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Adolesanlarda Anormal Uterin Kanamanın Değerlendirilmesi: Tersiyer Merkez Deneyimi

Yıl 2026, Cilt: 13 Sayı: 1 , 34 - 42 , 30.03.2026
https://doi.org/10.34087/cbusbed.1666448
https://izlik.org/JA86GW28KX

Öz

Adolesanlarda Anormal Uterin Kanamanın Değerlendirilmesi: Tersiyer Merkez Deneyimi

The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience

Reyhan Gündüz

Dicle Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı/Diyarbakır/Türkiye

e-mail: ryhn.gunduz@gmail.com
ORCID: https://orcid.org/0000-0001-8468-7038

*Sorumlu Yazar / Corresponding Author: Reyhan Gündüz
Gönderim Tarihi / Received:
Kabul Tarihi / Accepted:
DOI: 10.34087/cbusbed.
Öz
Giriş ve Amaç: Anormal uterin kanaması olan adolesanların demografik, ultrasonografik, klinik ve laboratuvar verilerini değerlendirmektir. Anemi derecelerine göre menorajisi olan adolesanları üç gruba ayırıp kanama etiyolojisini ve şiddetini belirleyerek literatüre katkı sunmaktır.
Gereç ve Yöntemler: Adolesan dönemde olup menorajisi olan 112 kadının verileri retrospektif olarak incelendi. Hafif menoraji Hemoglobin (Hgb) > 12 g/dl, orta derecede menoraji Hgb 10-12 g/dl ve şiddetli menoraji Hgb ≤ 10 g/dl olarak üç gruba ayrıldı. Veriler bu üç grup arasında karşılaştırıldı.
Bulgular: Çalışmaya dahil edilen adolesanların yaş ortalamaları 17.9±1.5 yıl, Hgb değerleri ortalama olarak 11±3.5 g/dl olarak belirlendi. %59.6’sında (53) hafif anemi, %19.1’inde (17) orta derecede anemi, %21.3’ünde (19) ağır derecede anemi belirlendi. Hgb değerine göre ayırdığımız üç grup arasında demografik ve klinik veriler açısından istatistiksel olarak anlamlı fark bulamadık. İki hastada faktör 8 eksikliği, bir hastada glanzman trombositopenisi ve altı hastada ITP tespit ettik. Gebeliğe bağlı menorajiyi %25 (28) olarak belirledik.
Sonuç: Adolesan dönemde yoğun olarak görülebilen menorajinin değerlendirilmesinde disfonksiyonel uterin kanama dışında sebep olabilecek kanama bozukluklarını ve gebeliği de aklımızda tutup multidisipliner olarak bu durumu yönetmemiz gerekmektedir.

Anahtar kelimeler: Adolesan, anormal uterin kanama, menoraji, kanama bozukluğu, gebelik


Abstract
Aim; The purpose of the present study was to evaluate demographic, ultrasonographic, clinical, and laboratory data of adolescents who had abnormal uterine bleeding. The study also aimed to contribute to the literature by dividing adolescents who had menorrhagia into three groups based on their degree of anemia and determining the etiology and severity of bleeding.
Method; The data of 112 women who had menorrhagia during adolescence were retrospectively analyzed. Mild menorrhagia was divided into three groups as Hemoglobin (Hgb) > 12 g/dl, moderate menorrhagia Hgb 10-12 g/dl, and severe menorrhagia Hgb ≤ 10 g/dl. The data were then compared among these three groups.
Results; The mean age of the adolescents included in the study was 17.9 ±1.5 years, and the mean Hgb value was 11 ±3.5 g/dl. Mild anemia was determined in 59.6% (53), moderate anemia in 19.1% (17), and severe anemia in 21.3% (19). No statistically significant differences were detected in demographic and clinical data among the three groups we separated based on Hgb values. Factor 8 deficiency was detected in two patients, Glanzmann Thrombocytopenia in one patient, and ITP in six patients. Pregnancy-related menorrhagia was determined in 25% (28).
Conclusion; In the evaluation of menorrhagia, which might be detected frequently in adolescence, clinicians must keep in mind the bleeding disorders and pregnancy that might cause it, other than dysfunctional uterine bleeding, and manage this condition in a multidisciplinary manner.

