Fibrinolysis in idiopathic menorrhagia

Abstract EN

Objective: the role of fibrinolysis in idiopathic dysfunctional uterine bleeding (IDUB).

Design: prospective clinico-haematological study.

Setting: patients were collected in Albatool maternity teaching hospital; a haematological study was conducted in Ibn Sina teaching hospital in Mosul from 10th January to 10th of June 2004.

Participants: 53 patients with mean age of 40.5 years and a range of 15-54 years, complaining of idiopathic dysfunctional uterine bleedings(IDUB) served as experimental group, and 30 presumed healthy women served as a control group, their ages were between 18-45years.

After exclusion of organic causes, drugs, IUCD, medical causes, and bleeding tendency, blood samples were tested for haemoglobin, plasma D-dimer test and plasma fibrinogen.

Results: D-dimer test was positive in 16 out of 53 cases (30.2%) of experimental group (Group 1).

It was significantly positive (p< 0.005) in cases of idiopathic menorrhagia compared to the control group.

D-dimer test was significantly positive in those with prolonged duration of vaginal bleeding >7days, compared to those with heavy periods and short duration of vaginal bleeding (p<0.05), D-dimer test was negative in the remaining cases (group II).

The fibrinogen level was significantly lower in patients with positive D-dimer (p<0.05).

Antifibrinolytic agent tranexamic acid was given to all patients in both groups; 93% of women responded to the treatment in group 1, while the response in group II was 54%.

Conclusion: Idiopathic menorrhagias appear to be due to increased fibrinolytic activity; such patients are likely to benefit from antifibrinolytic agents.