title: Combined laboratory and diary method for objective assessment of menstrual blood loss.
abstract: BACKGROUND
  To develop an objective measurement system for menstrual blood loss applicable in clinical practice.
  
  
  METHODS
  One hundred and fifty-six patients were enrolled in a randomized trial of the treatment of menorrhagia in all five gynecology departments of the university teaching hospitals in Finland. Correlation between venous blood hemoglobin concentration (Hb) and absorbance at 564 nm (A564) was investigated in experiments with blood samples. Amount of collected menstrual blood and menstrual diary data were analyzed.
  
  
  RESULTS
  Hb concentration and A564 of the blood were linearly correlated (r=0.99). One hundred and fifty-four women (99%) returned used sanitary protection and menstrual diaries. On average, 12% (range 0-57%) of menstrual blood was lost during collection. The median amount of blood recovered from sanitary protection was 89 ml (range 14-724 ml), with 58% (n=90) of the women exceeding 80 ml per cycle. When the spilled blood was taken into account, the corresponding figures were 104 ml (range 15-724 ml) and 66% (n= 101).
  
  
  CONCLUSIONS
  The spectrophotometric measurement of venous blood in the conventional alkaline hematin method can be replaced by measurement of Hb concentration. All blood incompletely collected should be recorded. Objective measurement of menstrual blood loss can be applied in routine clinical practice.
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Hurskainen
authors.forename: J
authors.initials: J
authors.lastname: Teperi
authors.forename: U
authors.initials: U
authors.lastname: Turpeinen
authors.forename: S
authors.initials: S
authors.lastname: Grenman
authors.forename: A
authors.initials: A
authors.lastname: Kivelä
authors.forename: E
authors.initials: E
authors.lastname: Kujansuu
authors.forename: K
authors.initials: K
authors.lastname: Vihko
authors.forename: M
authors.initials: M
authors.lastname: Yliskoski
authors.forename: J
authors.initials: J
authors.lastname: Paavonen
mesh_terms: D000328:Adult; D001810:Blood Volume; D005260:Female; D006427:Hemin / Q000032:analysis; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008595:Menorrhagia / Q000175:diagnosis / Q000503:physiopathology*; D008598:Menstruation; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D013053:Spectrophotometry; D014680:Veins
chemical_list: D006454:Hemoglobins; D006427:Hemin