Pictorial blood loss assessment chart for quantification of menstrual blood loss: a systematic review

Abstract

To evaluate the diagnostic accuracy of pictorial blood loss assessment chart (PBLAC) compared to objective measurements of menstrual blood loss (MBL), a systematic search of MEDLINE, EMBASE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Web of Science, and EBM Reviews-Cochrane Central Register of Controlled Trials from inception until September 30, 2014 was performed. Terms referring to Bpictorial blood loss assessment chart,^Bmenstrual blood loss evaluation,^and Balkaline hematin^were used. The ability of PBLAC to predict significant blood loss, compared to alkaline hematin as a standard objective method, represents our primary outcome. Out of 255 reports identified by the primary search, seven reports were included in the review. Quality of these reports was assessed. Compared to alkaline hematin, PBLAC sensitivity and specificity ranged from 58 to 98 % and 7.5 to 97 %, respectively, with likelihood ratios (LR) for positive ranging from 1.1 to 7.8 and LR for negative tests ranging from 0.04 to 0.48. Diagnostic odds ratio ranged from 2.6 to 86.9. Although diagnostic testing was not always supportive in terms of sensitivity, specificity, and LRs, most studies support the use of PBLAC as a semi-objective method that can be implemented in research and clinical practice.

Traditional Dry Cupping Therapy Versus Medroxyprogesterone Acetate in the Treatment of Idiopathic Menorrhagia: A Randomized Controlled Trial

“…The primary outcome was menstrual blood loss that was assessed with pictorial blood loss assessment chart (PBAC) (15,16). The PBAC score was calculated by assigning a score of 1, 5, or 20, respectively, to a lightly, moderately, or fully soiled sanitary pad, and a score of 1 or 5, respectively, for the passage of small or large clots.…”

The Effect of Capsella bursa-pastoris Extract on Heavy Menstrual Bleeding and Quality of Life in Patients with Uterine Leiomyoma: A Double-blind Randomized Clinical Trial

“…In the past, tyramine and choline were responsible for controlling the bleeding by the plant. Todays, new researches have shown that other substances that are not fully recognized may be responsible for such an effect [25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Anyway, the contractile and hemostatic nature of this drug cannot be ignored.…”

“…If the score is more than 100, it indicates uterine bleeding is more than 80 cc. The accuracy of this test has been reported differently in different studies but is still the most applicable method for measuring the amount of menstrual blood loss [34]. In addition, the Persian version of the Menorrhagia Questionnaire (MQ) was used to assess the quality of life.…”

How I treat heavy menstrual bleeding associated with anticoagulants

“…28 However, its sensitivity and specificity vary widely. 29 For a qualitative assessment, several menstrual bleeding-specific questionnaires that incorporate quality-of-life assessment have been used. 30,31 However, a standardized and validated questionnaire is needed to attenuate variability in outcomes and to increase generalizability.…”