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ORGINAL ARTICLE
Etiological Evaluation of Primary Amenorrhea In A Rural Teaching Hospital
Asma Akhtar1,Sunita Sudhir P2
1Junior Resident, Dept. of OBG, Kamineni Institute of Medical Sciences, Narketpally 2Professor, Dept. of OBG, Kamineni Institute of Medical Sciences, Narketpally
ABSTRACT
Introduction: Menstruation is the physical herald to physiologic capacity of conception.
Attainment of menarche in a girl brings a lot of confidence and feminism in a girl. Though the
incidence of primary amenorrhea is less than 1%, it accounts for significant amount of
psychological trauma. In the present day scenario, there are a lot of treatment modalities
which can at least restore her menstrual functions, and prevent complications.
Objectives: To determine various causes of primary amenorrhea in a rural Medical College
and to emphasize general approach to primary amenorrhea.
Materials and Methods: A retrospective study was performed using 15 complete medical
records of women with primary amenorrhea who attended Gynecology OPD, Department of
Obstetrics & Gynecology, from June 2016 to June 2018. Cases were analyzed according to
clinical profile, development of secondary sexual characters, physical examination, pelvic and
rectal examination, hormone profile, pelvic USG, MRI and cytogenetic study including
karyotype.
Results: The most common cause of primary amenorrhea was Mullerian anomalies (60%) in
present study. There were 2 cases of early gonadal failure, 1 case of pure gonadal
dysgenesis, 1 case of Turner mosaic, 1 case of Androgen insensitivity syndrome and 1 case
of congenital adrenal hyperplasia.
Conclusion: In this study, Mullerian anomaly was the most prevalent etiological factor
leading to amenorrhea followed by premature ovarian failure. However, this was a small
scale study and larger study group study must be needed. Racial, genetic and environmental
factors could play role in the cause of primary amenorrhea.