The ISTH-BAT score and outcomes after endometrial ablation in women with heavy menstrual bleeding

Haemophilia. 2023 Nov;29(6):1573-1579. doi: 10.1111/hae.14872. Epub 2023 Sep 27.

Abstract

Background: The International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT), is used during the diagnostic workup of bleeding disorders. Data on ISTH-BAT scores in women with heavy menstrual bleeding (HMB) undergoing endometrial ablation (EA) could be essential in optimizing HMB counselling.

Objective: To investigate the postsurgical incidence of amenorrhea, dysmenorrhea, quality of life, re-intervention after EA, and ISTH-BAT score.

Methods: This study included women who have undergone EA because of HMB. During a follow-up of 2 to 5 years, ISTH-BAT, pictorial blood assessment chart (PBAC), and Short Form-36 survey (SF-36) were administered. At 10 years of follow-up surgical re-interventions were evaluated.

Results: Seventy-one women were included of whom 77% (n = 55) had an ISTH-BAT score < 6, versus 23% (n = 16) ISTH-BAT score ≥6 (mean age 46.3 versus 42.3, p = 0.004). In the ISTH-BAT ≥6 group versus < 6 group, amenorrhea occurred in 63% (10/16) versus 82% (45/55) (p = 0.111), dysmenorrhea in 38% (6/16) versus 18% (10/55) (p = 0.111), and surgical re-intervention in 19% (3/16) versus 25% (14/55) (p = 0.582). SF-36 item (Bodily) pain was lower in the ISTH-BAT ≥6 group versus < 6 (median score 58.7 vs. 80.0, p = 0.104).

Conclusions: An ISTH-BAT score ≥6 may be related to a lower amenorrhea incidence and higher dysmenorrhea rate after EA.

Keywords: bleeding disorders; endometrial ablation techniques; heavy menstrual bleeding.

MeSH terms

  • Amenorrhea
  • Dysmenorrhea / surgery
  • Endometrial Ablation Techniques*
  • Female
  • Hemorrhage
  • Hemostasis
  • Humans
  • Menorrhagia* / surgery
  • Middle Aged
  • Quality of Life
  • Thrombosis*