A simple visual assessment technique to discriminate between menorrhagia and normal menstrual blood loss

Janssen, Catharina A.H.; Scholten, Piet C.; Heintz, A. Peter M.

doi:10.1016/0029-7844(95)00062-v

Cited by 247 publications

(50 citation statements)

References 16 publications

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“…It is common in premenopausal women. Patients with menstrual bleeding greater than 80 mL are likely to be anemic; however, even if the hemoglobin level is within the normal range, menorrhagia cannot be excluded (sensitivity 43%, specificity 94%) [2]. Menorrhagia primarily occurs due to an intracavitary abnormality, but may also occur without such abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Hysterectomy due to Abnormal Uterine Bleeding in a 15-year Old Girl with Rubinstein-Taybi Syndrome

et al. 2016

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Rubinstein-Taybi syndrome is characterized by mental retardation, atypical facial features, broad thumbs and toes, and scoliosis. Polycystic ovaries are associated with chronic anovulation and abnormal uterine bleeding. A 15-year old female patient was diagnosed with Rubinstein-Taybi Syndrome, and had prolonged abnormal uterine bleeding for 2 years, accompanied by a polycystic ovary. As she showed no improvement during hormonal therapy or medical treatment, a hysterectomy was performed to control the bleeding.

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Section: Discussionmentioning

confidence: 99%

Hysterectomy due to Abnormal Uterine Bleeding in a 15-year Old Girl with Rubinstein-Taybi Syndrome

et al. 2016

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“…The bleeding score was calculated according to the ISTH bleeding assessment tool (ISTH‐BAT) 3. His 30‐year‐old mother had epistaxis, easy bruising, gum bleeding, and abnormal menstrual score according to the Pictorial Bleeding Assessment Chart4 (PBAC = 192, nv < 185). His 40‐year‐old father and his sister did not show bleeding symptoms.…”

Section: Methodsmentioning

confidence: 99%

Combined effects of two mutations in von Willebrand disease 2M phenotype

Woods

Paiva

Kempfer

et al. 2018

Research and Practice in Thrombosis and Haemostasis

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Essentials Compound heterozygosity causes a VWD2M phenotype in a child with severe bleeding symptoms.p.P1648fs*45 changes the folding of A2 domain altering VWF binding to GPIbα and type VI collagen.p.P1648fs*45 was considered as an apparent de novo mutation; AS‐PCR revealed paternal mosaicism.Bleeding score and DDAVP's response were worse than those seen in VWD2M heterozygous controls. BackgroundType 2M von Willebrand disease (VWD2M) is usually characterized by VWF:RCo/VWF:Ag<0.6 and normal multimeric profile; desmopressin (DDAVP) challenge test commonly shows poor response of VWF:RCo.ObjectiveWe describe the bleeding tendency and the laboratory phenotype in a patient carrying two heterozygous mutations affecting VWF‐A1 domain and VWF‐A2 domain.Subjects/methodsA 12‐year‐old patient (O blood group) with severe hemorrhagic tendency was phenotypically and genotypically analyzed; his parents were also studied.ResultsThe proband showed decrease FVIII:C, VWF:RCo/VWF:Ag, and VWF:CB6/VWF:Ag ratios, but normal platelet count, VWF:CB1/VWF:Ag ratio, VWFpp and multimeric pattern, suggesting a VWD2M phenotype. The DDAVP challenge test, compared to controls (VWD2M patients with mutations in VWF‐A1 domain), showed lower increase of FVIII:C and VWF:Ag than in heterozygous, but very similar to homozygous control. Two mutations were found in heterozygous and trans presentation: p.Pro1648fs*45 and a novel missense mutation, p.Arg1426Cys. The mother was p.Arg1426Cys heterozygous carrier, with few clinical symptoms. The father was asymptomatic, with no mutations. The p.Pro1648fs*45 was considered an apparent de novo mutation; proband's AS‐PCR revealed mosaicism in the paternal allele. According to the predicted models, p.Arg1426Cys would not be affecting the binding of GPIbα to A1 domain, whereas p.Pro1648fs*45 seems to modify the folding of A2 domain, and in this way, it would affect the binding to GPIbα and type VI collagen. We believe that the combination of these two heterozygous mutations, in a child with O blood group, could result in a defective phenotype enhancer.

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“…Menorrhagia was diagnosed based on the patient’s history and amount of menstrual bleeding while the number of used pads per day by the patient was measured based on bleeding scores (29). Inclusion criteria were defined as having bleeding that lasted for more than seven days or resulted in a loss of more than 80 mL of blood per menstrual cycle, being an adolescent with menorrhagia, adult female with menorrhagia without any other cause or female undergoing a hysterectomy for menorrhagia.…”

Section: Methodsmentioning

confidence: 99%

Screening of Von Willebrand Disease in Iranian Women With Menorrhagia

Rahbar¹,

Faranoush²,

Ghorbani³

et al. 2015

Iran Red Crescent Med J

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Background:Menorrhagia is a common health problem in women, particularly those with bleeding disorders. Little is known about the course of menorrhagia or other bleeding symptoms in women with the most common congenital bleeding disorder, von Willebrand disease (vWD).Objectives:The aim of this study was to estimate the prevalence of vWD in women with diagnosed menorrhagia.Materials and Methods:In this cross-sectional study, a total of 460 consecutive patients, presenting menorrhagia, were analyzed. The initial screening and confirmation tests for the diagnosis of vWD included determination of prothrombin time (PT), partial thromboplastin time (PTT), bleeding time (BT), fibrinogen, factor VIII, vWF antigen, and vWF activity. A questionnaire was filled for every patient. The data were then analyzed using the SPSS software.Results:Mean age of our patients was 32.5 ± 10.6 years. The level of von Willebrand factor in 22.5% and von Willebrand activity in 19.6% of patients was abnormal. The prevalence of vWD among patients with menorrhagia was 24%.Conclusions:The high prevalence of vWD among our patients was the same as other previous reports, suggesting low awareness about this disease and under diagnosis of mild cases.

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A simple visual assessment technique to discriminate between menorrhagia and normal menstrual blood loss

Cited by 247 publications

References 16 publications

Hysterectomy due to Abnormal Uterine Bleeding in a 15-year Old Girl with Rubinstein-Taybi Syndrome

Hysterectomy due to Abnormal Uterine Bleeding in a 15-year Old Girl with Rubinstein-Taybi Syndrome

Combined effects of two mutations in von Willebrand disease 2M phenotype

Screening of Von Willebrand Disease in Iranian Women With Menorrhagia

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