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cpeedahsa
Century Club
Joined: 21 Apr 2007
Posts: 922
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 Posted: Fri Aug 31, 2007 11:52 pm Post subject: Amenorrhea - Causes |
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Major causes of primary and secondary amenorrhea
Pregnancy
Anatomic abnormalities
Congenital abnormality in Mullerian development*
Isolated defect
Testicular feminization syndrome
5-Alpha-reductase deficiency
Vanishing testes syndrome
Defect in testis determining factor gene
Congenital defect of urogenital sinus development* Agenesis of lower vagina
Imperforate hymen
Acquired ablation or scarring of endometrium Asherman's syndrome, Tuberculosis * Present as primary amenorrhea only.
Disorders of the hypothalamic-pituitary-ovarian axis
Hypothalamic dysfunction
Pituitary dysfunction
Ovarian dysfunction
Other |
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EMAK
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Joined: 26 Nov 2006
Posts: 572
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| Posted: Sat Sep 01, 2007 5:00 am Post subject: |
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| Quote: | Congenital abnormality in Mullerian development*
Isolated defect
Testicular feminization syndrome
5-Alpha-reductase deficiency
Vanishing testes syndrome
Defect in testis determining factor gene |
Gonads are not belong to mullarian system   |
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rpwalavalkar
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Joined: 20 Jul 2006
Posts: 973
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| Posted: Sat Sep 01, 2007 5:11 am Post subject: |
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well spotted emak!!!  
Origin and derivatives of the Mullerian ducts
The coelomic epithelium lateral to the Wolffian duct invaginates to form the Mullerian duct which grow caudally, at first solid, but later canalise .
the duct shifts more and more medially till it meets its fellow of the opposite side .
The septum between the 2 Mullerian ducts disappear . The proximal parts of the Mullerian ducts form the fallopian tubes , while the distal parts meet together to form the body and cervix of the uterus and the upper 4/5 ths of the vagina . The stroma and muscles develop from the surrounding mesoderm .The fusion of the 2 Mullerian ducts brings together 2 peritoneal folds which become the broad ligaments
The Mullerian ducts reach the down to the urogenital sinus and at the meeting point , form the Mullerian tubercle which meet a pair of endodermal sinovaginal bulbs which arise from the urogenital sinus . The most lower portion of the uterovaginal canal becomes occluded by a solid core of tissue (the vaginal plate) , the origin of which is unclear . This tissue elongates over the subsequent 2 months and canalizes by a process of central desquamation, and the peripheral cells becomes the vaginal epithelium .
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Dr Miss. Raj Walavalkar MBBS MRCOG
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rpwalavalkar
Teale Fenning Administrator
Joined: 20 Jul 2006
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| Posted: Sat Sep 01, 2007 5:12 am Post subject: |
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Development of the ovary passes into three phases:
1st: Migration of the germ cells from the yolk sac to the posterior body wall at level of 10th thoracic level to enter the Genital ridge.
2nd: the germ cells differentiate into oogonia then primary oocytes and become arrested until puberty.
3rd: descent of the ovary to reach the pelvis along a ligamentous cord called the gubernaculum that is attached inferiorly to the inguinal region. The gubernaculum becomes incorporated into the uterine wall at the point of entry of the fallopian tube and persists in the adult as the ovarian ligament and the round ligament.
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Dr Miss. Raj Walavalkar MBBS MRCOG
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SR O&G Wessex Region |
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rpwalavalkar
Teale Fenning Administrator
Joined: 20 Jul 2006
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| Posted: Sat Sep 01, 2007 5:13 am Post subject: |
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External genitalia development
Clitoris from the genital tubercle (by slight elongation)
Labia minora from the genital folds (by remaining separate)
Labia majora from the genital swellings (by enlarging greatly)
Vestibule develops from the lower most part of the urogenital sinus.
r
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Dr Miss. Raj Walavalkar MBBS MRCOG
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SR O&G Wessex Region |
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rpwalavalkar
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Joined: 20 Jul 2006
Posts: 973
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| Posted: Sat Sep 01, 2007 5:14 am Post subject: |
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cepeed,
good list though.
r
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Dr Miss. Raj Walavalkar MBBS MRCOG
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cpeedahsa
Century Club
Joined: 21 Apr 2007
Posts: 922
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| Posted: Sat Sep 01, 2007 11:26 pm Post subject: |
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| EMAK wrote: | | Quote: | Congenital abnormality in Mullerian development*
Isolated defect
Testicular feminization syndrome
5-Alpha-reductase deficiency
Vanishing testes syndrome
Defect in testis determining factor gene |
Gonads are not belong to mullarian system |
Actually-   nothing wrong with the classification mentioned above.
AFS/ASRM uses this classification with exactly the same terminology to classify. You can put all of these under RECEPTOR ABNORMALITIES AND ENZYME DEFICIENCIES causing abnormal Mullerian Development or just put them as Congenital abnormality in Mullerian development.
In the above mentioned disorders  Early failure prior to testicular development (before about eight weeks of gestation) is associated with streak-like inactive gonads that never produce testosterone, estrogen, or müllerian inhibiting substance. The net effect is feminization of both the internal and external genitalia and gonadal failure.
Gonads definitely do not belong to the Mullerian system --- but all the above abnormalities come under Congenital abnormality in Mullerian development because in all of them there is regression of all müllerian structures. That is the theory behind that classifiaction.
Reference- uptodate |
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