Research Article
Year 2019,
Volume: 9 Issue: 1, 59 - 64, 27.03.2019
Abstract
AMAÇ: Aşırı menstruel kanama (AMK)
adolesanlarda sık görülmekte olup adolesanın fiziksel, duygusal ve sosyal yaşam
kalitesini bozmaktadır. Bu çalışmada adolesanlarda AMK nedenleri, şiddeti,
uygulanan tedaviler ve sonuçları araştırıldı.
GEREÇ VE YÖNTEM: 01.09.2016 – 01.09.2018
tarihleri arasında adolesan merkezine aşırı menstruel kanama şikayetiyle
başvuran olguların dosyaları retrospektif olarak incelendi. Menstruel kanaması
8 günden daha uzun ve/veya siklusları 21 günden sık ve/veya bir siklusta artmış
kan kaybı bulguları olan 132 olgu çalışmaya dahil edildi. AMK’sı olan
adolesanlar hemoglobin düzeyine göre sınıflandırıldı.
BULGULAR: AMK nedeniyle başvuranlarda
sıklıkla kanamalı gün sayısında artış (%70,5) şikayeti vardı, bunu menstruel
siklusun kısalması (%59,1) ve bir siklusta artmış kan kaybı (%24,2) şikayetleri
izlemekteydi. Bir siklustaki kanamalı gün sayısı ve/veya bir günde kullanılan
ped sayısı ve/veya sikluslararası kanamasız gün sayısı arttıkça olguların hemoglobin
konsantrasyonu düşmekteydi. Bu parametrelerden bir günde kullanılan ped
sayısının aneminin ağırlaşmasında en önemli etken olduğu saptandı. Hiçbir olguda
yapısal patoloji saptanmadı, olgular yapısal olmayan AMK nedenleri açısından
araştırıldığında %3’ünde (n:4) koagülasyon problemi, %10,6’sında (n:14)
polikistik over sendromuna bağlı ovulatuar disfonksiyon, %0,8’inde (n:1)
hipotiroidiye bağlı ovulatuar disfonksiyon, %85,6’sında ise adolesanın fizyolojik
ovulatuvar disfonksiyonu mevcuttu. Olguların %56,1’inde hafif, %20,5’inde orta,
%23,5’inde ağır AMK mevcuttu. Olguların yaklaşık yarısı demir desteği ve nonsteroid
antiinflamatuar ilaç tedavisi ile takip edildi. Diğer yarısına oral kontraseptif
ve demir tedavisi verilmişti olguların %5,3’ünde hemodinamik yetmezlik
bulguları olması nedeniyle oral kontraseptif tedavisine ek olarak eritrosit
süspansiyonu, %1,6’sına traneksamik asit tedavisi verildi.
SONUÇ: AMK adolesan dönemde sık
görülmektedir ve adolesanlarda aneminin önemli bir nedenidir. AMK olgularının
%5,3’ünde hayatı tehdit edecek boyutta anemi saptanmıştır.
