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Pouraliroudbaneh S, Marino J, Riggs E, Saber A, Jayasinghe Y, Peate M. Heavy menstrual bleeding and dysmenorrhea in adolescents: A systematic review of self-management strategies, quality of life, and unmet needs. Int J Gynaecol Obstet 2024; 167:16-41. [PMID: 38654586 DOI: 10.1002/ijgo.15554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Heavy menstrual bleeding (HMB) and dysmenorrhea (DM) are common gynecological problems. OBJECTIVE To systematically review the needs, quality of life (QOL), and effectiveness of self-management strategies among young women (12-25 years) with DM or HMB. SEARCH STRATEGY Relevant terms were searched through PubMed, EBSCO, Google Scholar, ProQuest, and Ovid between 2010 and 2022. SELECTION CRITERIA Qualitative and quantitative studies published in peer-reviewed journals, females aged 12-25, exploring DM or HMB, reporting supportive care needs, quality of life, self-treatment strategies, and/or treatment-seeking behavior. DATA COLLECTION AND ANALYSIS Abstracts were reviewed for eligibility by two researchers. Included studies were extracted and assessed for quality independently by two authors, with discrepancies resolved through consensus or the involvement of a third researcher. Data extracted included study details, menstrual history, symptoms, self-care strategies, and quality of life. The Joanna Briggs Institute checklists were used for quality assessment. MAIN RESULTS The search returned 285 190 studies, of which 55 were eligible for inclusion. Prevalence rates of HMB and DM were in the ranges 4%-63% and 42%-94%, respectively. Over 80% of young women with DM and HMB experienced physical and psychological problems, including pelvic pain, sleep issues, mood disturbance, diarrhea, and nausea. Academic performance and daily activities were severely affected. Most (>62%) named their mothers as their primary source of information, and friends as the secondary source (10%-65%). Few studies explored needs, but they could be inferred and fell under school-related and social needs. QOL was poorer in those who had DM than those who did not. Pain was the most common issue that drove young women to find treatment. More than 70% used medication to reduce pain. More than half chose home remedies (e.g., heat therapy, massages, herbal tea, hot drinks). No studies provided information about the efficacy and dosage of medication and herbal remedies. CONCLUSIONS HMB and DM have a large impact on daily living, with large areas of unmet need. Limited access to information impairs the management of symptoms and consequent QOL.
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Affiliation(s)
- Shiva Pouraliroudbaneh
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer Marino
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Victoria, Australia
- Specialty of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children Research Institute, Parkville, Victoria, Australia
- Department of General Practice, University of Melbourne, Parkville, Victoria, Australia
| | - Ashraf Saber
- Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
| | - Yasmin Jayasinghe
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
- Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
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Jose AA, Daniel M, Phansalkar MD. Hysteropathological Correlation in Abnormal Uterine Bleeding in a Tertiary Care Hospital in South India. J Obstet Gynaecol India 2024; 74:150-157. [PMID: 38707886 PMCID: PMC11065816 DOI: 10.1007/s13224-023-01888-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/15/2023] [Indexed: 05/07/2024] Open
Abstract
Background Abnormal uterine bleeding is a common problem mainly encountered in reproductive age group and post-menopausal women. Hysteroscopy is a safe, simple, well tolerated and reliable procedure for the diagnosis of AUB across all age groups. The aim of the study is to determine the association of hysteroscopy and histopathologic examination (HPE) findings in abnormal uterine bleeding. The secondary objective of the study are to enumerate the hysteroscopy findings in patients with AUB and to evaluate the pattern of AUB. Materials and Methods Observational cross-sectional study among 60 women in reproductive and post-menopausal age group presenting with features/symptoms suggestive of abnormal uterine bleeding were studied. All patients reporting in the outpatient department (OPD) and who are eligible to participate were included in the study, after obtaining written informed consent. Detailed history, Clinical examination, Ultrasound pelvis and endometrial thickness assessment is done. Hysteroscopic findings were compared against histopathological findings. Results The various patterns of bleeding documented in our study population were menorrhagia, metrorrhagia, menometrorrhagia, polymenorrhea, and post-menopausal bleeding. Out of these patterns, the commonest was menorrhagia at 50.0% and post-menopausal bleeding at 26.67%. In our study population, the various hysteroscopy findings were strawberry, tongue-shaped projections, pebble stones, polypoidal patterns, and cerebroid patterns. Out of these, the most common was a polypoidal pattern, strawberry pattern, and tongue-shaped