TY - JOUR
T1 - Screening women with menorrhagia for underlying bleeding disorders
T2 - The utility of the platelet function analyser and bleeding time
AU - Philipp, Claire S.
AU - Miller, C. H.
AU - Faiz, A.
AU - Dilley, A.
AU - Michaels, L. A.
AU - Ayers, C.
AU - Bachmann, G.
AU - Dowling, N.
AU - Saidi, P.
PY - 2005/9
Y1 - 2005/9
N2 - Menorrhagia is a very common clinical problem among women of reproductive age and recent studies have suggested that underlying bleeding disorders, particularly von Willebrand's deficiency and platelet function defects, are prevalent in women presenting with menorrhagia. The objective of this study was to determine the utility of the platelet function analyser (PFA-100) and bleeding time (BT) as initial screening tests for underlying bleeding disorders in women with menorrhagia. In this study, 81 women with a physician diagnosis of menorrhagia underwent PFA-100 testing, BT and comprehensive haemostatic testing. The effectiveness of the PFA-100 and BT as screening tools in women with menorrhagia was assessed using results of haemostatic testing for von Willebrand's disease (VWD) and platelet dysfunction. In women presenting with menorrhagia, the PFA-100 had a sensitivity 80%, specificity 89%, positive predictive value (PPV) 33%, negative predictive value (NPV) 98% and efficiency 88% for VWD. For platelet aggregation defects, the PFA-100 closure time had a sensitivity 23%, specificity 92%, PPV of 75%, NPV of 52% and efficiency 55%. The data suggest that the PFA-100 may be useful in stratifying women with menorrhagia for further von Willebrand testing; however, neither the PFA-100 nor the BT tests are effective for purposes of classifying women for standard platelet aggregometry testing in women presenting with menorrhagia.
AB - Menorrhagia is a very common clinical problem among women of reproductive age and recent studies have suggested that underlying bleeding disorders, particularly von Willebrand's deficiency and platelet function defects, are prevalent in women presenting with menorrhagia. The objective of this study was to determine the utility of the platelet function analyser (PFA-100) and bleeding time (BT) as initial screening tests for underlying bleeding disorders in women with menorrhagia. In this study, 81 women with a physician diagnosis of menorrhagia underwent PFA-100 testing, BT and comprehensive haemostatic testing. The effectiveness of the PFA-100 and BT as screening tools in women with menorrhagia was assessed using results of haemostatic testing for von Willebrand's disease (VWD) and platelet dysfunction. In women presenting with menorrhagia, the PFA-100 had a sensitivity 80%, specificity 89%, positive predictive value (PPV) 33%, negative predictive value (NPV) 98% and efficiency 88% for VWD. For platelet aggregation defects, the PFA-100 closure time had a sensitivity 23%, specificity 92%, PPV of 75%, NPV of 52% and efficiency 55%. The data suggest that the PFA-100 may be useful in stratifying women with menorrhagia for further von Willebrand testing; however, neither the PFA-100 nor the BT tests are effective for purposes of classifying women for standard platelet aggregometry testing in women presenting with menorrhagia.
KW - Bleeding time
KW - Menorrhagia
KW - Platelet dysfunction
KW - Platelet function analyser
KW - von Willebrand's disease
UR - http://www.scopus.com/inward/record.url?scp=24644519808&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=24644519808&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2516.2005.01129.x
DO - 10.1111/j.1365-2516.2005.01129.x
M3 - Article
C2 - 16128894
AN - SCOPUS:24644519808
SN - 1351-8216
VL - 11
SP - 497
EP - 503
JO - Haemophilia
JF - Haemophilia
IS - 5
ER -