Haid Patologis

Ramadina, SpOG
 Pendahuluan
 Kelainan 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
 Amenore

 Amenore primer
 Amenore sekunder
 Amenore fisiologi
Amenore Primer

 Pertumbuhan seks sekunder (-)

usia 14 tahun
 Tidak haid pada usia 16 th,
walaupun seks sekunder (+)
Amenore sekunder
 Definisi : tidak ada haid 3
bulan berturut-turut atau 6
bulan lamanya tidak haid
Puberty
 The 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 Development
1. Accelerated growth
2. Adrenarche
3. Breast development
(Thelarche)
4. Menarche
Etiologi
 Hipotalamus / hipofisis
 Gagal produksi gonadotropin
 Ovarium
 Gagal produksi estradiol
 Disfungsi ovarium
 Cavum uteri abnormal
 Obstruksi
Etiologi
Rencana
 Anamnesis :
 Amenore primer, sekunder ,
fisiologi
 Riwayat penyakit akut / kronis,
penyakit metabolik

 Pemeriksaan fisik :
 Pemeriksaan fisik :
 TB, BB, BMI
 Ciri seks sekunder
 Kelainan genitalia interna &
eksterna
 Primary amenorrhea

Secondary sexual characteristic

No Yes

Uterus Uterus

Uterus absent Uterus present Uterus absent Uterus present

Karyotype FSH Karyotype Outflow obstruction

Low High XX XY Hymen imperforata

XY

Karyotype
PAIS Rokitansky CAIS

XX XO

CAH HH Turner
Mayer-Rokitansky-Kuster-Hauser Syndrome
(utero-vaginal agenesis)

 15% of primary amenorrhea

 Normal secondary
development & external
female genitalia
 Normal female range
testosterone level
 Absent uterus and upper
vagina
 Karyotype 46-XX
 15-30% renal, skeletal and
middle ear anomalies
Imperforate Hymen
Secondary amenorrhea