projections with 45%, 31.67%, and 26.7%, respectively. The most common histopathology finding was secretory and proliferative constituting 35% and 26.67%, respectively. Carcinoma endometrium constitutes about 6.67% of the study population. The sensitivity, specificity, PPV, and NPV of strawberry appearance in hysteroscopy in comparison with secretory changes in histopathology were 52.38%, 79.49%, 57.89%, and 75.61%, respectively. The sensitivity, specificity, PPV, and NPV of tongue-shaped projections appearance in hysteroscopy in comparison with HPE findings was 60%, 76.36%, 18.75%, and 95.45%, respectively. The sensitivity, specificity, PPV, and NPV of polypoidal pattern in hysteroscopy in comparison with Endometrial hyperplasia in histopathology was 66.67%, 56.14%, 7.41%, and 96.97%, respectively. The sensitivity, specificity, PPV, and NPV of cerebroid appearance in hysteroscopy in comparison with carcinoma endometrium in histopathology were 75.0%, 100%, 100%, and 98.25%, respectively. This correlation of cerebroid pattern with carcinoma endometrium was highly significant. Among all correlations, the highly reliable was in Carcinoma endometrium followed by endometrial polyps. Conclusion Hysteroscopy has high sensitivity and specificity in diagnosing intrauterine pathology especially endometrial cancer followed by endometrial polyps. Among the various patterns of abnormal uterine bleeding, menorrhagia was the most common. A combination of hysteroscopy and endometrial sampling was found to increase diagnostic accuracy in patients with abnormal uterine bleeding and will effectively guide us in planning the appropriate management for these patients.
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Affiliation(s)
- Ashwin Antony Jose
- Department of Obstetrics & Gynaecology, Indira Gandhi Medical College and Research Institute, A Government of Puducherry Institution, Puducherry, India
| | - Mary Daniel
- Department of Obstetrics & Gynaecology, Pondicherry Institute of Medical Sciences, (A Unit of the Madras Medical Mission), Puducherry, India
| | - Manjiri Dilip Phansalkar
- Department of Pathology, Pondicherry Institute of Medical Sciences, (A Unit of the Madras Medical Mission), Puducherry, India
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Agarwal M, Singh S, Jyoti C, Sinha S, Simran S. Understanding Adolescent Gynecological Issues: A Cross-Sectional Study at a Tertiary Care Center. Cureus 2024; 16:e57713. [PMID: 38711716 PMCID: PMC11072692 DOI: 10.7759/cureus.57713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Adolescence is a crucial phase in a woman's life, as it signifies the beginning of her reproductive journey. During this time, there are notable variations in sexual development and a sense of caution that can present challenges for healthcare providers. The rationale for studying adolescent gynecological problems lies in the need to understand and address the unique reproductive health challenges faced by young girls. By investigating these issues, researchers and healthcare professionals can develop effective strategies for prevention, early detection, and treatment of gynecological conditions in adolescents. This knowledge is crucial for promoting the overall well-being and reproductive health of young girls, ensuring they receive appropriate care and support during this critical stage of development. This study focuses on identifying the most common gynecological issues in teenagers, exploring the root causes, examining the available treatment options, and understanding how they are managed at a tertiary care facility. Methods: This cross-sectional observational study took place at a tertiary care center and focused on gynecological issues in adolescent females who sought care at the gynecology department from January 2016 to December 2022. The study participants were categorized into three groups: early adolescence (10-13 years), middle adolescence (14-16 years), and late adolescence (17-19 years) for analysis. Ethical approval was obtained for this hospital-based research, which involved examining, investigating, and treating the study participants. RESULTS Out of the 49,700 new female patients, 2000 (4.02%) fell within the specified age range. The average age of the participants was 16.87±2.16, and the majority of them sought help for menstrual issues (63.45%), followed by abdominal discomfort (15.6%) and vaginal discharge (7.2%). Menstrual disorders were the most common concern, with dysmenorrhea and puberty menorrhagia being prevalent issues. Abdominal pain was caused by various factors, such as urinary tract infections, ovarian tumors, pelvic inflammatory disease, endometriosis, and endometrial tuberculosis. The majority of cases were treated conservatively, with only a small percentage requiring surgical intervention. CONCLUSION The significance of early detection and intervention in addressing gynecological issues among adolescents is highlighted in the findings of this research, underscoring the necessity for specialized healthcare services that cater to the specific needs of this demographic. Adolescent gynecology plays a crucial role in safeguarding the reproductive health and overall well-being of young women, emphasizing the importance of seeking assistance proactively.
