title: Prevalence of hemostatic disorders in adolescents with abnormal uterine bleeding.
abstract: OBJECTIVE
  To evaluate the incidence of hemostatic disorders in a population of adolescents with various patterns of abnormal uterine bleeding (AUB).
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred thirteen adolescents with AUB; mean age at menarche and mean age at the onset of symptoms 12 ± 1.2 years and 13.5 ± 2.8 years, respectively.
  
  
  METHODS
  Data on menstrual history, bleeding symptoms, co-existing medical conditions, and medical therapies were assessed. All patients were screened for hemostatic disorders with laboratory testing. The incidence of the disorders was calculated. Subjects were further divided in 2 groups based on whether the AUB started in the first 2 years from menarche (group 1) or later (group 2). A statistical analysis was performed using a chi-square test to compare incidence of hemostatic disorders between the groups.
  
  
  RESULTS
  One hundred thirteen adolescents with AUB were identified. Overall, 54 (47.8%) patients had some underlying hemostatic disorder, of which a platelet dysfunction was the most common (17.7%). Von Willebrand disease was detected in 13.3% of cases and a deficiency of a coagulation factor in 12.4%. In 7.1% of patients an isolated increase of bleeding time was observed. When divided in 2 groups, 44.2% of patients in group 1 and 59.2% in group 2 had a coagulation disorders, with no statistically significant difference between the 2 groups (P = .17).
  
  
  CONCLUSIONS
  AUB in adolescents is frequently associated with an underlying disorder of hemostasis, most commonly a platelet function disorder. The results highlight the importance of screening for coagulation disorders in adolescents with AUB, independently from the gynecologic age at onset.
authors.affiliation: Pediatric and Adolescent Gynecology Unit, Department of Science for Child and Women's Health, University of Florence, Florence, Italy. Electronic address: violaseravalli@gmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Seravalli
authors.forename: S
authors.initials: S
authors.lastname: Linari
authors.forename: E
authors.initials: E
authors.lastname: Peruzzi
authors.forename: M
authors.initials: M
authors.lastname: Dei
authors.forename: E
authors.initials: E
authors.lastname: Paladino
authors.forename: V
authors.initials: V
authors.lastname: Bruni
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D020147:Coagulation Protein Disorders / Q000150:complications / Q000453:epidemiology*; D005260:Female; D020141:Hemostatic Disorders / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008572:Menarche; D008595:Menorrhagia / Q000453:epidemiology* / Q000209:etiology; D008796:Metrorrhagia / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult; D014842:von Willebrand Diseases / Q000150:complications / Q000453:epidemiology*
keywords: Abnormal uterine bleeding; Adolescents; Hemostatic disorders; Platelet function disorders; von Willebrand disease