A young female presents with the history of spontaneous abortions and secondary amenorrhea since then. FSH 6 ILI/mL. What is the most probably cause of amenorrhea?
Ovarian failure
Pituitary failure
Fresh pregnancy
Uterine synechiae
Ans. D. Uterine synechiaeFSH within normal limit rules out other options. Recurrent spontaneous abortions supports the answer.Asherman Syndrome* Intrauterine synechiae is also known as Asherman syndrome.* This condition occurs due to vigorous uterine curettage in early pregnancy which may lead to scarring that interferes with normal endometrial growth and shedding.* Asherman syndrome is classified as mild, moderate, or severe depending upon the degree and extent of adhesion.* The patients present with secondary amenorrhea, hypomenorrhea, and infertility or habitual abortions.* Hysteroscopy confirms uterine synechiae, type (flimsy or fibrous) and extent of adhesions.Treatment: Reformation of adhesions is prevented by insertion of IUCD for 3 months and giving estrogen cyclically (21 days) for 3 months to developendometrium.
Disorders in Menstruation