Mj. Gannon et al., A NEW METHOD FOR MEASURING MENSTRUAL BLOOD-LOSS AND ITS USE IN SCREENING WOMEN BEFORE ENDOMETRIAL ABLATION, British journal of obstetrics and gynaecology, 103(10), 1996, pp. 1029-1033
Objective 1. To develop and validate a method for measuring menstrual
blood loss in a routine setting, and 2. To assess the value of measuri
ng menstrual blood loss before endometrial ablation. Design A prospect
ive, observational study. Setting Four Yorkshire hospitals: The Genera
l Infirmary at Leeds, St James's University Hospital, Leeds, St Luke's
Hospital, Bradford and The Friarage Hospital, Northallerton. Particip
ants Three hundred and seventy-two women who had been offered endometr
ial ablation for menorrhagia. Measurement Sanitary material was washed
with a nonionic detergent in a known volume of water. The haemoglobin
in a sample of solution was measured by mixing with sodium carbonate
for spectrophotometric analysis. Interventions The menstrual blood los
s result was revealed to each woman. Electrosurgical endometrial ablat
ion was performed for those who decided to have surgery. Main outcome
measures Proportion of women with normal menstrual blood loss (less th
an or equal to 80 mt) who avoided surgery. Comparison of endometrial a
blation outcome in women with and without genuine menorrhagia. Results
Thirty-six women (10%) with normal menstrual blood loss who declined
surgery continued to avoid surgery after a mean of 27 months. Two hund
red and ninety-two women were followed up for one year after endometri
al ablation. Those with genuine menorrhagia (n = 122) were less likely
to be dissatisfied (9% vs 18%) (OR 2.5, 95% CI 1.1-4.7) or to require
hysterectomy (4% vs 7%) (OR 1.8, 95% CI 0.6-5.2) than women with norm
al menstrual blood loss (n = 170). Conclusions The objective diagnosis
of menorrhagia can be undertaken in a routine setting and may provide
some women, who have a normal menstrual blood loss, sufficient reassu
rance to refrain from surgery. Women with genuine menorrhagia have a b
etter outcome after endometrial ablation than those with normal menstr
ual blood loss.