Department of Obstetrics and Gynecology, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea.
Medicina (Kaunas). 2023 May 1;59(5):874. doi: 10.3390/medicina59050874.
: Menorrhagia is defined as a blood loss of more than 80 mL, which is significant enough to cause anemia. Previously known methods for evaluating menorrhagia, such as the alkalin-hematin method, pictograms, and measuring the weight of sanitary products, were all impractical, complex, and time-consuming. Therefore, this study aimed to determine which item among menstrual history taking was most associated with menorrhagia and devised a simple evaluating method for menorrhagia through history taking that can be applied clinically. : The study was conducted from June 2019 to December 2021. A survey was conducted on premenopausal women who underwent outpatient treatment or surgery and those who underwent a gynecologic screening test, and their blood tests were analyzed. The presence of iron deficiency anemia was identified with a Hb level of less than 10 g/dL with microcytic hypochromic anemia on a complete blood count performed within one month of the survey. A questionnaire survey was conducted on six items related to menorrhagia to investigate whether each item was related to "significant menorrhagia". : There were 301 participants in the survey during the period. In univariate analysis, the results revealed a statistically significant association between significant menorrhagia and the following items: self-judgement of menorrhagia; menstruation lasting over 7 days; total pad counts in a single menstrual period; Number of sanitary products changed per day; and leakaging of menstrual blood and presence of coagulated menstrual blood. In multivariate analysis, only the "self-judgement of menorrhagia" item showed a statistically significant result (-value = 0.035; an odds ratio = 2.217). When the "self-judgement of menorrhagia" item was excluded, the "passage of clots larger than one inch in diameter" item showed a statistically significant result (-value = 0.023; an odds ratio = 2.113). : "Patient self-judgement of menorrhagia" is a reliable item for evaluating menorrhagia. Among several symptoms indicating menorrhagia, determining the presence of the "passage of clots larger than one inch in diameter" during the menstrual period is the most useful item for evaluating menorrhagia in clinical history taking. This study suggested using these simple menstrual history taking items to evaluate menorrhagia in real clinical practice.
月经过多定义为失血量超过 80 毫升,足以导致贫血。以前评估月经过多的方法,如碱化血红素法、图表法和测量卫生用品重量法,都不切实际、复杂且耗时。因此,本研究旨在确定在月经史采集过程中哪一项与月经过多最相关,并通过月经史采集制定一种简单的月经过多评估方法,以便在临床上应用。
该研究于 2019 年 6 月至 2021 年 12 月进行。对接受门诊治疗或手术的绝经前妇女以及接受妇科筛查试验的妇女进行了调查,并对她们的血液检查进行了分析。在调查后的一个月内进行全血细胞计数,当 Hb 水平<10 g/dL 且存在小细胞低色素性贫血时,确定存在缺铁性贫血。对与月经过多相关的六个项目进行了问卷调查,以调查每个项目是否与“明显月经过多”相关。
在该期间,共有 301 名参与者参与了调查。在单因素分析中,结果显示,“自我判断月经过多”、“经期持续超过 7 天”、“单个月经周期的总护垫计数”、“每天更换卫生产品的次数”、“经血渗漏”和“存在凝结的月经血”与“明显月经过多”之间存在统计学关联。在多因素分析中,只有“自我判断月经过多”这一项具有统计学意义(-值=0.035;比值比=2.217)。当排除“自我判断月经过多”这一项时,“直径大于 1 英寸的血块排出”这一项具有统计学意义(-值=0.023;比值比=2.113)。
“患者自我判断月经过多”是评估月经过多的可靠项目。在几种表明月经过多的症状中,在月经期间确定是否存在“直径大于 1 英寸的血块排出”是评估临床月经史采集过程中月经过多最有用的项目。本研究建议在实际临床实践中使用这些简单的月经史采集项目来评估月经过多。