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Safer Care Victoria’s Best Care resources support patients and healthcare providers to have conversations and make decisions together about the most appropriate pathways for care.

This resource, developed for clinicians, details a specific elective surgery procedure that should now only be done for specific indications. Evidence-based recommendations that detail ‘best care’ pathways should be discussed with your patient to determine the most appropriate pathway of care.

Advice

When treating abnormal uterine bleeding, medical therapy is usually considered appropriate initial treatment. 

Endometrial ablation for abnormal uterine bleeding should not been offered until medical therapy is found to be contraindicated or unsuccessful.

When is the procedure indicated?

Endometrial ablation may be recommended for abnormal uterine bleeding when future conception is not desired and where medical management is contraindicated or unsuccessful.

Best care recommendations

Treatment should not be initiated until the aetiology of abnormal uterine bleeding has been evaluated (or evaluation is underway) and cancer excluded.

Endometrial ablation should only be considered when future fertility is not desired and reliable contraception is in place.

Evidence

Australian Commission on Safety and Quality in Health Care. The second Australian atlas of healthcare variation. Women’s health and maternity; Endometrial ablation. Sydney (NSW): The Australian Commission on Safety and Quality in Health Care; 2017 [cited 2020 Jun 13]. 

National Institute for Health and Care Excellence. Heavy menstrual bleeding. London (UK): National Institute for Health and Care Excellence; 2018 [cited 2020 Jun 29]. 

Society of Obstetricians and Gynaecologists of Canada. Choosing Wisely Canada Obstetrics and Gynaecology: Ten things physicians and patients should question. Ottawa (ON): Society of Obstetricians and Gynaecologists of Canada; 2017 [cited 2020 Jun 13]. 

Page last updated: 23 Dec 2020

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