Adolescent Menorrhagia: Study of the Coagulation Profile in a Tertiary Centre in South India 1589-1592
Kishan Prasad H.L., Asst professor,
Department of Pathology, K.S. Hegde Medical Academy of
Nitte University, Deralakatte, Mangalore, Karnataka, India.
Background: Abnormal uterine bleeding accounts for approximately 50% of the visits of adolescent girls to gynaecologists. These complaints encompass disorders which range from minimal spotting to profuse bleeding. These affect the quality of life in a majority of women who are affected. The prevalence of menorrhagia in the adolescent population with bleeding disorders varies between 14 to 48%. The common conditions which are associated with adolescent menorrhagia include the von Willebrand disease (vWD), platelet functional disorders, and coagulation factor deficiencies. This prospective study was conducted to identify the frequency of the bleeding disorders in women who presented with menorrhagia from the Indian subcontinent.
Material and Methods: 688 adolescent girls were evaluated, amongst which 40 cases were included in our study. Each case was analyzed for the demographic profile, the duration of menorrhagia, the severity of the symptoms, the degree of anaemia, and laboratory investigations.
Results: Amongst the 40 cases, 14 (35%) cases were found to be suffering from haemostatic disorders. The haemostatic disorders were divided into platelet related abnormality i.e., primary (9 cases) and clotting factor abnormality i.e., secondary disorders (5 cases). The leading cause of menorrhagia was found to be vWD and quantitative platelet disorders. A majority of the girls had anaemia (97.5%). The commonest blood group which was found in the girls was O, followed by the A group, with all the cases of vWD having the O group.
Conclusion: Menorrhagia may be an important clinical manifestation in an inherited bleeding disorder and it has been suggested that these patients need to be investigated for these disorders, especially for vWD. Early diagnosis and treatment with individualization of each case is the keystone in the management of adolescent menorrhagia.