This study aims to investigate uterine bleeding during menstruation in women taking antithrombotic medications after cardiac surgery. It will evaluate the proportion of patients with abnormal bleeding, such as heavy menstrual bleeding and prolonged menstrual periods, identify associated risk factors, and determine the characteristics of high-risk female patients.
Female patients aged 18 to 49 years.
Underwent cardiovascular surgery at our institution (e.g., coronary artery bypass grafting, heart valve repair/replacement, aortic surgery, congenital heart disease correction, heart transplantation).
Absence of heavy menstrual bleeding (HMB) or prolonged menstrual bleeding (> 8 days) during the two consecutive menstrual cycles immediately prior to surgery.
Experienced at least one complete menstrual bleeding episode within the predefined postoperative follow-up window.
Previous diagnosis of congenital bleeding or coagulation disorders (e.g., hemophilia, von Willebrand disease, congenital coagulation factor deficiencies, congenital thromboembolic diseases).
History of endometrial ablation/resection, bilateral oophorectomy, or hysterectomy.
Current diagnosis of gynecological malignancies requiring chemotherapy, radiotherapy, or targeted therapy.
Pregnant or within 3 months postpartum prior to surgery or during the follow-up period.
Women of childbearing age receiving oral antithrombotic therapy after cardiac surgery
Cohort
Prospective
antithrombotic drugs
DrugAntithrombotic agents such as anticoagulants (e.g., warfarin, rivaroxaban) and antiplatelet drugs (e.g., aspirin, clopidogrel)
The occurrence of abnormal uterine bleeding in women was assessed using the Pictorial Blood Loss Assessment Chart (PBAC) developed by Higham
The Pictorial Blood Loss Assessment Chart (PBAC) is primarily used to evaluate the occurrence of prolonged menstruation (duration of menstrual bleeding ≥ 9 days) and/or heavy menstrual bleeding (PBAC score ≥ 100) in women.
Assessment of Healthcare-Seeking Behaviors for Abnormal Uterine Bleeding Using Custom Items
In this study, custom questionnaire items were used to evaluate the clinical management of patients with AUB, including their healthcare-seeking behaviors (such as physician consultations, inpatient admissions, and emergency care) and specific therapeutic interventions (such as the dose reduction or interruption of oral antithrombotics, and blood transfusions).
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