Keywords
References
- Referans 1 Bennett AR, Gray SH. What to do when she's bleeding through: the recognition, evaluation, and management of abnormal uterine bleeding in adolescents. Current opinion in pediatrics 2014; 26 (4):413-419.Referans 2 Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 2011;113:3-13.Referans 3 Caufriez A. Menstrual disorders in adolescence: pathophysiology and treatment. Hormone research 1991; 36 (3-4):156-159.Referans 4 Haamid F, Sass AE, Dietrich JE. Heavy menstrual bleeding in adolescents. J Pediatr Adolesc Gynecol 2017; 30:335–340.Referans 5 Friberg B, Orno AK, Lindgren A, et al: Bleeding disorders among young women: a population-based prevalence study. Acta Obstet Gynecol Scand 2006; 85:200-208.Referans 6 Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2011; 113 (1):3-13.Referans 7 Pecchioli Y, Oyewumi L, Allen LM, Kives S. The Utility of Routine Ultrasound in the Diagnosis and Management of Adolescents with Abnormal Uterine Bleeding. Journal of pediatric and adolescent gynecology 2017; 30 (2):239-242.Referans 8 Claessens EA, Cowell CA. Acute adolescent menorrhagia. American journal of obstetrics and gynecology 1981; 139 (3):277-280.Referans 9 Rosenfield. Adolescent anovulation: Maturational mechanisms and implications. J Clin Endocrinol Metab 2013;98(9):3572-3583. Referans 10 Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F. Growth references for Turkish children aged 6 to 18 years. Acta Paediatr 2006;95:1635-1641.Referans 11 Gray SH. Menstrual disorders. Pediatrics in review 2013; 34 (1):6-17; quiz 17-18.Referans 12 Rajpurkar M, O'Brien SH, Haamid FW, Cooper DL, Gunawardena S, Chitlur M. Heavy Menstrual Bleeding as a Common Presenting Symptom of Rare Platelet Disorders: Illustrative Case Examples. Journal of pediatric and adolescent gynecology 2016; 29 (6):537-541.Referans 13 Lazar L, Meyerovitch J, de Vries L, Phillip M, Lebenthal Y. Treated and untreated women with idiopathic precocious puberty: long-term follow-up and reproductive outcome between the third and fifth decades. Clin Endocrinol (Oxf). 2014 Apr;80(4):570-6.Referans 14 Benjamins LJ. Practice guideline: evaluation and manage¬ment of abnormal vajinal bleeding in adolescents. J Pediatr Health Care 2009;23:189-93.Referans 15 ACOG Committee on Adolescent Health Care. ACOG com¬mittee opinion no. 349, Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Obstet Gynecol 2006;108:1323-8.Referans 16 Karaman K, Ceylan N, Karaman E, et al. Evaluation of the hemostatic disorders in adolescent girls with menorrhagia: experiences from a tertiary referral hospital. Indian J Hematol Blood Transfus 2016; 32:356–361.Referans 17 Maslyanskaya S, Talib HJ, Northridge JL, et al. Polycystic ovary syndrome: an under-recognized cause of abnormal uterine bleeding in adolescents admitted to a children’s hospital. J Pediatr Adolesc Gynecol 2017; 30:349–355.Referans 18 Ahuja SP, Hertweck SP: Overview of bleeding disorders in adolescent females with menorrhagia. J Pediatr Adolesc Gynecol 2010; 23(6 Suppl):S15.Referans 19 Chi C, Pollard D, Tuddenham EG, et al: Menorrhagia in adolescents with inherited bleeding disorders. J Pediatr Adolesc Gynecol 2010; 23:215.Referans 20 Santos M, Hendry D, Sangi-Haghpeykar H, Dietrich JE. Retrospective review of norethindrone use in adolescents. Journal of pediatric and adolescent gynecology 2014; 27 (1):41-44.Referans 21 Cowan BD, Morrison JC. Management of abnormal genital bleeding in girls and women. The New England journal of medicine 1991; 324 (24):1710-1715.Referans 22 Gray S.H. ESJ. Abnormal vaginal bleeding in the adolescent. In: Emans S.J. LMR, (editor). Emans, Laufer, Goldstein's Pediatric & Adolescent Gynecology, 6th edn. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 159.
