Etiology and Diagnosis of Heavy Menstrual Bleeding among Adolescent and Adult Patients: A Systematic Review and Meta-Analysis of the Literature.

IF 5.5 2区 医学 Q1 HEMATOLOGY
Kyle J Comishen, Meha Bhatt, Katie Yeung, Jehan Irfan, Ayesha Zia, Robert F Sidonio, Paula James
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引用次数: 0

Abstract

Background: Heavy menstrual bleeding (HMB) is excessive menstrual blood loss that interferes with an individual's quality of life. Many individuals with HMB are inadequately managed by healthcare providers. This systematic review aims to provide a comprehensive summary of the etiologies and diagnosis of HMB while calculating the prevalence of underlying causes among premenopausal patients and quantifying the test accuracy of diagnostic strategies.

Methods: MEDLINE, EMBASE, the Cochrane Library, and Web of Science were searched since inception to include studies investigating the prevalence of underlying etiology and diagnostic accuracy of investigations for HMB. The primary outcome was the prevalence of the causes of HMB, secondary outcome included the prevalence of etiology by age. Meta-analyses were conducted via random effects model.

Results: 53 studies were included. Forty-five studies included data on the prevalence of underlying HMB etiology, totaling 41541patients. The overall prevalence of bleeding disorders was 30% [95% CI 14-46], von Willebrand disease (VWD) of 8% [95% CI 7-10], platelet function defect (PFD) of 9% [95% CI 7-12], abnormal thyroid of 3% [95% CI 0-6], and polycystic ovarian syndrome (PCOS) of 8% [95% CI 4-12]. Subgroup analysis showed bleeding disorders were prevalent in 16% [95% CI -8-41] of adults with HMB, but 39% [95% CI 18-60] of adolescents with HMB.

Conclusions: Many diagnoses were associated with bleeding disorders and, therefore, warrant investigation when assessing a patient with HMB of unknown etiology. The causes are likely age-dependent and should be considered when diagnosing HMB.

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来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
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