How should acute abnormal uterine bleeding be managed in a hemodynamically stable patient?

In cases of acute abnormal uterine bleeding in a hemodynamically stable patient, the management often revolves around hormonal therapy, particularly the use of high-dose estrogen or progestin. This approach works by promoting endometrial stabilization and facilitating clotting. High-dose estrogen can quickly control bleeding by stimulating the endometrium, promoting vasoconstriction, and supporting coagulation processes. Progestins can also be effective in cases where the bleeding may be due to anovulation or other hormonal imbalances, as they help to regulate the menstrual cycle and stabilize the endometrium.

Immediate surgical intervention is not typically indicated in a hemodynamically stable patient unless there are signs of severe pathology that might require urgent surgery. Observation alone might be appropriate in some cases where bleeding is light and the patient is stable, but it does not actively address the underlying cause of significant bleeding. Blood transfusion may be necessary if there is significant blood loss leading to hemodynamic instability or severe anemia, but in a stable patient without these complications, it is not the first line of management.