Year 2019,
Volume: 9 Issue: 1, 59 - 64, 27.03.2019
Abstract
References
- Referans 1 Bennett AR, Gray SH. What to do when she's bleeding through: the recognition, evaluation, and management of abnormal uterine bleeding in adolescents. Current opinion in pediatrics 2014; 26 (4):413-419.Referans 2 Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 2011;113:3-13.Referans 3 Caufriez A. Menstrual disorders in adolescence: pathophysiology and treatment. Hormone research 1991; 36 (3-4):156-159.Referans 4 Haamid F, Sass AE, Dietrich JE. Heavy menstrual bleeding in adolescents. J Pediatr Adolesc Gynecol 2017; 30:335–340.Referans 5 Friberg B, Orno AK, Lindgren A, et al: Bleeding disorders among young women: a population-based prevalence study. Acta Obstet Gynecol Scand 2006; 85:200-208.Referans 6 Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2011; 113 (1):3-13.Referans 7 Pecchioli Y, Oyewumi L, Allen LM, Kives S. The Utility of Routine Ultrasound in the Diagnosis and Management of Adolescents with Abnormal Uterine Bleeding. Journal of pediatric and adolescent gynecology 2017; 30 (2):239-242.Referans 8 Claessens EA, Cowell CA. Acute adolescent menorrhagia. American journal of obstetrics and gynecology 1981; 139 (3):277-280.Referans 9 Rosenfield. Adolescent anovulation: Maturational mechanisms and implications. J Clin Endocrinol Metab 2013;98(9):3572-3583. Referans 10 Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F. Growth references for Turkish children aged 6 to 18 years. Acta Paediatr 2006;95:1635-1641.Referans 11 Gray SH. Menstrual disorders. Pediatrics in review 2013; 34 (1):6-17; quiz 17-18.Referans 12 Rajpurkar M, O'Brien SH, Haamid FW, Cooper DL, Gunawardena S, Chitlur M. Heavy Menstrual Bleeding as a Common Presenting Symptom of Rare Platelet Disorders: Illustrative Case Examples. Journal of pediatric and adolescent gynecology 2016; 29 (6):537-541.Referans 13 Lazar L, Meyerovitch J, de Vries L, Phillip M, Lebenthal Y. Treated and untreated women with idiopathic precocious puberty: long-term follow-up and reproductive outcome between the third and fifth decades. Clin Endocrinol (Oxf). 2014 Apr;80(4):570-6.Referans 14 Benjamins LJ. Practice guideline: evaluation and manage¬ment of abnormal vajinal bleeding in adolescents. J Pediatr Health Care 2009;23:189-93.Referans 15 ACOG Committee on Adolescent Health Care. ACOG com¬mittee opinion no. 349, Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Obstet Gynecol 2006;108:1323-8.Referans 16 Karaman K, Ceylan N, Karaman E, et al. Evaluation of the hemostatic disorders in adolescent girls with menorrhagia: experiences from a tertiary referral hospital. Indian J Hematol Blood Transfus 2016; 32:356–361.Referans 17 Maslyanskaya S, Talib HJ, Northridge JL, et al. Polycystic ovary syndrome: an under-recognized cause of abnormal uterine bleeding in adolescents admitted to a children’s hospital. J Pediatr Adolesc Gynecol 2017; 30:349–355.Referans 18 Ahuja SP, Hertweck SP: Overview of bleeding disorders in adolescent females with menorrhagia. J Pediatr Adolesc Gynecol 2010; 23(6 Suppl):S15.Referans 19 Chi C, Pollard D, Tuddenham EG, et al: Menorrhagia in adolescents with inherited bleeding disorders. J Pediatr Adolesc Gynecol 2010; 23:215.Referans 20 Santos M, Hendry D, Sangi-Haghpeykar H, Dietrich JE. Retrospective review of norethindrone use in adolescents. Journal of pediatric and adolescent gynecology 2014; 27 (1):41-44.Referans 21 Cowan BD, Morrison JC. Management of abnormal genital bleeding in girls and women. The New England journal of medicine 1991; 324 (24):1710-1715.Referans 22 Gray S.H. ESJ. Abnormal vaginal bleeding in the adolescent. In: Emans S.J. LMR, (editor). Emans, Laufer, Goldstein's Pediatric & Adolescent Gynecology, 6th edn. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 159.
There are 1 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | March 27, 2019 |
| Acceptance Date | March 12, 2019 |
| Published in Issue | Year 2019 Volume: 9 Issue: 1 |