Levonorgestrel-releasing intrauterine system for treatment of heavy menstrual bleeding in adolescents with Glanzmann’s Thrombasthenia: illustrated case series

Lu, Meiqiu; Yang, Xin

doi:10.1186/s12905-018-0533-0

Cited by 13 publications

(10 citation statements)

References 22 publications

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“…One hundred and thirty‐two articles were examined in full text, of which 69 were eventually included in this systematic review. These comprised 61 case reports and series and eight cohort studies . The exact number of women with HMB is uncertain due to incomplete reporting in one article .…”

Section: Resultsmentioning

confidence: 99%

Menstrual and obstetrical bleeding in women with inherited platelet receptor defects—A systematic review

et al. 2020

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Introduction Women with inherited platelet receptor defects (IPRD) may have an increased risk of heavy menstrual bleeding (HMB) and postpartum haemorrhage (PPH). Aim To present a systematic overview of the literature on the prevalence and management of menstrual and obstetrical bleeding in women with IPRD. Methods Electronic databases were searched for original patient data on the prevalence and management of HMB and PPH in women with known IPRD or who were being investigated for IPRD. Results Sixty‐nine papers (61 case reports/series and 8 cohort studies) were included. Overall, studies were rated as ‘poor quality’. The included cohort studies reported HMB in 25% (13/52) of women with Bernard‐Soulier syndrome and in 22.1% (34/154) of women with Glanzmann thrombasthenia. In total, 164 deliveries in women with IPRD were described. Excessive bleeding occurred in 16.9% (11/65) of deliveries described in the largest cohort. PPH occurred in 63.2% (55/87) of deliveries described in case reports/series. PPH occurred in 73.7% (14/19) of deliveries that were not covered by prophylaxis compared with 54.2% (32/59) of deliveries that were (OR = 2.36, 95% CI 0.75‐7.40). Neonatal bleeding complications were reported in 10.0% (8/80) of deliveries. In all (6/6) deliveries with neonatal bleeding complications wherein the presence of alloantibodies was investigated, either antiplatelet or anti‐HLA antibodies were detected. Discussion/Conclusion Menstrual and particularly obstetrical bleeding problems frequently occur in women with IPRD, based on small case reports and series of poor quality. International collaboration, preferably on prospective studies, is needed to improve clinical management of women‐specific bleeding in IPRD.

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Section: Resultsmentioning

confidence: 99%

Menstrual and obstetrical bleeding in women with inherited platelet receptor defects—A systematic review

et al. 2020

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“…Nevertheless, we believe that evaluating the effects of combination methods in real-world settings is an important research topic to be investigated in the near future. Although previous studies investigated the impact of LNG-IUS insertion in different populations in different geographical locations [ 38 – 42 ], further evidence regarding the role of ethnicity needs to be accumulated to better understand the efficacy of LNG-IUS. Finally, whether the MDQ and MMAS scores could further improve beyond the present study’s 12-month observation period is currently unknown, and long-term 5-year follow-up studies are warranted in the future to confirm this.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life of Japanese Dysmenorrhea/Heavy Menstrual Bleeding Patients Treated with Levonorgestrel Intrauterine Delivery System in a Real-World Setting

et al. 2022

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Introduction The present study collected 1-year follow-up patient-reported outcome data from Japanese women with dysmenorrhea and/or heavy menstrual bleeding (HMB) who underwent insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) 52 mg. We aimed to evaluate the quality of life (QOL) of Japanese women over the course of the investigational period. Methods This was a multicenter, non-interventional, prospective, single-cohort, post-marketing surveillance study (J-MIRAI). The primary outcome was the median change in the Menstrual Distress Questionnaire (MDQ) and Menorrhagia Multi-Attribute Scale (MMAS) scores from baseline to 3 and 12 months after LNG-IUS insertion, with decreasing and increasing scores, respectively, indicating improvement. The secondary outcomes were the statistical relationships between the MDQ and menstrual pain (measured by a visual analog scale, VAS), and between the MMAS and pictorial blood loss assessment chart (PBAC) scores by regression analysis. Results In total, 593 patients were evaluated; 376, 467, and 250 patients were diagnosed with dysmenorrhea, HMB, or both, respectively. The median MDQ score decreased significantly at 3 and 12 months after LNG-IUS insertion in both the premenstrual and menstrual periods (both p < 0.001 vs baseline), and the median MMAS score showed a similar improvement during the menstrual period. Changes in median MDQ and MMAS scores were observed regardless of patient background. Correlations between MDQ and menstrual pain (VAS) and between MMAS and PBAC scores were found (estimated regression coefficients 0.29 and − 0.15, respectively). Conclusion The LNG-IUS contributed to improvements in the QOL of patients with dysmenorrhea, HMB, and both, regardless of patient background characteristics. Trial Registration Registered at ClinicalTrials.gov (NCT02475356) on 18 June 2015. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02205-2.

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“…Other methods have been described in the literature to achieve initial cessation of HMB in this patient population ranging from uterotonics such as methylergonovine maleate to uterine packing with tampons [ 10 ]. Lu and Yang found success with the levonorgestrel-releasing intrauterine system (LNG-IUS) in two 14-year-old patients with a history of HMB since menarche [ 6 ]. Due to higher rate of expulsion in women with bleeding disorders, Lee et al recommend acute management of HMB prior to placement of the LNG-IUS [ 10 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Adolescent females with GT often suffer from heavy menstrual bleeding (HMB), clinically defined as blood loss of more than 80 mL per cycle. The prevalence of HMB in females with GT exceeds 9 per 10 cases and can severely affect their quality of life leading to multiple hospital admissions and blood transfusions [ 6 ]. The treatment options of GT-related HMB are largely based on case studies and expert opinion to date [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Management of Refractory Menstrual Bleeding in an Adolescent with Glanzmann Thrombasthenia: A Case Report and Review

King

Huff

Heber

et al. 2020

Case Reports in Obstetrics and Gynecology

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Glanzmann Thrombasthenia is a rare bleeding disorder causing life-threatening bleeding at menarche in the adolescent female. Bleeding often necessitates admission and multiple blood transfusions. Due to the rarity of the disease, management of acute bleeding in new-onset menarche poses a particular challenge. A 12-year-old menarchial female had persistent vaginal bleeding despite multiple treatment modalities including aminocaproic acid, recombinant factor VIIa, intravenous estrogen, and gonadotropin receptor hormone agonists. Although the standard treatment of bleeding in patients with GT is primarily rFVIIa, new-onset menstrual bleeding in conjunction with an immature hypothalamic-pituitary-ovarian axis often requires expanding treatment to include multiple drug modalities. In our case, a two-step approach was necessary. The first is targeting the cessation of the first menses. The second is optimizing ongoing management of long-term control of heavy menstrual bleeding to achieve amenorrhea, prevent further hospital admissions, and avoid recurrent transfusions.

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Levonorgestrel-releasing intrauterine system for treatment of heavy menstrual bleeding in adolescents with Glanzmann’s Thrombasthenia: illustrated case series

Cited by 13 publications

References 22 publications

Menstrual and obstetrical bleeding in women with inherited platelet receptor defects—A systematic review

Menstrual and obstetrical bleeding in women with inherited platelet receptor defects—A systematic review

Quality of Life of Japanese Dysmenorrhea/Heavy Menstrual Bleeding Patients Treated with Levonorgestrel Intrauterine Delivery System in a Real-World Setting

Management of Refractory Menstrual Bleeding in an Adolescent with Glanzmann Thrombasthenia: A Case Report and Review

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