Azei Sam 2: Dr.. my patient claimed that she's having menses 3 times a month since menarche. She claimed it is always like that. For the first time she's having it, it wil be about 4-5 days, then the second time will be about 3-4 days and the third time in a month it will be about 3-4 days too. She said the pad will be fully soaked everytime she's bleed. About 2 pads each day.
Is it considered regular menses? And does this means menorrhagea? She doesn't have any sign symptoms of anaemia. And for this type of patient is it possible to calculate her LMNP. Because she gets her EDD through calculation.
Dr Shaiful Ehsan: Frankly speaking...I have encounter only those pts with twice menstrual cycles per month...
Never encounter up to 3 times per month...
About the 1st question: is that regular menses?....nope...it is not..as it is not fulfill the 28 to 30 days cycle...
2nd Q: is it menorrhagia?
Theoretically menorrhagia is define as those with prolonged menses or several consecutive cycles per month or more than 80ml per cycle (can use pictorial picture chart...try look for it - useful for quantify amount of bleeding).
For ur patient, she falls on 2nd point. Nevertheless, to support for points towards menorrhagia...u should ask other features such as presence of blood clots & flooding, plus symptoms of anaemia...
Dr Shaiful Ehsan: LNMP only can be calculate if:
Sure of date
Regular menses
Not taking OCP or other hormonal contraceptives methods or brestfedding at least 3 months prior to her lmp...
Thus in your case, can not use her LMP as LNMP....
Dr Shaiful Ehsan: What we can do is do earliest TAS...and repeat 2 weeks later...if subsequent scan follow the 1st scan...then REDD is taken from the 1st scan....and POG can be calculated...
Hopefully she BENEFITED early scan less than 12 weeks POG.
Dr Shaiful Ehsan: Tq.
Azei Sam 2: Thank you Dr. 👍🏻
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