Comprehensive evaluation of hemostasis in normal women: impact on the diagnosis of mild bleeding disorders.
Women with mild bleeding disorders (MBDs) pose a diagnostic challenge and menorrhagia, the most common presenting symptom that remains underreported. We tested the hypothesis that screening apparently normal females using general and gynecological bleeding assessment tools and a global hemostatic assay together with platelet aggregation can help predict MBDs. We assessed 47 women using electronic bleeding assessment tools; e-bleeding questionnaire; and e-Pictorial Bleeding Assessment Chart (e-PBAC) based on previously validated methods, thrombelastography (TEG), and platelet aggregation together with basic coagulation testing. Three women had elevated bleeding score with von Willebrand disease diagnosis confirmed in one case and eleven cases had elevated e-PBAC. We report normal ranges for TEG and platelet aggregation in women during the first half of the menstrual cycle and show 23.4% of apparently normal women may have general or heavy menstrual bleeding. This is a prelude to a larger study to determine the validity of bleeding assessment tools in screening for MBDs in women.
Health Science Department, St Lawrence College, Kingston, Ontario, Canada Saint Elizabeth Health Care, Kingston, Ontario, Canada.
Kimberly
K
MacEachern
Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
Harmanpreet
H
Kaur
Health Science Department, St Lawrence College, Kingston, Ontario, Canada Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
Mazen
M
Toukh
Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
Iqra
I
Mumal
Health Science Department, St Lawrence College, Kingston, Ontario, Canada Department of anesthesiology and preoperative medicine, Queen's University, Kingston, Ontario, Canada.
Alexander
A
Hamilton
New Atom Technologies Inc, Kingston, Ontario, Canada.
Stephen
S
Scovil
Department of Medicine, Queen's University, Kingston, Ontario, Canada.
Paula
P
James
Health Science Department, St Lawrence College, Kingston, Ontario, Canada Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
Hisham S
HS
Elbatarny
Health Science Department, St Lawrence College, Kingston, Ontario, Canada Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada mothman@sl.on.ca othman@queensu.ca.
Maha
M
Othman
D000293:Adolescent; D000328:Adult; D001780:Blood Coagulation Tests; D005260:Female; D006403:Hematologic Tests; D006474:Hemorrhagic Disorders / Q000097:blood / Q000175:diagnosis*; D006487:Hemostasis; D006801:Humans; D008595:Menorrhagia / Q000097:blood / Q000175:diagnosis; D008597:Menstrual Cycle / Q000097:blood; D008875:Middle Aged; D010974:Platelet Aggregation; D010979:Platelet Function Tests; D012016:Reference Values; D011795:Surveys and Questionnaires; D013916:Thrombelastography; D055815:Young Adult; D056725:von Willebrand Disease, Type 1 / Q000097:blood / Q000175:diagnosis
PBAC; electronic bleeding questionnaire; menorrhagia; thromboelastography; women bleeding