Our reportable case was a 13 years old girl who comes from Zahedan and was reflected to hospital. because of A.U.B. She had spotting or moderate VAGINAL BLEEDING from two weeks ago. She had called on Physicians in this period and was treated with oral contraceptives and progestin's, none of these. medications were effective. In physical examination a little black lump was seen in the proximal port of the vagina. This mass was extracted by forceps. Surprisingly it was a leech. After a short time her VAGINAL BLEEDING was stopped.

Introduction: VAGINAL BLEEDING due to leech bites is a highly unusual and serious problem in postmenopausal women, potentially leading to severe complications and even death. Case Presentation: A 68-year-old rural woman, 13 years post-menopause, was admitted to a hospital in eastern Iran with a complaint of continuous VAGINAL BLEEDING with clot discharge for 12 days. During the medical examination, a dark worm moving in waves was observed in the labia minora of the vulva. The area was washed with 0.9% normal saline solution, and the leech was removed from the inner surface of the labia minora using forceps and pincers. The patient was monitored as an outpatient for 4 hours to control the BLEEDING and was subsequently discharged in good condition. She was advised to take iron tablets and folic acid for one month.Her test results were as follows: Hemoglobin = 10 mg/dL, hematocrit = 32%, platelet count = 145,000, prothrombin time = 13 seconds, partial thromboplastin time = 35 seconds, and INR = 1.1. Her vital signs at admission were: temperature = 37.5°C, pulse rate = 100/min, blood pressure = 120/60 mmHg, and respiratory rate = 30 breaths per minute. Conclusions: Vulvar and VAGINAL leech bites can cause severe VAGINAL BLEEDING and anemia in postmenopausal women. To reduce complications caused by delays in diagnosis or treatment, healthcare workers should consider the possibility of vulvar and VAGINAL leech bites in postmenopausal rural women and individuals who use river water for drinking, bathing, or showering. Taking a detailed history and performing a thorough physical examination before any diagnostic procedure can help quickly and accurately diagnose the cause of BLEEDING in these patients.

Poor rural residents who drink leech-contaminated water are more likely to get human leeches. Atrophic endometrium, carcinoma, and other atypical postmenopausal VAGINAL BLEEDING causes must be diagnosed and treated immediately. Postmenopausal women may die from this. This paper describes the leech-induced atypical VAGINAL BLEEDING of a 72-year-old postmenopausal woman with six days of BLEEDING and weakness. Her medical history includes a year of tinnitus, three months of dizziness, and true vertigo. Anemia, weakness, and a low hemoglobin level (7.1 mg/dL) resulted from postmenopausal VAGINAL BLEEDING. She was transfused with one unit of whole blood and one liter of crystalloid, and she was admitted to a public referral hospital's gynecology ward. The VAGINAL leech was surgically removed. The patient was discharged five days after the leech was removed. VAGINAL BLEEDING due to leech infestation is a very uncommon but important gynecological problem.

BACKGROUND AND OBJECTIVE: Abnormal VAGINAL BLEEDING under the age of 10 is rare among girls. In such cases, local lesions, trauma, intra– VAGINAL foreign body, malignant genital tumors, and precocious puberty should be taken into account. Leech infestation is one of the rare causes of severe prepubertal VAGINAL BLEEDING. One case of prepubertal VAGINAL BLEEDING due to leech infestation is presented here. CASE REPORT: An eight– year– old girl referred to the emergency department after three days of painless VAGINAL BLEEDING. The BLEEDING was moderate during the first two days and the patient experienced intensified BLEEDING and large menstrual clots on the third day. The patient had no history of trauma, coagulation disorder, systemic illness, and drug use, but noted the history of swimming in the muddy creek within a few days before referral to the emergency department. After examining the genital system, a black mass with wavelike movements was observed in the lower one-third of the vagina, and a piece of it was slightly out of the hymen. The leech was removed by forceps without damaging hymen. After a short time, the BLEEDING stopped. On the next visit, the patient had no VAGINAL BLEEDING and was discharged without any problem. CONCLUSION: In cases of prepubertal VAGINAL BLEEDING, accurate examination of the genital system and evaluating the history of swimming or bathing in contaminated creeks, springs, qanats and pools are essential.