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Affiliation(s)
- Mukta Agarwal
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Smita Singh
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Chandra Jyoti
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Shivangi Sinha
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Simran Simran
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Patna, Patna, IND
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Waghmare BV, Jajoo S. Navigating the Challenges: A Comprehensive Review of Adolescent Gynecological Problems. Cureus 2024; 16:e56200. [PMID: 38618317 PMCID: PMC11016329 DOI: 10.7759/cureus.56200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
This comprehensive review delves into the spectrum of adolescent gynecological problems, shedding light on the multifaceted challenges faced by individuals between the ages of 10 and 19. Covering normal developmental changes, common issues such as menstrual disorders, and the intricate interplay of psychosocial and cultural factors, the review provides a holistic understanding of adolescent gynecological health. Key findings underscore the importance of tailored education, destigmatizing reproductive health discussions, and recognizing the critical role of mental health in overall well-being. The conclusion issues a compelling call to action, urging healthcare providers to adopt patient-centered practices, educators to integrate comprehensive sexual education, and policymakers to advocate for inclusive policies. This review serves as a valuable resource, guiding collective efforts to enhance the well-being of adolescents as they navigate the challenges of gynecological health on their journey to adulthood.
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Affiliation(s)
- Bhavana V Waghmare
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Shubhada Jajoo
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Hall EM, Ravelo AE, Aronoff SC, Del Vecchio MT. Systematic review and meta-analysis of the etiology of heavy menstrual bleeding in 2,770 adolescent females. BMC Womens Health 2024; 24:136. [PMID: 38378571 PMCID: PMC10880246 DOI: 10.1186/s12905-024-02921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/21/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Adolescent heavy menstrual bleeding(HMB), menorrhagia or abnormal uterine bleeding commonly occur in adolescent women. The differential diagnosis can be challenging. The pneumonic: PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified), is commonly used but it does not stratify as to the likelihood of a disorder. We have sought to develop a probability-based differential diagnosis for Adolescent HMB, menorrhagia or abnormal uterine bleeding. METHODS A comprehensive literature search was conducted using PubMed, EMBASE, and SCOPUS databases. Case series describing adolescents from 10-19 years of age with HMB, menorrhagia or abnormal uterine bleeding was acceptable if: more than 10 patients were included; editorials, case reports, and secondary sources such as review articles, or book chapters were excluded. No language filter was used, but an English abstract was required. The etiology of HMB, menorrhagia or abnormal uterine bleeding, and the country of origin was extracted from articles that met inclusion criteria. Cumulative rate estimates were determined by Bayesian probability modeling. RESULTS Seventeen full text articles were reviewed in detail; 2,770 patients were included. The most frequent causes of HMB were Ovarian Uterine Disorders (23.7%; 95% CredI 22-25.5%), Coagulation Disorders (19.4%; 95% CredI 17.8-21.1%), and Platelet Disorders (6.23%; 95% CredI 5.27-7.27%) with 45.9% (95% CredI 43.8-47.%9) of the cases of indeterminate origin. CONCLUSIONS The leading causes of HMB in healthy adolescent females were varied. The sub-analysis identified distinct etiologies, suggesting that multiple factors must be considered in the evaluation of HMB. While PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified) provides us with a comprehensive picture of the possible causes of HMB in females, this systematic review assigns probabilities to the etiologies of HMB in adolescent females, providing physicians with a more focused and efficient pathway to diagnosis.
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Affiliation(s)
- Erin M Hall
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Ana E Ravelo
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Stephen C Aronoff
- Department of Pediatrics, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Michael T Del Vecchio
- Department of Pediatrics, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
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Divya S, Thomas TM, Ajmeera R, Hegde A, Parikh T, Shivakumar S. Assessment of the Menstrual Problems among Teenage Girls: A Tertiary Care Center Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S281-S284. [PMID: 37654320 PMCID: PMC10466533 DOI: 10.4103/jpbs.jpbs_495_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/16/2022] [Accepted: 12/13/2022] [Indexed: 09/02/2023] Open
Abstract
Introduction Due to shame over discussing menstruation and fear of illness, many adolescent girls with monthly problems never visit their family doctor or gynecologist. The presentation can be delayed as a result. The current study's goal was to assess the sociodemographic characteristics of adolescent females experiencing menstruation issues and the nature of those problems, and how they were handled. Materials and Methods The problems faced by the adolescent girls attending the Department of Obstetrics and Gynecology were analyzed retrospectively, and all their study characteristics and conditions were evaluated. The descriptive demographics are only represented in the current study. Results Two hundred-two teenage girls with menstruation issues visited our hospital overall. 64% of them were late adolescents, 96% lived in cities, 89 were unmarried, and 50% belonged to the middle class socioeconomically. Amenorrhea, dysmenorrhea, and irregular menstrual periods affected 86 (61%) people, 38 (27%) people, and 17 (12%) people, respectively. Patients were treated with appropriate counseling and medicinal and/or surgical care. Conclusion Most of the teenage girls in our study had anemia. Therefore, it is essential to educate people on the importance of nutrition, different menstrual disorders, normal physiology, and the prevention and management of anemia. Adolescent-friendly health care has been attempted and partially developed in India's governmental and private systems. As a result, counseling and management of adolescent menstrual difficulties must be offered in the current health and medical care systems.
