Management has changed over the past two decades with the introduction in the mid-1980s of therapeutic endo-scopic endometrial destructive procedures and in 1995 of the levonorgestrel-releasing intrauterine device in the UK. The number of hysterectomies for menorrhagia have been estimated to have fallen by 36% between 1989 and 2002/3 [6,12] (Fig. 40.1). Also an inverse social gradient in hysterectomy has been observed with surgery being inversely related to social class and education, especially at younger ages [7,13].
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.