Present address: A. Dilley, Worldwide Epidemiology Glaxo Smith Kline Research and Development, Collegeville, PA, USA.
Screening women with menorrhagia for underlying bleeding disorders: the utility of the platelet function analyser and bleeding time
Article first published online: 26 AUG 2005
Volume 11, Issue 5, pages 497–503, September 2005
How to Cite
Philipp, C. S., Miller, C. H., Faiz, A., Dilley, A., Michaels, L. A., Ayers, C., Bachmann, G., Dowling, N. and Saidi, P. (2005), Screening women with menorrhagia for underlying bleeding disorders: the utility of the platelet function analyser and bleeding time. Haemophilia, 11: 497–503. doi: 10.1111/j.1365-2516.2005.01129.x
- Issue published online: 26 AUG 2005
- Article first published online: 26 AUG 2005
- Accepted after revision 21 June 2005
- bleeding time;
- platelet dysfunction;
- platelet function analyser;
- von Willebrand's disease
Summary. Menorrhagia is a very common clinical problem among women of reproductive age and recent studies have suggested that underlying bleeding disorders, particularly von Willebrand's deficiency and platelet function defects, are prevalent in women presenting with menorrhagia. The objective of this study was to determine the utility of the platelet function analyser (PFA-100) and bleeding time (BT) as initial screening tests for underlying bleeding disorders in women with menorrhagia. In this study, 81 women with a physician diagnosis of menorrhagia underwent PFA-100 testing, BT and comprehensive haemostatic testing. The effectiveness of the PFA-100 and BT as screening tools in women with menorrhagia was assessed using results of haemostatic testing for von Willebrand's disease (VWD) and platelet dysfunction. In women presenting with menorrhagia, the PFA-100 had a sensitivity 80%, specificity 89%, positive predictive value (PPV) 33%, negative predictive value (NPV) 98% and efficiency 88% for VWD. For platelet aggregation defects, the PFA-100 closure time had a sensitivity 23%, specificity 92%, PPV of 75%, NPV of 52% and efficiency 55%. The data suggest that the PFA-100 may be useful in stratifying women with menorrhagia for further von Willebrand testing; however, neither the PFA-100 nor the BT tests are effective for purposes of classifying women for standard platelet aggregometry testing in women presenting with menorrhagia.