Author : Shamdeen, Maida
Annals of the College of Medicine, Mosul,
Volume 31, Issue 2, Pages 62-65
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.Keywords: Menometrorrhagia, dysfunctional uterine bleeding, fibrinolysis.