The ISTH-BAT score and outcomes after endometrial ablation in women with heavy menstrual bleeding.

Abstract

The International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT), is used during the diagnostic workup of bleeding disorders. Data on ISTH-BAT scores in women with heavy menstrual bleeding (HMB) undergoing endometrial ablation (EA) could be essential in optimizing HMB counselling. To investigate the postsurgical incidence of amenorrhea, dysmenorrhea, quality of life, re-intervention after EA, and ISTH-BAT score. This study included women who have undergone EA because of HMB. During a follow-up of 2 to 5 years, ISTH-BAT, pictorial blood assessment chart (PBAC), and Short Form-36 survey (SF-36) were administered. At 10 years of follow-up surgical re-interventions were evaluated. Seventy-one women were included of whom 77% (n=55) had an ISTH-BAT score<6, versus 23% (n=16) ISTH-BAT score ≥6 (mean age 46.3versus 42.3, p=0.004). In the ISTH-BAT ≥6 group versus<6 group, amenorrhea occurred in 63% (10/16) versus 82% (45/55) (p=0.111), dysmenorrhea in 38% (6/16) versus 18% (10/55) (p=0.111), and surgical re-intervention in 19% (3/16) versus 25% (14/55) (p=0.582). SF-36 item (Bodily) pain was lower in the ISTH-BAT ≥6 group versus <6 (median score 58.7vs. 80.0, p=0.104). An ISTH-BAT score ≥6 may be related to a lower amenorrhea incidence and higher dysmenorrhea rate after EA.