Clinical Presentation and Management of Puberty Menorrhagia at Tertiary Care Teaching Hospital
Journal Title: Scholars International Journal of Obstetrics and Gynecology - Year 2018, Vol 1, Issue 1
Abstract
Abstract: Abnormal and heavy bleeding during menses is a one of the common menstrual abnormality during puberty and adolescence. Puberty menorrhagia is most often due to physiological immaturity of neuro hormonal mechanism of control of menstruation and ovulation. Sometimes it may be an expression of some hidden endocrinal or haematological disturbance. A prospective cross sectional study was carried out to analyse the demographic profile, clinical presentation and treatment outcome of 28 cases of puberty menorrhagia reported over a period of three years at Pravara Rural Hospital, Loni, Ahmednagar district in Maharashtra.It was observed that 54 percent of cases were in the age group of 13-14 years. The duration of symptom was less than three months in 61 percent cases. Anaemia was observed in 93% of cases, of which 50% cases had severe anaemia. Anovulatory DUB was the commonest cause (75% cases) for menorrhagia, other causes being Hypothyroidism (11% cases) and Idiopathic thrombocytopenic purpura (7% cases). Majority of cases responded to either progestogen therapy (64%) and remaining to either combination of oestrogen and progesterone (32%) or oestrogen (4%) alone. All cases were given haemostatic agents in the form of either ethamsylate or tranexamicacid.Oral iron supplements were given to all cases. Cases with hypothyroidism and idiopathic thrombocytopenia were treated with throxine and platelet transfusions respectively. Six cases (21.42%) required admission in intensive care unit for severe anemia with haemoglobin percentage of less than 2.5gram percent. One girl succumbed to congestive cardiac failure due to severe anaemia. She had reported in gasping condition in casualty.Puberty menorrhagia is one of the commonest menstrual abnormalities during adolescent age group. The heavy menstrual blood loss may result into anaemia and panic reaction in girl child and her parents. Early consultation with Gynaecologist, performance of necessary investigations and treatment with hormones, haemostatic and haematinic drugs usually give relief. Keywords: Puberty menorrhagia, hormonal therapy, hypothyroidism, idiopathic thrombocytopenic purpura, adolescent health education.
Authors and Affiliations
Vidyadhar Bangal
Keywords
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