Use of Ulipristal Acetate for the Management of Fibroid-Related Acute Abnormal Uterine Bleeding

J Obstet Gynaecol Can. 2016 Jan;38(1):80-3. doi: 10.1016/j.jogc.2015.11.005.

Abstract

Background: Episodes of acute abnormal uterine bleeding related to uterine fibroids can cause significant morbidity. Traditional management with high-dose hormonal regimens may not be as effective when used in women with fibroids.

Case: A 32-year-old woman with a 12 cm uterine fibroid presented with an episode of acute abnormal uterine bleeding requiring blood transfusion. In lieu of using a hormonal maintenance regimen after the bleeding had stabilized, the patient was treated with ulipristal acetate 5 mg daily for three months. Amenorrhea was induced rapidly and the patient had no further episodes of acute excessive uterine bleeding. She subsequently underwent a laparoscopic myomectomy with a satisfactory outcome.

Conclusion: Ulipristal acetate has been shown to induce amenorrhea rapidly in women with uterine fibroids, and it can be a useful treatment in the emergency management of fibroid-related acute abnormal uterine bleeding.

Keywords: Ulipristal acetate; acute uterine bleeding; fibroids; leiomyoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Transfusion / methods
  • Contraceptive Agents / administration & dosage
  • Female
  • Humans
  • Laparoscopy / methods
  • Leiomyoma* / complications
  • Leiomyoma* / pathology
  • Leiomyoma* / therapy
  • Norpregnadienes / administration & dosage*
  • Severity of Illness Index
  • Treatment Outcome
  • Uterine Hemorrhage* / etiology
  • Uterine Hemorrhage* / physiopathology
  • Uterine Hemorrhage* / therapy
  • Uterine Myomectomy / methods*
  • Uterine Neoplasms* / complications
  • Uterine Neoplasms* / pathology
  • Uterine Neoplasms* / therapy

Substances

  • Contraceptive Agents
  • Norpregnadienes
  • ulipristal acetate