Pictorial Blood Loss Assessment Chart for evaluating heavy menstrual bleeding in Asian women

Abstract

Introduction: Heavy menstrual bleeding is a common gynaecological problem, but some women may prefer not to articulate their menstrual problems. The objective of this study was to evaluate the usefulness and acceptability of the Pictorial Blood Loss Assessment Chart (PBAC) as a self-screening tool in evaluation of menstrual blood loss among Asian women in Hong Kong.

Methods: This prospective cohort study recruited 206 women from the general gynaecology ward and out-patient clinic: 118 had self-perceived heavy menstrual bleeding and 88 had self-perceived normal menstrual flow. Participants were asked to fill in the PBAC for one menstrual cycle.

Results: Compared with women who had self-perceived normal menstrual flow, women with self-perceived heavy menstrual bleeding had significantly higher total PBAC scores and numbers of flooding episodes, larger clot sizes and numbers, more days of bleeding, and lower haemoglobin levels. Receiver-operating characteristic curve analysis demonstrated good pairwise associations of self-perceived symptoms with PBAC score and haemoglobin level.

Conclusions: The PBAC can be used to differentiate self-perceived heavy and normal menstrual bleeding in Asian women in Hong Kong. It can also serve as an additional indicator of possible heavy menstrual bleeding to alert women of the need to seek early medical attention.

引言：大量經血是常見婦科問題，但部份女性不擅於表達甚至不察覺她們的月經失調問題。本研究旨在評估月經失血圖（PBAC）作為香港亞洲女性經血的自我篩查工具的效用性和可接受性。 方法：這項前瞻性隊列研究納入來自普通婦科病房和門診的206名女性，當中118例自我感受經血量大，88例自我感受經血量正常。參與者被要求填寫一個月經週期的PBAC評估。 結果：與自我感受經血量正常的女性相比，自我感受經血量多的女性的PBAC總分和血崩發作次數顯著更高、血塊大小和數量更大、出血天數更多，以及血紅蛋白水平更低。接受者操作特性曲線分析表明自我感受症狀與PBAC評分和血紅蛋白水平間存在良好的成對關聯。 結論：PBAC可用於區分香港亞洲女性自我感受的大量經血和正常經血，以及作為可能大量經血的額外指標，提醒婦女需要及早就醫。