The search of bleeding diathesis in patients with menorrhagia

INTRODUCTION AND OBJECTIVE: The term "menorrhagia" is used for extreme bleedings taking place throughout for several menstrual cycles. In this study, coagulation disorders were investigated in etiology of adolescent girls presenting with menorrhagia. MATERIAL AND METHOD: The study is carried out prospectively in Sakarya University Medical Faculty, Pediatric Hematology-Oncology and Pediatric Endocrinology Clinics between 01.07.2019 and 01.07.2020. Fifty-one patients aged 8-18 years with heavy menstrual bleeding were included in the study. Using more than 20 pads in 7 days or intensive bleedings containing clots which last more than 7 days was considered as heavy menstrual bleedings. Complete blood cell count, bleeding time, peripheral smear, PT, aPTT, INR, fibrinogen, vWF antigen, ristocetin co-factor activity, factor 8 activity, and factor 13 activity tests were performed. Patients were also examined by Gynecology and Obstetrics and Pediatric Endocrinology clinics. RESULTS: The mean age of the patients was 14,33 years. The mean duration of menstruation was 12,49±4,76 days, the mean menstruation interval was 26,61±14,13 days. A total of 9 (17,70%) patients were found to have abnormal coagulation tests, including low vWF levels, low factor 8 levels, low factor 7 levels. Laboratory values and menstrual characteristics of the patients with and without abnormal coagulation tests were similar except mean vWF antigen, ristocetin cofactor and factor 8 levels. Furthermore, 21,57% of the cases had gynecological pathologies and 52,94% had endocrinologic pathologies. CONCLUSION: None of the 51 adolescent girls included in our study was diagnosed with coagulation disorders. However, a significant number of the patients have gynecological diseases or pathologies related to the endocrine system. A mildly low vWF or factor 8 level does not affect the clinical findings of the patients. Key Words : Clotting disorder, menorrhagia