Stable patients
Stable patients can be referred to an outpatient gynaecology clinic or rapid-access gynaecology services28. These services usually include a TVUS +/- hysteroscopy and biopsy under a two-week wait pathway9.
Patients with symptomatic anaemia may require transfusion within the ED then discharge to outpatient services. Anticoagulation should not be routinely reversed for PMB but should be considered for all patients on a risk/benefit basis.
All patients should be safety netted to return if bleeding worsens or they become unwell.
Learning Bite
It can be useful to ask gynaecology colleagues to identify the most appropriate referral pathway for your patient, as pathways vary by region.