الفهرس 
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Abstract
Although mild bleeding disorders are still poorly defined, they are clinically important since they may be associated with serious hemorrhagic complications during trauma or surgical procedures. These disorders are mainly related to dysfunction of primary or secondary hemostasis.
Causes of primary disorders include vWD, some qualitative platelet disorders, thrombocytopenias, pharmacological platelet inhibitors, bone marrow diseases, and severe renal failure. While causes of disorders of secondary hemostasis include, some coagulation factor deficiencies (including hemophilia carrier state), liver diseases, vitamin K deficiency, coagulation factor inhibitors, and pharmacologicl anticoagulants.
A patient undergoing evaluation for mild bleeding symptoms still remains a diagnostic challenge. The first step in the evaluation is made by using standardized questionnaire, this is a bleeding score which is generated by summarising the severity of all bleeding symptoms reported by a subject, and is administered and reviewed by a physician. If a bleeding disorder is suspected, simple screening laboratory tests such as platelet count, APTT and PT, supplemented by a specific laboratory testing are needed for attaining a diagnosis. It is also possible that global assays such as thromboelastography or thrombin generation tests could be of help in the understanding and investigation of MBD.
Several pharmacological agents are available for prevention and treatment of MBD. For example, desmopressin (DDAVP), amicar or tranexamic acid which is used for dental and oral surgeries and it may reduce bleeding with other operative procedures. For women with menorhagia, initial therapy is often an oral contraceptive or a fibrinolytic inhibitor. However, before prophylactic administration of such drugs, a trade-off between their thrombotic risks and excessive bleeding should be made.
Mild bleeding disorders remain a challenge, even for specialists. These disorders are usually silent and only become manifest after trauma or surgery. In order to prevent some severe bleeding complications in a particular patient as well as for his/her family members, who may still be asymptomatic, it is important to decide whether laboratory assays should be performed, and if yes which ones. This can be done only after a medical (personal and family) history has been carefully taken.
Bleeding scores can be of real help, particularly as they oblige physicians to use a systematic approach in each patient and ameliorate communication between health-care providers. However physicians should use them with awareness of their limitations until full validation is performed by ongoing studies.