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Affiliation(s)
- S. Divya
- Department of Obstetrics and Gynaecology, Wayanad Institute of Medical Sciences, Wayanad, Kerala, India
| | - Titty Mary Thomas
- Specialist Family Medicine, Aster Clinic, Dubai, United Arab Emirates
| | - Rajunaik Ajmeera
- Department of ENT, Kakatiya Medical College, Warangal, Telangana, India
| | - Ambika Hegde
- Department of Obstetrics and Gynecology, Father Mullers Medical College and Hospital, Mangalore, Karnataka, India
| | - Taral Parikh
- Consulting Pediatrician, Hamilton Health Center, Harrisburg, PA, USA
| | - Shruti Shivakumar
- Department of Pedodontics, JSS Dental College and Hospital, Mysore, Karnataka, India
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Rajput E. Pelvic Ultrasound Imaging-Based Prevalence of Gynecological Morbidity in a Population of Asymptomatic Reproductive-Age Women Attending a Healthcare Outreach Program in the Andaman and Nicobar Islands of India. Indian J Radiol Imaging 2023; 33:183-186. [PMID: 37123576 PMCID: PMC10132887 DOI: 10.1055/s-0043-1760746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AbstractGynecological morbidity in the reproductive age is defined as any condition, disease, or dysfunction of the reproductive system that is not related to pregnancy, abortion, or childbirth. Common gynecological symptoms include irregular menstruation, white vaginal discharge, burning urination, itching of the vulva, inguinal swelling, and nonmenstrual bleeding or spotting and chronic pelvic pain. Masses of the reproductive tract, adnexal masses, and polycystic ovary syndrome also occur in the reproductive age group. Gynecological disease contributes to nearly 4.5% of the overall global disease burden and exceeds the prevalence of other major global diseases such as malaria, tuberculosis, ischemic heart disease, and maternal conditions. Ultrasound is a painless, noninvasive imaging modality that can be used for the detection of gynecological abnormalities. This study uses pelvic ultrasound imaging to estimate the prevalence of gynecological morbidity in a population of asymptomatic reproductive-age women attending a healthcare outreach program in the Andaman and Nicobar Islands of India.
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Affiliation(s)
- Eesha Rajput
- Department of Imaging and Interventional Radiology, INHS Asvini, Colaba, Mumbai, Maharashtra, India
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Kumar P, Srivastava S, Chauhan S, Patel R, Marbaniang SP, Dhillon P. Factors associated with gynaecological morbidities and treatment-seeking behaviour among adolescent girls residing in Bihar and Uttar Pradesh, India. PLoS One 2021; 16:e0252521. [PMID: 34086759 PMCID: PMC8177445 DOI: 10.1371/journal.pone.0252521] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 05/17/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Gynaecological morbidities are more common than reproductive and contraceptive morbidities and constitute a substantial proportion of disease burden in women. This study aimed to examine the prevalence and factors associated with gynaecological morbidities and the treatment-seeking behaviour among adolescent girls residing in Bihar and Uttar Pradesh, India. METHODOLOGY The study utilized data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey with a sample size of 14,625 adolescents girls aged 10-19 years. We defined gynaecological morbidity in dichotomous form, created from five questions on different morbidities. Further, the treatment-seeking behaviour was assessed for reported gynaecological morbidities three months prior to the survey. Univariate and bivariate analysis was used to perform analysis to carve out the preliminary results. Additionally, the study employed the heckprobit selection model, a two-equation model, to identify the determinants of outcome variables. RESULTS Overall, about one-fourth (23.6%) of the adolescent girls reported suffering from gynaecological morbidities, and only one-third of them went for treatment. Non-Scheduled Caste/Scheduled Tribe (Non-SC/ST) adolescents were significantly less likely to have gynaecological morbidities (β: -0.12; CI: -0.18, -0.06) compared to SC/ST counterparts; however, they were more likely to go for the treatment (β: 0.09; CI: 0.00, 0.19). The adolescents who had 8-9 (β: 0.17; CI: 0.05, 0.29) or ten and above years of education (β: 0.21; CI: 0.09, 0.34) had a higher likelihood of going for the treatment than adolescents with no education. Moreover, adolescents who belonged to rural areas were less likely to go for the treatment of gynaecological morbidities (β: -0.09; CI: -0.17, -0.01) than urban counterparts. CONCLUSION Multi-pronged interventions are the need of the hour to raise awareness about the healthcare-seeking behaviour for gynaecological morbidities, especially in rural areas. Adolescent girls shall be prioritized as they may lack the knowledge for gynaecological morbidities, and such morbidities may go unnoticed for years. Mobile clinics may be used to disseminate appropriate knowledge among adolescents and screen asymptomatic adolescents for any possible gynaecological morbidity.
