Bleeding disorders in teenagers presenting with menorrhagia.
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.
Jayasinghe
Yasmin
Y
Department of Paediatric and Adolescent Gynaecology, Royal Children's Hospital, Melbourne, Australia. yasmin.jayasinghe@rch.org.au
Moore
Patricia
P
Donath
Susan
S
Campbell
Janine
J
Monagle
Paul
P
Grover
Sonia
S
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