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Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data

  • Pamela E Warner
    Affiliations
    Division of Community Health Sciences, University of Edinburgh Medical School,a Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology,b Edinburgh, Scotland; and Obstetrics and Gynaecology, University of Glasgow, Royal Infirmary,c Glasgow, Scotland, United Kingdom
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  • Hilary O.D Critchley
    Affiliations
    Division of Community Health Sciences, University of Edinburgh Medical School,a Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology,b Edinburgh, Scotland; and Obstetrics and Gynaecology, University of Glasgow, Royal Infirmary,c Glasgow, Scotland, United Kingdom
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  • Mary Ann Lumsden
    Affiliations
    Division of Community Health Sciences, University of Edinburgh Medical School,a Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology,b Edinburgh, Scotland; and Obstetrics and Gynaecology, University of Glasgow, Royal Infirmary,c Glasgow, Scotland, United Kingdom
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  • Mary Campbell-Brown
    Affiliations
    Division of Community Health Sciences, University of Edinburgh Medical School,a Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology,b Edinburgh, Scotland; and Obstetrics and Gynaecology, University of Glasgow, Royal Infirmary,c Glasgow, Scotland, United Kingdom
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  • Anne Douglas
    Affiliations
    Division of Community Health Sciences, University of Edinburgh Medical School,a Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology,b Edinburgh, Scotland; and Obstetrics and Gynaecology, University of Glasgow, Royal Infirmary,c Glasgow, Scotland, United Kingdom
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  • Gordon D Murray
    Affiliations
    Division of Community Health Sciences, University of Edinburgh Medical School,a Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology,b Edinburgh, Scotland; and Obstetrics and Gynaecology, University of Glasgow, Royal Infirmary,c Glasgow, Scotland, United Kingdom
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      Abstract

      Objective

      Menorrhagia is defined as blood loss of >80 mL, but in routine clinical practice measurement is seldom undertaken. Our aim was to identify the features of the clinical history that best predict menorrhagic blood loss.

      Study design

      A questionnaire survey of 952 menstrual complaint referrals at 3 hospital gynecology clinics in Glasgow and Edinburgh included 226 women with putatively heavy periods who also had consented to the measurement of their blood loss.

      Results

      Only 34% (95% CI, 28%-40%) of women had blood loss volume of >80 mL, but the volume was associated with subjective heaviness of period. Logistic regression with ferritin status, clots, and changing rate during full flow correctly predicts a loss of >80 mL for 76% of women (n = 161 patients; sensitivity, 60%; specificity, 86%). Diagnosis and treatment of patients seem unrelated to the volume of blood loss.

      Conclusion

      The subjective judgment of the volume of blood loss is better than has been believed. Clinical features can be combined to predict losses of >80 mL.

      Keywords

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