Keywords: Adolescent, abnormal uterine bleeding, menorrhagia, bleeding disorder, pregnancy

Kaynakça

  • ACOG Committee Opinion No. 651. (2015). Menstruation in girls and adolescents: Using the menstrual cycle as a vital sign. Obstet Gynecol, 126(6), e143–6. https://doi.org/10.1097/ AOG.0000000000001215.
  • Fraser, IS., Critchley, HOD., Broder, M., Munro, MG. (2011). The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med, 29, 383-90.
  • Fraser, IS., Langham, S., Uhl-Hochgraeber, K. (2009). Health-related quality of life and economic burden of abnormal uterine bleeding. Expert Review of Obstetrics & Gynecology, 4, 179-89.
  • Haamid, F., Sass, AE., Dietrich, JE. (2017). Heavy menstrual bleeding in adolescents. J Pediatr Adolesc Gynecol, 30, 335-40.
  • Hernandez, A., Dietrich, JE. (2020). Abnormal Uterine Bleeding in the Adolescent. Obstet Gynecol, 135, 615–21. Kabra, R., Fisher, M. (2022). Abnormal uterine bleeding in adolescents. Curr Probl Pediatr Adolesc Health Care, 52, 101185.
  • Karaman, K., Ceylan, N., Karaman, E., Akbayram, S., Akbayram, HT., Kaba, S., et al. (2016). Evaluation of the Hemostatic Disorders in Adolescent Girls with Menorrhagia: Experiences from a Tertiary Referral Hospital. Indian J Hematol Blood Transfus, 32(3), 356–61.
  • Kızılcan Çetin, S., Aycan, Z., Özsu, E., Şıklar, Z., Ceran, A., Erişen Karaca, S., et al. (2023). Evaluation of Abnormal Uterine Bleeding in Adolescents: Single Center Experience. J Clin Res Pediatr Endocrinol, 15(3), 230-37.
  • Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Committee Opinion No. 651. American College of Obstetricians and Gynecologists. (2015). Obstet Gynecol, 126, e143–6.
  • Munro, MG., Critchley, HOD., Fraser, IS., FIGO Menstrual Disorders Committee. (2018). The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet, 143, 393–408.
  • Pecchioli, Y., Oyewumi, L., Allen, LM., Kives, S. (2017). The utility of routine ultrasound in the diagnosis and management of adolescents with abnormal uterine bleeding. J Pediatr Adolesc Gynecol, 30, 239–42 Prasad, DB., Jagannath, P., Bora, BMK. (2016). Evaluation of Menorrhagia in Adolescent Girls: A Clinical Study Sch. J. App. Med. Sci, 4(6F), 2307-11.
  • Ravi, R., Shah, P., Palani, G., Edward, S., Sathiyasekaran, BWC. (2016). Prevalence of Menstrual Problems among Adolescent School Girls in Rural Tamil Nadu. J Pediatr Adolesc Gynecol, 29, 571-576.
  • Revel-Vilk, S., Paltiel, O., Lipschuetz, M., Ilan, U., Hyam, E., Shai, E., Varon, D., et al. (2012). Underdiagnosed menorrhagia in adolescents is associated with underdiagnosed anemia. J Pediatr, 160, 468–72.
  • Rosen, MW., Weyand, AC., Pennesi, CM., Stoffers, VL., Bourdillon, CM., George, JS., et al. (2020). Adolescents Presenting to the Emergency Department with Heavy Menstrual Bleeding. J Pediatr Adolesc Gynecol, 33, 139-43.
  • Srivaths, LV., Dietrich, JE., Yee, DL., Sangi-Haghpeykar, H., Mahoney, D. (2015). Oral Tranexamic Acid versus Combined Oral Contraceptives for Adolescent Heavy Menstrual Bleeding: A Pilot Study. J Pediatr Adolesc Gynecol, 28, 254-57.
  • Vaidya, AA., More, VS. (2018). A case series on Glanzmann thrombasthenia in adolescent girls with puberty menorrhagia. International Journal of Clinical Obstetrics and Gynaecology, 2(1), 4-6.
  • World Health Organization: Women's health. (2010). Available: http://www.who.int/ mediacentre/factsheets/fs334/en. Accessed July 1.

The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience

Yıl 2026, Cilt: 13 Sayı: 1 , 34 - 42 , 30.03.2026
https://doi.org/10.34087/cbusbed.1666448
https://izlik.org/JA86GW28KX

Öz

Adolesanlarda Anormal Uterin Kanamanın Değerlendirilmesi: Tersiyer Merkez Deneyimi

