Blood clotting occurs due to a complex process of coagulation that heals a bleeding blood vessel with at clot. Blood platelets and plasma protein fibrinogen are vital to the blood clotting process. People can suffer from various blood clotting disorders such as formation of blood clots due to excessive blood clotting. The PT or Prothrombin Time Blood Test is done before any surgery to check a patient's bleeding and clotting factors. PTT or Partial Thromboplastin Time Blood Test checks for a clotting disorder.
Blood clots can form in the heart or legs or brain or even in the lungs. These clots can travel through the blood vessels and hamper the flow of blood. This can lead to damage in the organs. Blood clot in the veins of the arm or legs can lead to DVT or Deep Venous Thrombosis. Pulmonary embolism is a condition where a blood clot travels to the lungs. Blood clots during pregnancy can lead to miscarriage or pre eclampsia.
Bleeding disorders can occur due to severe liver disease. Hemophilia is an inherited bleeding disorder. Bleeding disorders can also be a side effect of medicines.
Afibrinogenemia is an inherited blood disorder that is caused due to a recessive gene. Congenital Afibrinogenemia is caused due to deficiency of fibrinogen protein that is essential for blood clotting. Afibrinogenemia is tested by checking for PT (Prothrombin time), blood clotting time, fibrinogen level and bleeding time.
Symptoms of afibrinogenemia include abnormal bleeding in Gastrointestinal tract, nose, joints and bruises. Intracranial bleeding (bleeding in the brain) is a situation that can be fatal to the patient. A person suffering from Afibrinogenemia can be given blood plasma before any surgery or to treat excessive bleeding situations. Care should be taken to ensure that the patient is vaccinated against Hepatitis B. Such patients are likely to from blood clots (thrombosis).
Heavy menstrual bleeding may happen due to underlying conditions such as hormonal imbalance, uterine polyps and ovarian dysfunction. Menorrhagia is also an inherited disorder as it is associated with blood clotting impairments like Von willebrand's disease. In most cases, endometrial biopsies are done to determine histological overview of the conditions. Many treatment options are suggested depending upon the age, lifestyle and medical history of the patient. Among many prophylactic measures, endometrial ablation or uterus ablation is increasingly becoming the most preferred method.
The inner layer of the uterus called as the endometrium is removed using the diathermy electrode. The patient is subjected to general anesthesia during the procedure. Careful examination of the uterine wall is done to identify any underlying uterine disorders. The electrode is 4mm and it helps in cutting of the endometrium. In addition to this, the myometrium is also destroyed to eliminate the underlying endometrial basal cells.
The basal cells of the endometrium are also called basalis. They enable the multiplication and thickening of the endometrium forming the superficial layer of the endometrium which is shed out. The walls of the uterus are examined for bleeding points and then the patient is sent to the recovery room. Other modern techniques such as the administration of microwave endometrial ablation, cryoablation, diode laser phototherapy are considered.
Endometrial ablation is not advisable for patients who might be in early pregnancy, have a history of uterine cancer and menopause. Women who undergo endometrial ablation have a chance of conception; however there is a possibility of miscarriage. This happens because the uterine lining has been removed.
Endometrial ablation is also recommended as an alternative to hysterectomy. Endometrial ablation is also done on an outpatient basis with a given recovery time. The results of the endometrial ablation treatment include absence of menstrual bleeding. In some cases, there is a possibility of reduced bleeding. Consult a doctor in the case of spotting to identify the emergence of conditions such as fibroids or polyps of the uterus. Endometrial ablation procedure is widely administered among women in the age group of 30 to 45.
Endometrial Resection : The Loop Electrosurgical Excision Procedure(LEEP) is used to destroy the uterine lining. The use of LEEP is faster and provides faster recovery than any comparable surgical procedure.
Complications of Endometrial Ablation
The most significant complication is perforation caused to the uterus. In these cases laparoscopy is done. Other possibilities include perforations to organs such as the bladder, blood vessels and the organs in pelvic region.
The fluid absorption during the endometrial ablation procedure may result in the lowering of blood salt levels causing damage to the lungs and brain. In post-operative cases, vaginal bleeding is common for a few days. However, if the discharge or bleeding from the vagina is associated with foul smell, infections of the uterus are suspected. Women who have undergone the endometrial ablation procedure are generally advised to take progestogens which help in reducing the risk of uterine cancers. Sexual intercourse is advised only after two weeks to prevent vaginal bleeding or pain.
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Bibliography / Reference
Collection of Pages - Last revised Date: April 1, 2020