THE STUDY OF MENSTRUAL AND OTHER BLOOD LOSS, AND CONSEQUENT IRON DEFICIENCY BY Fe$sup 59$ WHOLE BODY COUNTING

Price, David C.; Forsyth, Edward; Cohn, S. H.; Cronkite, Eugene P.

doi:10.2172/4070957

Cited by 7 publications

(3 citation statements)

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“…The discriminatory power of three methods to measure iron/labelled blood in pads [ 31 ], from menstrual products [ 43 ], or in the whole body [ 29 ] was assessed: all of the techniques were able to discriminate between normal and high MBL, or between non-anemic and anemic women, but statistical significance was not reported (Additional file 6 ). In a fourth study, the amount of iron lost in pads strongly correlated with MFL [ 47 ] (Additional file 5 ).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of methods to measure menstrual blood loss

Magnay¹,

O’Brien

Gerlinger

et al. 2018

BMC Women's Health

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BackgroundSince the publication over 50 years ago of the alkaline hematin method for quantifying menstrual blood loss (MBL) many new approaches have been developed to assess MBL. The aim of this systematic review is to determine for methods of measuring MBL: ability to distinguish between normal and heavy menstrual bleeding (HMB); practicalities and limitations in the research setting; and suitability for diagnosing HMB in routine clinical practice.MethodsEmbase®™, MEDLINE®, and ClinicalTrials.gov were screened for studies on the development/validation of MBL assessment methods in women with self-perceived HMB, actual HMB or uterine fibroids, or patients undergoing treatment for HMB. Studies using simulated menstrual fluid and those that included women with normal MBL as controls were also eligible for inclusion. Extracted data included study population, results of validation, and advantages/disadvantages of the technique.ResultsSeventy-one studies fulfilled the inclusion criteria. The sensitivity and/or specificity of diagnosing HMB were calculated in 16 studies of methods involving self-perception of MBL (11 pictorial), and in one analysis of the menstrual-fluid-loss (MFL) method; in 13 of these studies the comparator was the gold standard alkaline hematin technique. Sensitivity and specificity values by method were, respectively: MFL model, 89, 98%; pictorial blood loss assessment chart (PBAC), 58–99%, 7.5–89%; menstrual pictogram, 82–96%, 88–94%; models/questionnaires, 59–87%, 62–86%, and complaint of HMB, 74, 74%. The power of methods to identify HMB was also assessed using other analyses such as comparison of average measurements: statistical significance was reported for the PBAC, MFL, subjective complaint, and six questionnaires. In addition, PBAC scores, menstrual pictogram volumes, MFL, pad/tampon count, iron loss, and output from three questionnaires correlated significantly with values from a reference method in at least one study. In general, pictorial methods have been more comprehensively validated than questionnaires and models.ConclusionsEvery method to assess MBL has limitations. Pictorial methods strike a good balance between ease of use and validated accuracy of MBL determination, and could complement assessment of HMB using quality of life (QoL) in the clinical and research setting.Trial registrationPRISMA registration number: CRD42016032956.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0627-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A systematic review of methods to measure menstrual blood loss

Magnay¹,

O’Brien

Gerlinger

et al. 2018

BMC Women's Health

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“…In previous studies with the whole-body counter (Price, Forsyth, Cohn, and Cronkite, 1964;Holt et al, 1967), blood loss was calculated from the percentage change in 59Fe retention on the assumption that this was equivalent to the same percentage change of blood volume. For this calculation an accurate assessment of total blood volume was essential.…”

Section: Discussionmentioning

confidence: 99%

“…This method is similar to that described by Price, Reizenstein, Cohn, Cronkite, and Wasserman (1961) and more recently by Holt, Mayet, Warner, and Callender (1967), and is based on the fact that in normal men loss of iron from the body is very small, on average 06 mg per day (Finch, 1964), or roughly the equivalent of 1 ml of blood. After the intravenous injection of radioactive iron 5"Fe, the radionuclide is mostly incorporated into circulating haemoglobin.…”

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confidence: 95%

Measurement of blood and iron loss in colitis with a whole-body counter

Stack¹,

Smith²,

Jones³

et al. 1969

Gut

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SUMMARY Estimation with a whole-body counter of the fall in total body radioactivity due to loss of parenterally administered 59Fe has been used to measure blood loss in 17 patients with ulcerative colitis. It was shown that blood loss was related to the activity ofdisease as judged by sigmoidoscopic changes and less obviously to the extent of involvement of the colon.Blood losses of 50 to 150 ml per week were observed when the patient saw no blood in the stools and the rectal mucosa did not appear haemorrhagic.Some patients lost more than 0.5 g iron during the few weeks following an exacerbation of ulcerative colitis suggesting that repeated replacement of the body's iron stores is often necessary in this disease.

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