The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience

Reyhan Gündüz

Dicle Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı/Diyarbakır/Türkiye

e-mail: ryhn.gunduz@gmail.com
ORCID: https://orcid.org/0000-0001-8468-7038

*Sorumlu Yazar / Corresponding Author: Reyhan Gündüz
Gönderim Tarihi / Received:
Kabul Tarihi / Accepted:
DOI: 10.34087/cbusbed.
Öz
Giriş ve Amaç: Anormal uterin kanaması olan adolesanların demografik, ultrasonografik, klinik ve laboratuvar verilerini değerlendirmektir. Anemi derecelerine göre menorajisi olan adolesanları üç gruba ayırıp kanama etiyolojisini ve şiddetini belirleyerek literatüre katkı sunmaktır.
Gereç ve Yöntemler: Adolesan dönemde olup menorajisi olan 112 kadının verileri retrospektif olarak incelendi. Hafif menoraji Hemoglobin (Hgb) > 12 g/dl, orta derecede menoraji Hgb 10-12 g/dl ve şiddetli menoraji Hgb ≤ 10 g/dl olarak üç gruba ayrıldı. Veriler bu üç grup arasında karşılaştırıldı.
Bulgular: Çalışmaya dahil edilen adolesanların yaş ortalamaları 17.9±1.5 yıl, Hgb değerleri ortalama olarak 11±3.5 g/dl olarak belirlendi. %59.6’sında (53) hafif anemi, %19.1’inde (17) orta derecede anemi, %21.3’ünde (19) ağır derecede anemi belirlendi. Hgb değerine göre ayırdığımız üç grup arasında demografik ve klinik veriler açısından istatistiksel olarak anlamlı fark bulamadık. İki hastada faktör 8 eksikliği, bir hastada glanzman trombositopenisi ve altı hastada ITP tespit ettik. Gebeliğe bağlı menorajiyi %25 (28) olarak belirledik.
Sonuç: Adolesan dönemde yoğun olarak görülebilen menorajinin değerlendirilmesinde disfonksiyonel uterin kanama dışında sebep olabilecek kanama bozukluklarını ve gebeliği de aklımızda tutup multidisipliner olarak bu durumu yönetmemiz gerekmektedir.

Anahtar kelimeler: Adolesan, anormal uterin kanama, menoraji, kanama bozukluğu, gebelik


Abstract
Aim; The purpose of the present study was to evaluate demographic, ultrasonographic, clinical, and laboratory data of adolescents who had abnormal uterine bleeding. The study also aimed to contribute to the literature by dividing adolescents who had menorrhagia into three groups based on their degree of anemia and determining the etiology and severity of bleeding.
Method; The data of 112 women who had menorrhagia during adolescence were retrospectively analyzed. Mild menorrhagia was divided into three groups as Hemoglobin (Hgb) > 12 g/dl, moderate menorrhagia Hgb 10-12 g/dl, and severe menorrhagia Hgb ≤ 10 g/dl. The data were then compared among these three groups.
Results; The mean age of the adolescents included in the study was 17.9 ±1.5 years, and the mean Hgb value was 11 ±3.5 g/dl. Mild anemia was determined in 59.6% (53), moderate anemia in 19.1% (17), and severe anemia in 21.3% (19). No statistically significant differences were detected in demographic and clinical data among the three groups we separated based on Hgb values. Factor 8 deficiency was detected in two patients, Glanzmann Thrombocytopenia in one patient, and ITP in six patients. Pregnancy-related menorrhagia was determined in 25% (28).
Conclusion; In the evaluation of menorrhagia, which might be detected frequently in adolescence, clinicians must keep in mind the bleeding disorders and pregnancy that might cause it, other than dysfunctional uterine bleeding, and manage this condition in a multidisciplinary manner.

Keywords: Adolescent, abnormal uterine bleeding, menorrhagia, bleeding disorder, pregnancy