Background: VAGINAL BLEEDING is a tragedy that causes a high mortality and morbidity rate. The aim of this study was to find the most frequent causes of VAGINAL BLEEDING in first half of pregnancy. Materials and methods: This study is a cross sectional study performed on 161 cases with VAGINAL BLEEDING during pregnancy who had been referred to Taleghani Hospital. Sampling was achieved using non random convenient technique.Results: The mean age of subjects was 27.1±6.1 years and the mean gestational age was 16.3±10.1 weeks. Mean of gravidity was 2.5±1.6. Thirty three percents of subjects were primigravid. The most common causes of BLEEDING were: abortion (72.7%), placenta previa (12.4%), ectopic pregnancy (8.1%), and placenta abruptio (6.8%).Conclusion: Of 161 cases, 75 (46.5%) lead to abortion or curettage. Abortion was by far the most common cause of VAGINAL BLEEDING.

History and Objectives: DMPA one of the commonly used contraceptive methods because of its high rate of success, less complications, easily applicable and rapidity. The major complication of DMPA is the occurrence of irregularity in menses that is of high concern in Islamic culture. Therefore, the present study was carried out to determine the effect of DMPA on the pattern of VAGINAL BLEEDING in referrals of Mahdieh hospital in Tehran in 1999.Materials and Methods: The clinical strategy of this study was performed on 50 women with a history of regular menstrual cycle. DMPA at a dose of 150 mg was injected and for 90 days thereafter, the BLEEDING pattern was determined and classified. In addition, the role of BMI in this regard was determined. Results: out of 50 studied cases at an age range of 18-45 years, 20 cases showed BLEEDING itself or its signs. For the latter, it occurred for one time in 35% of them, for 2 times in 35% of them and for 3-6 times in 35% of cases. The average days of BLEEDING for all them was 41.8 ± 26.6 days. It is also evident that BMI can not affect the VAGINAL BLEEDING.Conclusion: It is concluded that the BLEEDING pattern is not a problem of high concern in consumers of DMPA, but it is recommended to perform more studies in this field.

Background: McCune-Albright syndrome (MAS) is a rare non-inherited disorder characterized by the clinical triad of precocious puberty, cafe-au-lait skin lesions, and fibrous dysplasia of bone.Case Presentation: We report a girl with MAS, presenting initially with VAGINAL BLEEDING at the age of 17 months. Ultrasonography revealed unilateral ovarian cysts and ureteral and ovarian enlargement. Considering the clinical and paraclinical findings, the patient diagnosed as a case of gonadotropin-independent precocious puberty was treated with medroxy-progestrone acetate (MPA) for three months. During the follow up, recurrent episodes of BLEEDING, ovarian activation and cyst formation, as well as breast size development were reported. At the age of 5.5 years, fibrous dysplasia was detected, which in coexistence with precocious puberty confirmed the diagnosis of MAS. The patient had no cafe-au-lait skin macles during follow up.Conclusion: Considering that clinical manifestations of MAS appear later in the course of recurrent periods of ovarian activation and cyst formation, a careful clinical observation and follow up of patients is necessary and the diagnosis of MAS must be kept in mind in cases with gonadotropinindependent precocious puberty.

Adenocarcinoma of fallopian tube is a rare malignancy of genital tract which bares many complications. If hysterectomy is performed without oophorectomy, saving the fallopian tubes is not necessary because they could cause tumors. In our case Cauliflower mass was seen many years after hysterectomy, accompanied by a rare condition in which the tube was attached to the VAGINAL cuff. The diagnosis of VAGINAL vault cancer was made and surgery was performed. However, post-operation diagnosis was fallopian tube cancer.

Hemangiomas of the uterine cervix are very rare. They are usually small and harmless. This is a case of cervical hemangioma presenting with intractable postpartum hemorrhage that made hysterectomy mandatory. This benign tumor may cause obstetrical complications.