University of Khartoum

Frequency of Bleeding Disorders in High School Adolescents with Menorrhagia in Khartoum – Sudan

Frequency of Bleeding Disorders in High School Adolescents with Menorrhagia in Khartoum – Sudan

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Title: Frequency of Bleeding Disorders in High School Adolescents with Menorrhagia in Khartoum – Sudan
Author: Eid, Hanan Mohamed Ali
Abstract: Background Menorrhagia is a common problem among adolescents’ females. It has many causes. It is common among patients with bleeding disorders and can be a presenting symptom. The study aimed to assess the frequency of bleeding disorders in high school adolescences with menorrhagia in Khartoum – Sudan Materials and Methods: This is a cross-sectional descriptive community based study, conducted in high school students in both Bahery Algademma and Elsheikh Hamad girls schools in the period from October 2016 to March 2017.According to the total number of high school female students in Khartoum State the sample size was calculated to be 1185 students. Those who did not reach menarche were excluded, and the rest 996 students were assessed for bleeding disorders using a bleeding score whereby a score of > 5 means significant bleeding. A family history and full clinical assessment were then done. Those who were found to have a bleeding score of >5 were investigated by doing a CBC, platelet count, haemoglobin concentration, prothrombin time, activated partial thromboplastin time, fibrinogen level, clotting factor assay (Factor VIII level, vWf antigen, XIII screening,) &finger prick platelet aggregation test.Data were collected using a designed questionnaire and a bleeding score and analyzed using Statistical package for social science program (SPSS) Results: Out of 1185 students, 189students (16%) did not reach menarche yet so they were excluded from the study. 977students (82%) were normal with bleeding score between (0-3). 19 students (2%) their bleeding score was significant (>5) so they were investigated. Eight students (42%) out of 19 students with menorrhagia, complained of other bleeding symptoms, mainly epistaxis and 3students (15.4%) complained of bleeding from minor wounds. A positive family history of bleeding disorders was found in 5 students (26.3%) with 2 of them having FH of von Will brand disease (vWD) and 1 student with platelets disorder and 2 of them were not sure about the diagnosis..Activated partial thromboplastin time was prolonged in 2 students (10.5%), prothrombin time was prolonged in 1 of them (5.3%) and vWf antigen was in the lower limit of normal in 2 students (10.5%) while the other haemostatic tests were within the normal range in all of the students. Six students (31.5%) showed anemia with Hb level less than 100 g / l which was microcytic hypochromic in type. Conclusion: Students with menorrhagia without a discernible cause need evaluation for haemostatic disorders. None of the students in this study had a diagnosis of an obvious bleeding disorder. This might be due to the fact that assessment of menorrhagia is subjective and those young girls did not have enough experience to estimate the amount of bleeding. Von Willebrand disease (vWD) is difficult to diagnose and its level is related to the blood group. Some cases of vWD need to be tested more than once to reach a diagnosis, so some of the girls might have mild vWD or type 2 vWD.
URI: http://khartoumspace.uofk.edu/123456789/26670


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