search for




 

Original Article
Predictive Value of Endometrial Thickness for Anemia in Adolescent Girls with Abnormal Uterine Bleeding
Clin Pediatr Hematol Oncol 2018;25:81-6.
Published online October 31, 2018
© 2018 Korean Society of Pediatric Hematology-Oncology and Korean Society for Pediatric Neuro-Oncology

Ji Sung Lee, M.D., Ph.D.1, Young Hwan Cho, M.D.2 and In-sang Jeon, M.D., Ph.D.2

Departments of 1Obstetrics and Gynecology and 2Pediatrics, College of Medicine, Gachon University, Incheon, Korea
Correspondence to: In-sang Jeon
Department of Pediatrics, College of Medicine, Gachon University, 21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 21565, Korea
Tel: +82-32-460-8382
Fax: +82-32-460-3224
E-mail: isjeon@gilhospital.com
ORCID ID: orcid.org/0000-0001-8714-9403
Received September 16, 2018; Revised September 30, 2018; Accepted October 8, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Immaturity of the endocrine system that controls the normal menstrual cycle frequently results in abnormal uterine bleeding (AUB) and elicits anemia in adolescent girls. This study was conducted to assess the predictive value of endometrial thickness (ET) for anemia in adolescent girls with AUB.
Methods: A retrospective chart review was performed for a cohort of adolescents (12-18 years old) with AUB who presented over a 10-year period. Complete blood count and ultrasonographic data of 115 adolescent girls with AUB were analyzed. Subjects were classified according to ET as group I (ET <11 mm) and group II (≥11 mm), and the incidence of anemia was compared. Subjects were also classified according to age as group Y (12-15 years old of age) and group O (16-18 yr), and ET, hemoglobin (Hb), and incidence of anemia were compared.
Results: The incidence of anemia in all subjects was 67.8% and was significantly higher in group II than in group I (P<0.001). The incidence of severe anemia was 56.9% in group II, which was higher than in group I (P=0.039). The incidence of anemia was not significantly different between groups Y and O. However, the incidence of severe anemia was significantly higher in group Y than in group O (P=0.001).
Conclusion: AUB can result in severe anemia in adolescent girls particularly those who are close to menarche or have a thick endometrium. Early supervision of AUB is required in order to avoid anemia in adolescent girls with AUB.
Keywords: Adolescent girl, Abnormal uterine bleeding, Anemia
References
  1. Grooms LP, Walsh M, Monnat LE. Treatment of anemia in the adolescent female. Pediatr Ann 2013;42:36-9.
    Pubmed CrossRef
  2. Swenne I. Haematological changes and iron status in teenage girls with eating disorders and weight loss-the importance of menstrual status. Acta Paediatr 2007;96:530-3.
    Pubmed CrossRef
  3. Sotnikova LS, Zhdanov VV, Udut VV, Dygai AM. Influence of poetam preparation on the state of autonomic nervous system in patients with severe anemia caused by dysfunctional uterine bleedings. Bull Exp Biol Med 2009;148:508-10.
    Pubmed CrossRef
  4. Matytsina LA, Zoloto EV, Sinenko LV, Greydanus DE. Dysfunctional uterine bleeding in adolescents: concepts of pathophysiology and management. Prim Care 2006;33:503-15.
    Pubmed CrossRef
  5. Deligeoroglou E, Karountzos V, Creatsas G. Abnormal uterine bleeding and dysfunctional uterine bleeding in pediatric and adolescent gynecology. Gynecol Endocrinol 2013;29:74-8.
    Pubmed CrossRef
  6. Elmaoğulları S, Aycan Z. Abnormal uterine bleeding in adolescents. J Clin Res Pediatr Endocrinol 2018;10:191-7.
    CrossRef
  7. Smith-Bindman R, Weiss E, Feldstein V. How thick is too thick? When endometrial thickness should prompt biopsy in postmenopausal women without vaginal bleeding. Ultrasound Obstet Gynecol 2004;24:558-65.
    Pubmed CrossRef
  8. Wang W, Bourgeois T, Klima J, Berlan ED, Fischer AN, O'Brien SH. Iron deficiency and fatigue in adolescent females with heavy menstrual bleeding. Haemophilia 2013;19:225-30.
    Pubmed CrossRef
  9. Bennett AR, Gray SH. What to do when she's bleeding through: the recognition, evaluation, and management of abnormal uterine bleeding in adolescents. Curr Opin Pediatr 2014;26:413-9.
    Pubmed CrossRef
  10. Warner PE, Critchley HO, Lumsden MA, Campbell-Brown M, Douglas A, Murray GD. Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods:a survey with follow-up data. Am J Obstet Gynecol 2004;190:1216-23.
    Pubmed CrossRef
  11. Deligeoroglou E, Tsimaris P. Menstrual disturbances in puberty. Best Pract Res Clin Obstet Gynaecol 2010;24:157-71.
    Pubmed CrossRef
  12. Van Look PF, Hunter WM, Fraser IS, Baird DT. Impaired estrogeninduced luteinizing hormone release in young women with anovulatory dysfunctional uterine bleeding. J Clin Endocrinol Metab 1978;46:816-23.
    Pubmed CrossRef


October 2018, 25 (2)
Full Text PDF
Citation
Send to a friend
Twitter
Facebook

Cited By Articles
  • CrossRef (0)

Author ORCID Information
  • In-sang Jeon