Screening for coagulation disorders in adolescents with abnormal uterine bleeding.

ABSTRACT

STUDY OBJECTIVE: To determine if screening for coagulation disorders was routinely performed during the evaluation of adolescents with abnormal uterine bleeding. DESIGN: A retrospective chart review. Data were analyzed using the chi-square test. P < 0.05 was considered significant. SETTING: Outpatient clinics of an academic center. PARTICIPANTS: Eligible charts of patients age eighteen years and under with abnormal uterine bleeding who were evaluated either by pediatric gynecologists, gynecologists, or pediatricians. INTERVENTIONS: A chart review. MAIN OUTCOME MEASURES: Data on provider type, documented patient history and laboratory tests ordered. RESULTS: In our review, 43% (n= 36) of patients were evaluated by gynecologists, 38% (n=32) by pediatricians and 19% (n=16) by pediatric gynecologists. The mean age of patients whose charts were reviewed was 15 years. Overall 36.6% (n=30) of providers indicated that they screened for a bleeding disorder by documenting at least one screening question in the patient's history. There was a significant difference among providers with 68.8% (n=11) of pediatric gynecologists documenting at least one screening question, compared to 31.4% (n=11) of gynecologists and 25.8% (n=8) of pediatricians (P < 0.05). Overall 14.6% (n=12) of subjects were screened for a coagulation disorder with laboratory testing. CONCLUSIONS: The majority of adolescents with abnormal uterine bleeding were not screened for bleeding disorders. The frequency of evaluation for blood dyscrasias varied by specialty.