Haid Patologis

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haid patologis

Transcript of Haid Patologis

  • Haid Patologis

    Ramadina, SpOG

  • PendahuluanKelainan dalam jumlah dan lamanya haid (hipermenore, hipomenore)Kelainan siklus (polimenore, oligomenore, amenore)Perdarahan di luar haid (metroragia)Gangguan lain yang ada hubungan dengan haid (premenstrual tension, mastodinia, Mittelschmerz, dismenore)

  • AMENORE

  • AmenoreAmenore primerAmenore sekunderAmenore fisiologi

  • Amenore Primer Pertumbuhan seks sekunder (-) usia 14 tahunTidak haid pada usia 16 th, walaupun seks sekunder (+)

  • Amenore sekunderDefinisi : tidak ada haid 3 bulan berturut-turut atau 6 bulan lamanya tidak haid

  • PubertyThe cascade of events initiated by the release of pulsatile GnRH from prepubertal and central negative inhibition that results in increased levels of gonadotropin and steroids with appearance of secondary sexual characteristics and eventual adult function (menarche, ovulation)

  • Stages of Pubertal DevelopmentAccelerated growthAdrenarcheBreast development (Thelarche)Menarche

  • EtiologiHipotalamus / hipofisis Gagal produksi gonadotropinOvarium Gagal produksi estradiolDisfungsi ovarium Cavum uteri abnormalObstruksi

  • Etiologi

  • Rencana Anamnesis :Amenore primer, sekunder , fisiologiRiwayat penyakit akut / kronis, penyakit metabolik

    Pemeriksaan fisik :

  • Pemeriksaan fisik : TB, BB, BMICiri seks sekunderKelainan genitalia interna & eksterna

  • Primary amenorrheaSecondary sexual characteristicYesNoUterusUterus absentUterus presentLowHighKaryotypeKaryotypeXYXXXOKaryotypeOutflow obstructionXXXYUterus absentUterusUterus presentHymen imperforataCAIS

    TurnerHHPAISFSHCAHRokitansky

  • Mayer-Rokitansky-Kuster-Hauser Syndrome (utero-vaginal agenesis)15% of primary amenorrhea Normal secondary development & external female genitaliaNormal female range testosterone levelAbsent uterus and upper vagina Karyotype 46-XX15-30% renal, skeletal and middle ear anomalies

  • Imperforate Hymen

  • Secondary amenorrhea