Abstract

Bleeding disorders in females is rare but when present, usually present with menorrhagia, mucocutaneous bleeding or per rectal bleed. We retrospectively analysed the spectrum of bleeding disorders in females referred to our laboratory for the workup of bleeding disorders.

Methodology: Females who were referred to our laboratory for workup of bleeding disorders were asked to fill form enquiring a detailed menstrual, family and significant past history including drug intake history. Samples were collected in Na citrate vacuitaners for testing the coagulation parameters.

Results: Out of 607 patients studied for bleeding disorders we found 10(2.1%) females (age range 3 months-69years) with deranged coagulation profile (Isolated increase in APTT). In 8/10 (80%) factor VIII was found reduced which on futher mixing studies 3 of them showed presence of inhibitors, 3/10 females had reduced vWF level so labelled as vWD, other 2/10 had reduced factor VIII so were labelled as mild Hemophillia. 2/10 (20%) were found to have reduced factor IX level but all three females were less than 6 month of age.

Conclusion: Heavy menstrual bleeding may be the only clinical manifestation of an inherited bleeding disorder in a substantial proportion of women and we suggest that all such patients should be investigated for Underlying hemostatic defects. This will not only help in diagnosis but also in proper management for future hemostatic challenges.