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Gynaecology & Obstetrics Secondary Amenorrhea 1bb5263c

Asher man n syndrome is secondary to -

A
Tuberculosis
B
Endometrial carcinoma
C
Endometriosis
D
Submucosal fibroid
High-Yield Explanation
Ans. is 'a' i.e., Tuberculosis Asherman's syndrome (AS) or Fritsch syndromeo It is a condition characterized by adhesions and/or fibrosis of the endometrium most often associated with dilation and curettage of the intrauterine cavity:o Intrauterine adhesions can also form after infection with tuberculosis or schistosomiasis,o The adhesions may cause amenorrhea (lack of menstrual periods). repeated miscarriages, and infertility:o Pain during menstruation and ovulation is also sometimes experiencedo The history of a pregnancy event followed by a D&C leading to secondary amenorrhea or hypomenorrhea is typicalo Hysteroscopy is ihe gold standard for diagnosis.o Imaging by sonohysterography or hysterosalpingography will reveal the extent of the scar formation.o Treatment involves surgery to cut and remove the adhesions or scar tissue (adhesiolysis). This can usually be done with hysteroscopy:o Progesterone challenge test is negative.Sites of genital TB% involvementTubes90-100%Uterus50-60%Ovaries20-30%Vagina & vulva1-2%o Menstrual problems occurring in TB patients:-Hypomenorrhea/Amenorrhea due to Asherman s syndrome.Polym enorrhea/Menorrhagia

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