Premium
Bleeding disorders in teenagers presenting with menorrhagia
Author(s) -
JAYASINGHE Yasmin,
MOORE Patricia,
DONATH Susan,
CAMPBELL Janine,
MONAGLE Paul,
GROVER Sonia
Publication year - 2005
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2005.00470.x
Subject(s) - medicine , dysfunctional uterine bleeding , family history , pediatrics , population , retrospective cohort study , presentation (obstetrics) , metrorrhagia , obstetrics , gynecology , family planning , surgery , environmental health , endometrium , research methodology
Objective: To assess the prevalence of bleeding disorders and establish the clinical variables that are predictive of a bleeding disorder in adolescent women. Design: A retrospective audit of all patients who had coagulation tests following presentation with menorrhagia. Setting: Inpatient and outpatients of a tertiary adolescent gynaecology service. Patients: Subjects aged 9–19 years with menorrhagia who had coagulation tests performed, and who did not have a known bleeding disorder prior to presentation were included. Outcome measures: A bleeding screen was performed to assess prevalence of bleeding disorders in the population. Variables that were investigated as predictive of a bleeding disorder included clinical history, family history, and haematological indices of blood loss. Results: The prevalence of an inherited bleeding disorder was 10.4%. The only statistically significant predictor was a family history of bruising and bleeding. Menstrual history was not predictive. Conclusion: Severity of menstrual loss was not predictive of a bleeding disorder, as a significant cause of teenage metrostaxis is due to anovulatory dysfunctional uterine bleeding. The authors recommend that a careful personal and family history of bruising and bleeding be taken in all teenagers who present de novo with menorrhagia. Routine screening in a primary care setting is impractical, but should be mandatory in all patients with a positive family history.