The prevalence of bleeding disorders in women with regular heavy menstrual bleeding at a secondary gynaecology clinic in central South Africa
| dc.contributor.advisor | Baloyi, S. M. | |
| dc.contributor.advisor | Coetzee, M. J. | |
| dc.contributor.advisor | Haupt, Leriska | |
| dc.contributor.author | Deiker, Motshidisi | |
| dc.date.accessioned | 2022-03-07T07:33:31Z | |
| dc.date.available | 2022-03-07T07:33:31Z | |
| dc.date.issued | 2021-06 | |
| dc.description.abstract | Background: Heavy menstrual bleeding (HMB) affects 10-15% of women. Studies from developed countries show that 20% of females with heavy menstrual bleeding have an underlying bleeding disorder. The prevalence of bleeding disorders in patients with HMB has not been determined in South Africa. Objectives: To determine the prevalence of bleeding disorders in women with heavy menstrual bleeding in a tertiary gynaecology clinic in central South Africa and to evaluate the use of the Molecular and Clinical Markers for the Diagnosis and Management of Type 1 VWD bleeding assessment tool (MCMDM-1 VWD BAT) and the bleeding time in identifying women with HMB with underlying bleeding disorders. Methods: This was a prospective descriptive study. Forty-one patients with heavy menstrual bleeding not attributable to other causes in the PALM-COEIN classification were recruited. Demographic data were collected, the MCMDM-1 VWD BAT was administered, a modified Ivy bleeding time was done, and routine laboratory testing was done to exclude non-haematological conditions. Screening tests for coagulation disorders were done. Results: Forty-one patients were recruited for the study, but only 36 had a complete data set. None of the patients were identified to have an underlying bleeding disorder even though seven patients (19.4%) had an elevated MCMDM-1 VWD score, despite the lack of laboratory evidence of a bleeding disorder. One (2.5%) patient had an elevated bleeding time. All the patients were referred from primary healthcare clinics. Conclusion: The prevalence of bleeding disorders in this study is low when compared to studies done elsewhere, even though there was selection bias. Half of the patients were already on contraceptives, which might have reduced their bleeding symptoms. Our functional Von Willebrand factor assays were dependent on ristocetin and may have overestimated the Von Willebrand factor concentration. The MCMDM-1 VWD bleeding assessment tool was easy to administer. The bleeding time did not contribute to the diagnosis. The study needs to be repeated in a primary care setting, using Von Willebrand factor assays that are independent of ristocetin. Such studies are indicated to determine to true prevalence of bleeding disorders in patients with heavy menstrual bleeding in South Africa. | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11660/11504 | |
| dc.language.iso | en | en_ZA |
| dc.publisher | University of the Free State | en_ZA |
| dc.rights.holder | University of the Free State | en_ZA |
| dc.subject | Dissertation (M.Med. (Obstetrics and Gynaecology))--University of the Free State, 2021 | en_ZA |
| dc.subject | Heavy menstrual bleeding | en_ZA |
| dc.subject | Bleeding disorders | en_ZA |
| dc.subject | Bleeding assessment tool | en_ZA |
| dc.title | The prevalence of bleeding disorders in women with regular heavy menstrual bleeding at a secondary gynaecology clinic in central South Africa | en_ZA |
| dc.type | Dissertation | en_ZA |