P07.07: Endometrium thickness—ultrasound criteria for functional juvenile uterine bleeding treatment

To establish the most efficient therapeutically attitude in order to stop and prevent functional juvenile uterine bleeding. We retrospectively analyzed 37 cases of nulligesta young women (10–20 years old) admitted in our unit for uterine bleeding, at the very first episode. The endometrial thickness was measured by transabdominal ultrasound scan between the opposite hipoechoic layers represented by basal endometrial and was considered normal between 4 and 8 mm. Patients with endometrial abnormal elevated thickness (26 cases) were treated with didrogesteron 30 mg b.d. for 3 days and then 20 mg b.d for another 7 days. In these cases, the preventing treatment was conducted in a discontinuous manner, with 20 mg didrogesteron b.d., ten days, starting with the 15th day of the cycle, for 3 months. Patients with endometrial atrophy (11 cases) were treated with combined oral contraceptive containing 30 µg etinilestradiol and 150 µg levonorgestrel, 2–3 pills b.d. until the bleeding ceased followed by 1 pill b.d. for completing 21 days of therapy. In these cases the preventive treatment was done in the same discontinuous manner, with didrogesteron. In both groups the bleeding ceased after a medium of 3, 6 days of treatment. One patient with endometrial hyperplasia needed after 6 days of treatment uterine haemostatic curettage. Four patients in the first group and one in the second have experienced in the following six months after completing preventive therapy bleeding recurrences. In these cases was applied the same treatment and no relapse was encountered another six months. The endometrial thickness ultrasound evaluation is a valuable criterion for the treatment of juvenile uterine functional bleeding. Hormonal therapy in such cases is highly efficient in bleeding cessation. Prevention of the illness's receive needs in 16% of cases am additional treatment until maturation of the hypothalamus-hypophysis-ovarian axe is established.