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Affiliation(s)
- Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Strong P. Marbaniang
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Preeti Dhillon
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
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Adolescents Presenting to the Emergency Department with Heavy Menstrual Bleeding. J Pediatr Adolesc Gynecol 2020; 33:139-143. [PMID: 31765796 DOI: 10.1016/j.jpag.2019.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/04/2019] [Accepted: 11/14/2019] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE To describe the adolescent population that seeks care in the emergency department (ED) for heavy menstrual bleeding (HMB), and to compare those who are discharged to those who are admitted to the hospital. DESIGN Retrospective study. SETTING Emergency department and inpatient unit at a national tertiary care hospital from 2006-2018. PARTICIPANTS Adolescents 11-19 years old with ICD-9 and ICD-10 codes for HMB. INTERVENTIONS Chart abstraction for demographic data, symptoms, laboratory tests, outcomes, and treatments. MAIN OUTCOME MEASURE Adolescents who were admitted were compared to girls who were treated as outpatients. RESULTS There were 258 adolescents who sought care for HMB in the ED during the study period. A total of 44 patients (17%) were admitted to the hospital, whereas 214 (83%) were discharged. The average age of those admitted was 15 years, compared to 17 years for those discharged (P < .001). In the admitted group, the mean initial hemoglobin (Hgb) was 6.3 g/dL compared to 12.0 g/dL in the discharged group (P < .0001). Only 23% of the discharged patients were released with medications; the remainder did not receive treatment. Anovulation was the etiology of HMB in the majority (56%) of both inpatients and outpatients. Of the 44 adolescents admitted to the hospital for HMB, 12 (27%) had a bleeding disorder (BD) and 32 (73%) did not. CONCLUSION The majority of adolescents who presented to the emergency department for HMB were not anemic and did not receive any treatment. Of those admitted, almost one-third had an underlying BD, which is higher than previously reported.
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Pegu B, Gaur BPS, Yadav A, Yadav V. Gynecological problems among adolescent girls in a tertiary care centre of South Andaman district. Int J Adolesc Med Health 2018; 32:/j/ijamh.ahead-of-print/ijamh-2017-0193/ijamh-2017-0193.xml. [PMID: 30118436 DOI: 10.1515/ijamh-2017-0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/26/2017] [Indexed: 06/08/2023]
Abstract
Background Gynecological problems of adolescents occupy a special space in the spectrum of gynecological disorders because they are often different from the conditions that affect adult women. The objective of study was to determine the different gynecological problems in adolescent girls attending outpatient departments. Methods Adolescent girls of age 10-19 years were included in this study. Various gynecological problems were evaluated by detailed history taking and thorough clinical examination. Investigations like haemogram, coagulation profile, hormonal assays and ultrasonography were done wherever indicated. Descriptive analysis was done and results are expressed in terms of percentage. Results A total of 824 (8.33%) adolescent girls attended the gynecology outdoor patient department (GOPD) during the study period. Menstrual disorders (67.11%) were the commonest complaint, followed by vaginal discharge (18.68%) and UTI (9.8%). Menstrual disorders varied from irregular menstruation (55.15%), dysmenorrhea (30.74%) and amenorrhea (14.10%). Dysfunctional uterine bleeding was the commonest cause of menstrual irregularity followed by polycystic ovarian disease (PCOD). Teenage pregnancy (0.84%) and ovarian tumor (0.60%) was found in a few cases. Conclusion Adolescent girls' gynecological problems should be evaluated thoroughly and managed accordingly. Adolescent health education needs to increase awareness and give further attention to gynecological problems.
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Affiliation(s)
- Bhabani Pegu
- Department of Obstetrics and Gynecology, ANIIMS Port Blair, Andaman and Nicobar Islands, India, Phone: (+91) 9476007785
| | | | - Anita Yadav
- Department of Obstetrics and Gynecology, ANIIMS Port Blair, Port Blair, Andaman and Nicobar Islands, India
| | - Vikas Yadav
- Department of Community Medicine, ANIIMS Port Blair, Andaman and Nicobar Islands, India
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