Coagulation hallmark indicators of menorrhagia in a comparative study between menorrhagic and healthy women attending Bungoma County Referral Hospital in Kenya

Abstract

Abstract Background Despite the significant burden of menorrhagia among women in Western Kenya, it remains unknown whether coagulation disorders are one of the important underlying causes of this condition in the region. This study evaluated the differences in coagulation profiles, associations between menorrhagia and coagulation profiles and compared the morphological features of platelets between menorrhagic patients and healthy women attending Bungoma County Referral Hospital in Kenya. Methods A comparative cross-sectional study of women [n = 428 (214 per group), aged 18–45 years] was performed. A Humaclot junior analyzer was used to evaluate prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (PT), fibrinogen, and the international normalized ratio (INR). The platelet count was determined using Celtac F ME822K, and Leishman-stained blood films were analyzed using an Olympus light compound microscope. The Chi-square test was used to analyze categorical descriptive data. The Mann‒Whitney U test was used to compare the data between the menorrhagic and control groups. Binary logistic regression was applied to determine the association between coagulation profile and menorrhagia incidence. The platelet morphological characteristics were reported as frequencies and percentages. Statistical significance was set at p≤0.05 indicated statistical significance. Results The results showed that a history of bleeding disorders (p < 0.0001), PT (p < 0.0001) and INR (p < 0.0001) were greater in menorrhagic women than in non-menorrhagic women. Menorrhagia was significantly associated with a high PT [OR = 2.129, 95% CI = 1.658–2.734; p < 0.0001] and INR [OR = 7.479, 95% CI = 3.094–18.080; p < 0.0001]. No morphological abnormalities in the platelets were observed in either healthy or non-menorrhagic women. Conclusions Family history of bleeding disorders, increased PT and INR are the hallmark indicators of menorrhagia in western Kenya. Therefore, routine assessment of the coagulation profile and history of bleeding disorders is critical for the diagnosis and management of menorrhagia.