Pictorial Blood Loss Assessment Chart Score Research Articles

Treatment of Menorrhagia with Tranexamic Acid

Objective: to evaluate the efficacy of tranexamic acid for essential menorrhagia.Subjects: women 18 to 45 years of age with a complaint of heavy menstrual bleeding.Design: two pre-treatment baseline cycles were compared to three consecutive treatment cycles of tranexamic acid (one g taken orally every six hours throughout days one to three of each menstrual period).Main outcome measurements: menstrual blood loss using the pictorial blood loss assessment chart (PBAC) and blood haemoglobin (g/L).Results: all eleven patients recruited into the study had objective evidence of menorrhagia, defined as an average PBAC score of greater than or equal to 100 over two pre-treatment cycles. The median difference between baseline and treatment PBAC scores of 96.8 was statistically significant (p = 0.003, Wilcoxon Signed Ranks Test, Range = 32.8 to 432.8). This represented a median 47.4 percent decrease in menstrual blood flow. Four patients recorded a mean PBAC score of less than 100 for the three treatment cycles, indicating a return to normal menstrual flow of less than 80 mL. Three patients were anaemic upon entry into the study as defined by WHO (haemoglobin < 120 g/L). The mean difference (post trial minus pretrial) in haemoglobin concentrations of 9.5 g/L was statistically significant (P = 0.014, paired t test; 95% Confidence Interval = 3.2 to 10.6) and represented a 7.7 percent increase. Three of the women were dissatisfied with their menstrual flow during each of the three treatment cycles. No major side effects were reported.Conclusions: Tranexamic acid is an effective, well-tolerated medication for the treatment of essential menorrhagia and may be utilitized as a first line therapy.

Assessment of menstrual blood loss using a pictorial chart: a validation study.

To assess the accuracy of a pictorial blood loss assessment chart (PBAC) as a method for estimating menstrual blood loss in women complaining of heavy periods. A prospective analysis of 103 consecutive women complaining of excessive menstrual blood loss. Women recruited into an on-going study of menstrual blood loss in a large district general hospital. Correlation between pictorial assessment of blood loss and actual measured menstrual blood loss. There was poor correlation between observed PBAC score and menstrual blood loss. We have not been able to validate previously published work. The pictorial assessment chart offers no significant improvement in the quality of objective diagnosis in women complaining of menorrhagia.

Does preoperative treatment with a gonadotropin-releasing hormone agonist improve the outcome of endometrial resection?

To verify if more favorable long-term results of endometrial resection can be obtained with preoperative gonadotropin-releasing hormone (GnRH) agonist treatment. Multicenter, randomized, controlled trial (Canadian Task Force classification I). Tertiary care academic department. Sixty-three premenopausal women with established menorrhagia. Eight weeks of goserelin depot treatment before endometrial resection or immediate surgery in the early proliferative phase of the cycle. Variations in menstrual patterns and bleeding scores as well as overall degree of satisfaction with treatment were determined 1 year after endometrial resection. Mean +/- SD monthly pictorial blood loss-assessment chart scores in the second 6-month follow-up period were 26.9 +/- 31.6 in the goserelin group and 44.0 +/- 45.7 in the immediate surgery group (mean difference 17.1 points, 95% CI -3.0 to +37.2, p = 0.09, unpaired t test). Respective amenorrhea rates were 34% (11/32) and 20% (6/20, p = 0.26, Fisher's exact test, 95% CI of difference -8% to +37%). Overall satisfaction with treatment was 91% and 87%, respectively. Administration of a GnRH agonist before endometrial resection is advantageous for surgery, but has a limited effect in terms of postoperative bleeding pattern and appears not to offer clear-cut long-term clinical benefit.