Amenorrhea And Mullerian Anomalies Flashcards
What is the definition of primary amenorrhea
Absent menarche by
Age 16 + SSC
Age 14 without SSC
What is the definition of secondary amenorrhea
Absent menses x 6 consecutive months in female with previous regular menses
12 mnths in patient with previous history of oligomenorrhea
What is the most common cause of primary amenorrhea
Gonadal dysgenesis 40%
Mullerian agenesis #2 10%
What is the incidence of Mayer rokitansky kuster hauser syndrome
1:5000 female births
What other anomalies are associated with MRKS syndrome
Renal anomalies
- unilateral renal agenesis
- horseshoe kidney
- pelvic kidney
- hydronephrosis
- double ureter
Spinal and long limb abnormalities
Most common uterine anomaly
Septate uterus 90%
What is the incidence of transverse vaginal septum
Unclear
1:30,000- 50,000
What are the locations and frequency of transverse septae
Upper- 46%
Middle- 30-40%
Lower- 15-20%
How do your differentiate between a inperforate hymen and transverse septum
The membrane for inperforate hymen is blue(blood) as it is thin while the transverse septum is thick and pink
What is the incidence of MRKH syndrome
1:5000 female births
What is the proposed genetic cause of MRKH syndrome
Autosomal dominant with incomplete penetrance
Management of transverse septum
-Surgical excision and end to end reanastamosis
- vaginal mold x 10 days (longer if high septum 3-6mnths)
- vaginal dilators 2-3 mnths to prevent stenosis
Pregnancy rates after transverse septum management
Lower septum : 100%
Middle: 40%
Upper: 20%
