Diagnostic Process of Adolescents with Abnormal Uterine Bleeding in Pediatric Departments: Single Center Results

Abnormal Uterine Bleeding

Abstract

Objective: The present study aims to assess patients, who applied to our hospital for abnormal uterine bleeding, and to examine the differences between cases diagnosed with hemostasis disorders and others.

Material and method: This study included 105 patients, who presented with abnormal uterine bleeding between 2021 and 2022 years, prospectively. Complete blood count, peripheral blood smear, prothrombin time, activated partial thromboplastin time, fibrinogen level, thrombin time, von Willebrand factor antigen, ristocetin cofactor activity, factor VIII: C activity, flow cytometric analysis of platelet surface glycoproteins (Gp Ib/V/IX and Gp IIb/IIIa), biochemical assessments of iron status and blood group analyses, pelvic ultrasonographic imaging, and endocrine evaluations were conducted on the patients. The other factor tests were also assessed in cases with suspected hemostasis disorders.

Results: The mean age of the 105 patients included in the present study was found to be 15.3 (min: 11.3-max: 19.3) years. The most common etiology was ovulatory dysfunction in 55% (n=58) cases, followed by hemostasis disorders with 13.3% (n=14) cases and genitourinary system infections with 9.5%. The level of deficiency was found to be mild in all cases found to have factor deficiency. The mean menarche-to-diagnosis time was determined to be 3.3 years for the patients with hemostasis disorders.

Conclusion: It is important to obtain detailed patient and family history, menstrual history and physical examination of adolescent patients and closely follow up on those having abnormal uterine bleeding for emergencies.  Some patients' hemoglobin levels may decrease severely, and their hemodynamics may be impaired.