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