Identification of Bleeding Disorders in Women with Menorrhagia in Gezira state, Sudan (2017-2018)

Abstract

Menorrhagia (Heavy menstrual Bleeding) (HMB) is defined as bleeding in excess of 80 ml per menstrual cycle when measured objectively or bleeding more than 7.0 days or both. It is common among patients with bleeding disorders and can be a presenting symptom. The aim of this study was to identify bleeding disorders in women with menorrhagia in Gezira state teaching hospitals, Sudan. This is prospective study, conducted at the period from June 2017 to June 2018. Seventy-six women with menorrhagia and 15 normal women (used as control) were enrolled in this study. 2.5 ml of venous blood were collected in trisodium citrate container, 2.5 ml in EDTA container during menstruation and after 14 days of ending menstruation. Bleeding time, activated partial thromboplastin time, platelets count and platelets aggregation were performed. Luteinizing hormone (LH), Follicle-stimulating Hormone (FSH), progesterone, factor VIII and Von Willebrand factor antigen during and post menstruation Measured. The data was analyzed by using statistical analysis program SPSS. The mean women age was 25.0 (+/- 3.0) years, ranged from 14 – 45 years. About 5.3% of participants has family history of bleeding and 93.5% has no family history. The result showed that there was significance difference between the mean of hemoglobin (9.340 +/- 2.066) with (p = 0.019), platelets count mean (311.29 +/-30.000) with (p = 0.027), bleeding time (4.89 +/- 1.856) minutes with (p =0.005), APTT(38.822 +/- 8.8926) seconds with (p =0.002), LH (P =0.075), FSH (P =0.000), progesterone (p =0.03) and VWF Ag (p =0.000) and no significance difference between Factor VIII (P =0.291) in patients and controls. According to the results of this study the possibly causative agents of menorrhagia were Von Willebrand factor antigen (5.3%), abnormal platelets aggregation (3.9%) (Platelets dysfunction), hormones abnormalities (1.6%), low platelets count (thrombocytopenia) (3%), 86.2% others causes (unknown).