Kaynakça

  • ACOG Committee Opinion No. 651. (2015). Menstruation in girls and adolescents: Using the menstrual cycle as a vital sign. Obstet Gynecol, 126(6), e143–6. https://doi.org/10.1097/ AOG.0000000000001215.
  • Fraser, IS., Critchley, HOD., Broder, M., Munro, MG. (2011). The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med, 29, 383-90.
  • Fraser, IS., Langham, S., Uhl-Hochgraeber, K. (2009). Health-related quality of life and economic burden of abnormal uterine bleeding. Expert Review of Obstetrics & Gynecology, 4, 179-89.
  • Haamid, F., Sass, AE., Dietrich, JE. (2017). Heavy menstrual bleeding in adolescents. J Pediatr Adolesc Gynecol, 30, 335-40.
  • Hernandez, A., Dietrich, JE. (2020). Abnormal Uterine Bleeding in the Adolescent. Obstet Gynecol, 135, 615–21. Kabra, R., Fisher, M. (2022). Abnormal uterine bleeding in adolescents. Curr Probl Pediatr Adolesc Health Care, 52, 101185.
  • Karaman, K., Ceylan, N., Karaman, E., Akbayram, S., Akbayram, HT., Kaba, S., et al. (2016). Evaluation of the Hemostatic Disorders in Adolescent Girls with Menorrhagia: Experiences from a Tertiary Referral Hospital. Indian J Hematol Blood Transfus, 32(3), 356–61.
  • Kızılcan Çetin, S., Aycan, Z., Özsu, E., Şıklar, Z., Ceran, A., Erişen Karaca, S., et al. (2023). Evaluation of Abnormal Uterine Bleeding in Adolescents: Single Center Experience. J Clin Res Pediatr Endocrinol, 15(3), 230-37.
  • Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Committee Opinion No. 651. American College of Obstetricians and Gynecologists. (2015). Obstet Gynecol, 126, e143–6.
  • Munro, MG., Critchley, HOD., Fraser, IS., FIGO Menstrual Disorders Committee. (2018). The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet, 143, 393–408.
  • Pecchioli, Y., Oyewumi, L., Allen, LM., Kives, S. (2017). The utility of routine ultrasound in the diagnosis and management of adolescents with abnormal uterine bleeding. J Pediatr Adolesc Gynecol, 30, 239–42 Prasad, DB., Jagannath, P., Bora, BMK. (2016). Evaluation of Menorrhagia in Adolescent Girls: A Clinical Study Sch. J. App. Med. Sci, 4(6F), 2307-11.
  • Ravi, R., Shah, P., Palani, G., Edward, S., Sathiyasekaran, BWC. (2016). Prevalence of Menstrual Problems among Adolescent School Girls in Rural Tamil Nadu. J Pediatr Adolesc Gynecol, 29, 571-576.
  • Revel-Vilk, S., Paltiel, O., Lipschuetz, M., Ilan, U., Hyam, E., Shai, E., Varon, D., et al. (2012). Underdiagnosed menorrhagia in adolescents is associated with underdiagnosed anemia. J Pediatr, 160, 468–72.
  • Rosen, MW., Weyand, AC., Pennesi, CM., Stoffers, VL., Bourdillon, CM., George, JS., et al. (2020). Adolescents Presenting to the Emergency Department with Heavy Menstrual Bleeding. J Pediatr Adolesc Gynecol, 33, 139-43.
  • Srivaths, LV., Dietrich, JE., Yee, DL., Sangi-Haghpeykar, H., Mahoney, D. (2015). Oral Tranexamic Acid versus Combined Oral Contraceptives for Adolescent Heavy Menstrual Bleeding: A Pilot Study. J Pediatr Adolesc Gynecol, 28, 254-57.
  • Vaidya, AA., More, VS. (2018). A case series on Glanzmann thrombasthenia in adolescent girls with puberty menorrhagia. International Journal of Clinical Obstetrics and Gynaecology, 2(1), 4-6.
  • World Health Organization: Women's health. (2010). Available: http://www.who.int/ mediacentre/factsheets/fs334/en. Accessed July 1.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma Makalesi
Yazarlar

Reyhan Gündüz 0000-0001-8468-7038

Gönderilme Tarihi 27 Mart 2025
Kabul Tarihi 19 Mayıs 2025
Yayımlanma Tarihi 30 Mart 2026
DOI https://doi.org/10.34087/cbusbed.1666448
IZ https://izlik.org/JA86GW28KX
Yayımlandığı Sayı Yıl 2026 Cilt: 13 Sayı: 1

Kaynak Göster

APA Gündüz, R. (2026). The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 13(1), 34-42. https://doi.org/10.34087/cbusbed.1666448
AMA 1.Gündüz R. The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience. CBU-SBED. 2026;13(1):34-42. doi:10.34087/cbusbed.1666448
Chicago Gündüz, Reyhan. 2026. “The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 13 (1): 34-42. https://doi.org/10.34087/cbusbed.1666448.
EndNote Gündüz R (01 Mart 2026) The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 13 1 34–42.
IEEE [1]R. Gündüz, “The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience”, CBU-SBED, c. 13, sy 1, ss. 34–42, Mar. 2026, doi: 10.34087/cbusbed.1666448.
ISNAD Gündüz, Reyhan. “The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 13/1 (01 Mart 2026): 34-42. https://doi.org/10.34087/cbusbed.1666448.
JAMA 1.Gündüz R. The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience. CBU-SBED. 2026;13:34–42.
MLA Gündüz, Reyhan. “The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 13, sy 1, Mart 2026, ss. 34-42, doi:10.34087/cbusbed.1666448.
Vancouver 1.Reyhan Gündüz. The Evaluation of Abnormal Uterine Bleeding in Adolescents: Tertiary Center Experience. CBU-SBED. 01 Mart 2026;13(1):34-42. doi:10.34087/cbusbed.1666448