A-42-years-old woman was ...

A-42-years-old woman had been experiencing vaginal bleeding for the past 25 days. She was also complaining of dizziness, lower stomach discomfort, and fatigue. The blood volume that had been lost was about 200-300ml/day. She has had irregular and heavy menstruation since 5 years ago. On physical examination, there was pallor of the conjunctivae, nail beds, face, palms, and palmar creases. Vital signs were within normal limits except the blood pressure, which showed 90/55 mmHg. The laboratory findings showed a decrease in haemoglobin levels (5,1 g/dL). The patient was diagnosed with anemia et causa, abnormal uterine bleeding suspected to myoma uteri. The patient was treated with crystaloid 500 ml for 15-30 minutes as the initial therapy, then tranexamic acid 500 mg 3 times a day for 5 days, primolut (norethisterone) 5 mg 4 times a day until the bleeding stopped, and transfusion 4 bags of PRC (packed red blood cells). The USG imaging was scheduled to establish the diagnosis.