Flashcards in Amenorrhea (Intrauterine Adhesions) Deck (17):
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Intrauterine adhesions a.k.a.?
Asherman's syndrome
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Secondary amenorrhea?
Absence of menses for 6+ months in a woman with previous menses
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Intrauterine adhesions? Form when?
When scar tissue forms and obliterates the endometrial cavity
Urine curettage following a pregnancy
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Hysterosalpingogram?
Radiopaque dye injected into the endometrial cavity via transcervical catheter to evaluate endometrial cavity and fallopian tubes
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Hysteroscopy?
Direct visualization of the endometrial cavity with an endoscope
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Uterine sounding?
Assessing the depth and direction of the cervical and uterine cavity with a thin blunt probe
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Necessary to form intrauterine adhesions?
Endometrial trauma (especially basalis layer)
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Adhesions consist of? Adhesions with poor prognosis?
Avascular fibrous tissue OR in active endometrium/myometrium
Myometrial adhesions are usually vascular and carry poor prognosis
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Typically found after radiation or tuberculosis endometritis? Prognosis?
Atrophic and sclerotic endometrium without adhesions; poor prognosis
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Risk factors for intrauterine scar formation?
1. Postpartum curettage 2-4 weeks after delivery
2. Hypoestrogenic states (breast-feeding or hypogonadotrophic hypogonadism)
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When to suspect intrauterine adhesions (findings)?
Dx by?
1. Secondary amenorrhea with negative pregnancy test and no progestin-induced withdrawal bleeding
Gold standard – hysteroscopy
Also good – Hysterosalpingogram
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Treatment for intrauterine adhesions?
1. Operative hysteroscopy
2. IUD or pediatric foley catheter to prevent reformation
3. Conjugated estrogens and progesterone
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Patient with amenorrhea. A biphasic basal body temperature suggests?
Normal functioning of the HPG axis
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Patient with secondary amenorrhea. Elevated FSH suggests? At risk for?
Premature ovarian failure; osteoporosis
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Hormonal status with intrauterine adhesions?
Normal
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Patient with amenorrhea but cramping pain every month - suggested diagnosis?
Cervical stenosis (not intrauterine adhesions)
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