Answer to the last #DiagnosticDilemma
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The answer to the last Diagnostic Dilemma (Which test is mandatory in the initial assessment of all women presenting with abnormal uterine bleeding?) is pregnancy test.

A 28-year-old woman explained that 2 years earlier, her menstrual cycle had changed and become irregular with prolonged heavy bleeding lasting between 15 and 20 days; before this, her periods had been regular, lasting 30 days with 5 days of bleeding. The woman had two children and no history of contraceptive use, hormonal therapy, or any other medications. 3 months after the irregular bleeding started, the patient visited her local gynaecologist, who reported no uterine or cervical disease and prescribed diosmin tablets.

At this stage, the patient's hemoglobin concentration was 10 g/dL—importantly, her urine and serum human chorionic gonadotropin (hCG) levels were not measured. The bleeding did not improve, and she had dilation and curettage of the uterus, during which a biopsy specimen was taken from the endometrium: histology showed a disordered proliferative endometrium. The woman was advised to take combined oral contraceptive pills, which only resulted in a reduction of the bleeding.

For Diagnostic Dilemma, refer https://www.plexusmd.com/md/post?pfpid=55677

Source: The Lancet
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