Background
Methods
Literature search and inclusion criteria
I. Title contains "Menorrhagia", "Abnormal Uterine Bleeding" or "Heavy Menstrual Bleeding" |
II. Minimum number of studied children is 10 |
III, Children are age 0–21 years old |
IV. Study entry criteria requires review of all children with menorrhagia without another co-existing diagnosis or treatment modality. For example, studies that examined the etiology of menorrhagia from only children with known bleeding disorders were excluded |
V. Not a case report |
VI. Not a review article |
VII. Not an editorial |
VIII. No language filter was utilized, but an English abstract was required |
Data extraction
Data synthesis
Results
Study search and selection
Study characteristics
First Author | Year Published | Study Design | Country | No. Of patients | Percentage of Total patients (%) |
---|---|---|---|---|---|
Aguirre [7] | 2020 | Prospective | Chile | 93 | 3.4% |
Alaqzam [8] | 2018 | Retrospective | USA | 73 | 2.6% |
Haberal [9] | 2008 | Retrospective | Turkey | 120 | 4.3% |
Hutspardol [10] | 2010 | Prospective | Thailand | 28 | 1.0% |
Jain [11] | 2020 | Prospective | USA | 200 | 7.2% |
Khamees [12] | 2015 | Prospective | USA | 673 | 24.3% |
Mikhail [13] | 2007 | Retrospective | USA | 61 | 2.2% |
Mills [14] | 2014 | Retrospective | USA | 114 | 4.1% |
O'Brien [15] | 2019 | Retrospective | Australia | 124 | 4.5% |
Oral [16] | 2002 | Retrospective | Turkey | 25 | 0.9% |
Rathod [17] | 2016 | Prospective | India | 97 | 3.5% |
Rosen [18] | 2020 | Retrospective | USA | 258 | 9.3% |
Seravalli [19] | 2013 | Retrospective | Italy | 113 | 4.1% |
Sharma [20] | 2015 | Prospective | India | 167 | 6.0% |
Smith [21] | 1998 | Retrospective | USA | 179 | 6.5% |
Zia [22] | 2020 | Prospective | USA | 200 | 7.2% |
Zia [23] | 2018 | Prospective | USA | 248 | 8.9% |
Etiologies | n | MLE | LCredL | UCredL |
---|---|---|---|---|
Indeterminate | 1030 | 45.9 | 43.8 | 47.9 |
Ovarian Uterine Disorders | 532 | 23.7 | 22 | 25.5 |
Coagulation Disorders | 436 | 19.4 | 17.8 | 21.1 |
Platelet Disorders | 140 | 6.23 | 5.27 | 7.27 |
Unspecified Bleeding Disorder | 46 | 2.05 | 1.5 | 2.67 |
Drug Induced Bleeding | 16 | 0.712 | 0.408 | 1.1 |
Bleeding Secondary Renal Disease | 11 | 0.49 | 0.245 | 0.818 |
Infection | 10 | 0.445 | 0.214 | 0.76 |
Isolated Increased Bleeding Time | 8 | 0.356 | 0.154 | 0.641 |
Chemotherapy Recipient | 5 | 0.223 | 0.0724 | 0.456 |
Exon 28 Polymorphism | 4 | 0.178 | 0.0486 | 0.39 |
Fanconi Anemia | 3 | 0.134 | 0.0276 | 0.321 |
Aplastic Anemia | 2 | 0.089 | 0.0108 | 0.248 |
Ehlers Danlos Syndrome | 2 | 0.089 | 0.0108 | 0.248 |
VWD and Platelet Dysfunction | 1 | 0.0445 | 0.00113 | 0.164 |
Uterine Disorders | n | MLE | LCredL | UCredL |
---|---|---|---|---|
Anovulatory Bleeding | 525 | 98.7 | 97.6 | 99.5 |
Endometriosis | 3 | 0.564 | 0.117 | 1.35 |
PCOS | 3 | 0.564 | 0.117 | 1.35 |
Uterine Polyps | 1 | 0.188 | 0.00477 | 0.692 |
Coagulopathies | n | MLE | LCredL | UCredL |
---|---|---|---|---|
Von Willebrand Disease | 384 | 88.1 | 84.9 | 90.9 |
Factor 8 Deficiency | 27 | 6.19 | 4.13 | 8.64 |
Clotting Factor Deficiency | 18 | 4.13 | 2.47 | 6.18 |
Other Coagulation Defects | 3 | 0.688 | 0.142 | 1.65 |
Syptomatic Hemophilia Carrier | 2 | 0.459 | 0.0557 | 1.27 |
Factor 11 Deficiency | 1 | 0.229 | 0.00582 | 0.844 |
Factor 9 Deficiency | 1 | 0.229 | 0.00582 | 0.844 |
Platelet Abnormalities | n | MLE | LCredL | UCredL |
---|---|---|---|---|
Platelet Function Disorder | 53 | 37.9 | 30 | 46 |
Inherited Thrombocytopenia | 24 | 17.1 | 11.4 | 23.8 |
Platelet Qualitative Disorder | 19 | 13.6 | 8.43 | 19.7 |
ITP | 12 | 8.57 | 4.54 | 13.7 |
Platelet Quantitative Disorder | 7 | 5 | 2.05 | 9.16 |
Dysfunctional Platelet Aggregation | 6 | 4.29 | 1.6 | 8.19 |
Multiple Platelet Secretion Defects | 4 | 2.86 | 0.79 | 6.18 |
Unspecified Thrombocytopenia | 4 | 2.86 | 0.79 | 6.18 |
Other Immune Thrombocytopenia | 2 | 1.43 | 0.175 | 3.94 |
Multiple Platelet Aggregation Defects | 1 | 0.714 | 0.0182 | 2.62 |
Platelet Secretion Defects | 1 | 0.714 | 0.0182 | 2.62 |
Aggregation Secretion Defects | 7 | 5 | 2.05 | 9.16 |