English: Background: Abnormal Uterine Bleeding (AUB) is a frequent gynecological complaint in premenopausal women. In many cases, structural causes are absent, leading to a diagnosis of "unexplained" AUB. This study aims to evaluate the prevalence of underlying coagulation disorders (coagulopathies) in women with non-structural AUB and assess the diagnostic utility of routine coagulation profiling. Methods: A prospective case-control study was conducted involving 150 premenopausal women with AUB (excluding structural pathology like fibroids/polyps) and 100 healthy controls. The diagnostic panel included Prothrombin Time (PT), Activated Partial Thromboplastin Time (aPTT), Fibrinogen, von Willebrand Factor (vWF) antigen, and platelet aggregation tests. Results: Hemostatic abnormalities were identified in 19.3% of patients with unexplained AUB compared to only 2.0% in the control group (p < 0.001). The most common disorder was von Willebrand Disease (Type 1), followed by platelet function defects. A significant correlation was found between prolonged bleeding time and severity of menorrhagia. Conclusion: Subclinical coagulopathies represent a significant etiology in women with unexplained AUB. The integration of a comprehensive coagulation profile into the diagnostic algorithm is crucial for accurate management and avoiding unnecessary surgical interventions such as hysterectomy.

Abnormal uterine bleeding (AUB), coagulopathy, von Willebrand Disease, hemostasis, menorrhagia, premenopausal women.

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