affect the use of emergency obstetric care services among pregnant women with antenatal bleeding. KEY CONCLUSIONS: delays in seeking emergency obstetric care among pregnant women with antenatal bleeding are due to the difficulties faced by women when deciding whether or not to seek health care. Access to health services and health institutions themselves do not cause any delay in terms of provision of emergency obstetric care to pregnant women with antenatal bleeding. IMPLICATIONS FOR PRACTICE: pregnant women should be informed about the causes of antenatal bleeding, what to do in the case of bleeding, and the need to seek health care as soon as possible. In addition, midwives should inform families and pregnant women about the use of emergency medical services and the relevant procedures.