ORIGINAL ARTICLESScreening hemostatic defects in Saudi University students with unexplained menorrhagia: a diagnosis, which could be missedBakr, Salwaa,b; Almutairi, Ameera Abdullahb; Dawalibi, Ahmadc; Owaidah, Mustafac; Almughiyri, Anwar Abdullahb; Owaidah, TarekdAuthor Information aDepartment of Clinical Pathology/Hematology, Faculty of Medicine, Fayoum University, Egypt bCollege of Medicine, Princess Nourah bint Abdulrahman University cCollege of Medicine, Alfaisal University dDepartment of Pathology, King Faisal Specialist hospital and Research Center, Riyadh, Saudi Arabia Correspondence to Salwa Bakr, MD, PhD, Department of Clinical Pathology/Hematology, Faculty of Medicine, Fayoum University, PO Box 63514, Egypt E-mail: [email protected], [email protected] Received 17 December, 2020 Revised 11 February, 2021 Accepted 1 March, 2021 Blood Coagulation & Fibrinolysis: June 2021 - Volume 32 - Issue 4 - p 278-284 doi: 10.1097/MBC.0000000000001033 Buy Metrics Abstract Bleeding disorders are a common cause of unexplained menorrhagia in adolescents. However, there is lack of information provided on Arab girls. To estimate the prevalence of coagulation factor deficiencies and platelet dysfunction among Saudi university students with unexplained menorrhagia. In this cross sectional study, 463 adolescent girls surveyed for having heavy menses for further evaluation of underlying bleeding tendencies using screening standardized questionnaire. Only 109 girls out of the total 463 girls reported menorrhagia and were included in the evaluation. All girls with menorrhagia were evaluated by Pictorial blood assessment chart (PBAC) for precise evaluation of menstrual blood loss (PBAC score >100), had underwent pelvic ultrasonography and screening of hemostatic abnormalities (complete blood count, PFA-100, PT, aPTT, vWF:RCo, vWF:Ag, coagulation factors assay). On the basis of the score of PBAC more than 100, 25.6% (28/109) of adolescent women (age ranged: 17–25 years old) had confirmed menorrhagia. In 30.8% of them, an ultimate diagnosis of bleeding tendency or hemostatic abnormality was detected [five cases of probable von Willebrand disease (vWD) or low level of vWF:Ag and/or vWF:RCo, two cases of probable platelet dysfunction, and one case of factorV (FV) deficiency]. Anemia was found in 39.28% (11/28) of them; however, only 4 (36%) had received iron supplements. Our study demonstrated that hemostatic defects are not uncommon in Saudi adolescent women presenting with menorrhagia but mostly unrecognized and untreated. It is probably advisable to screen women with menorrhagia for these defects. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.