Hematolog Approach to Abnormal Uterine Bleeding in Adolescents

Abstract

Introduction: Abnormal uterine bleeding (AUK) is a term used for changes in menstrual bleeding pattern, duration, or amount. In adolescent girls, it is associated with the immature hypothalamo-pituitary-ovarian axis, bleeding disorders, infections, endocrine disorders, systemic diseases, vagina-cervix-uterus and problems related to the ovary and drugs. There are different approaches between different disciplines in this assessment. In our study, we aimed to share our results and contribute to the hematological approach to these cases by retrospectively evaluating the abnormal uterine bleeding examination and treated cases in Afyon Health Sciences University Department of Pediatric Hematology. Materials and Methods: Between July 2016 and September 2019, patients over 12 years admitted to the Afyonkarahisar University of Health Sciences Department of Pediatric Hematology who had hemoglobin value <12 grams/dL and 60-80 mL bleeding in normal menstrual period (3-6 pads/day or 10-15 pads/cycle), menstrual cycle lasting longer than 8 days, and menstrual cycle repeated more than 21-28 days were included in the study and their records were analyzed retrospectively. The demographic features, admittion complaints, consultations, treatments applied and the results were documented and evaluated. Results: A total of 39 subjects were enrolled in the study. The mean age of the patients was 16.2 +/- 1.5 (13.2-21.5), the mean age at menarche was 12.4 +/- 1.1 (8-14). Hb <8 g/dL in 53.8% (n=21) of patients, hb 8-10 g/dL in 23% (n=9) and 10-12 g/dL in 23% (n=9) and von Willebrand Type 1 was detected in one patient. Conclusion: Abnormal uterine bleeding is an important cause of anemia in adolescent girls. It is necessary to conduct investigations for etiology and bleeding disorders especially von Willebrand disease, in differential diagnosis. The communication of different disciplines and the knowledge of other disciplines about the approach to the subject for effective treatment of abnormal uterine bleeding plays an important role in decreasing hospital admissions and increasing the success of treatment.