title: Bleeding disorders in teenagers presenting with menorrhagia.
abstract: OBJECTIVE
  To assess the prevalence of bleeding disorders and establish the clinical variables that are predictive of a bleeding disorder in adolescent women.
  
  
  METHODS
  A retrospective audit of all patients who had coagulation tests following presentation with menorrhagia.
  
  
  METHODS
  Inpatient and outpatients of a tertiary adolescent gynaecology service.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Paediatric and Adolescent Gynaecology, Royal Children's Hospital, Melbourne, Australia. yasmin.jayasinghe@rch.org.au
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Jayasinghe
authors.forename: Patricia
authors.initials: P
authors.lastname: Moore
authors.forename: Susan
authors.initials: S
authors.lastname: Donath
authors.forename: Janine
authors.initials: J
authors.lastname: Campbell
authors.forename: Paul
authors.initials: P
authors.lastname: Monagle
authors.forename: Sonia
authors.initials: S
authors.lastname: Grover
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D001778:Blood Coagulation Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006403:Hematologic Tests; D006801:Humans; D008595:Menorrhagia / Q000175:diagnosis* / Q000453:epidemiology*; D010976:Platelet Count; D011237:Predictive Value of Tests; D015995:Prevalence; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index