Bleeding disorders in adolescents presenting with abnormal uterine bleeding

Menstrual cycle lenght should be approximately 21-35 days, with menses lasting 2-7 days. Normal blood loss is 30-40 ml per cycle or 3-6 pads per day. Abnormal uterine bleeding describes any aberration of menstrual volume, frequency or duration in a nonpregnant female. AUB is a common menstrual symptom among female adolescents. Heavy menstrual bleeding refers to cycles lasting more than 7 days or a blood loss greater than 80 ml. per menses. Among adolescents presenting with heavy menstrual bleeding, up to 20% may be found to have an underlying bleeding disorder. In this study, ıt was aimed to screen bleeding disorders in adolescents presenting with abnormal uterine bleeding. The was performed prospectively in patients presenting with abnormal uterine bleeding to autpatient clinics of pediatric haemotology clinics. A detalied history regarding menarche, intervals between menses, duration of bleeding, amount of bleeding and signs of anemeia were obtained. Familiy history of bleeding disorders were obtained, in addition to assessing for easy bruising, epistaxis or gum bleeding. Patients with cronic inflamatory bowel disease, cronic liver and kidney disease were excluded from the study. Whole blood count, peripheral smear, blood gropu, serum transamines, urea, creatinine, ferritin, B12, template bleeding time, PT, aPTT, INR, fibrinogen, VWF:Ag, VWF:RCo, FVIII, FVII, FXI, FXIII, platelet aggregation assays were performed. Labratory tests include free testesteron, 17-OH progesteron, luteinizing hormone, follicle-stimulating hormone, and estradiol, thyroid stimulating hormone, free T4 to diagnosis variable endocrinologic disorders. The study was performed between Januar 2018-Januar2021 and 97 patient was presented with abnormal uterine bleeding though 90 of them completed the study. Mean age of the patients was 14,8±1,8 years. In %15,6 (n=14) of the patients, a bleeding disorder is detected ( 5,5% VWD, 5,5% factor deficiency, 3,3% PFD, 1,1% ITP). In %12,2 (n=11) of the patients endocrinologic disorder, In %26,6 (n=24) of the patients joint hipermobility is detected. No pathology had been detected in %55,6 (n=50) patient. Two patients with FXI deficieny, 1 patient FV deficiency, 1 patient FVII deficieny, 1 patient hypofibrinogenemia had been established as coagulation factor defiency. Two patient with Bernard-Soulier syndrome and one patient with Glanzmann's thrombasthenia had been established as platelet function disorders. Abnormal uterine bleeding affecting quality of life and adolescent well-being warrants investigation. In this study ıt was emphasized that adolescents presenting with abnormal uterine bleeding may be have an underlying bleeding disorder. Key words: Abnormal uterine bleeding, menorrhagia, bleeding disorders, von Willebrand disease, platelet function disorders, joint hpermobility.