- Most cases can be managed as outpatient in an office or emergency department.
- Rule out pregnancy complications and nonuterine bleeding.
- Treat severe or life-threatening bleeding acutely:
- Circulatory support, transfusion if necessary
- IV estrogen
- Curettage if necessary
- Hysterectomy in extreme cases
- Bleeding leading to orthostatic hypotension
- Hematocrit <25%
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