Etiology of Primary Amenorrhoea - A Study of 60 Cases in a Tertiary Care Centre, Western Rajasthan

OBJECTIVE: To determine the prevalence of etiologic causes of primary amenorrhoea in Indian population Material and method – A retrospective studywas performed using 60 complete medical records of girlswith primary ammenorrhoeea who attend umaid hospital, department of obstetrics and gynaecology, Dr. S. N. M. C from july 2019 to December 2019. cases were analyzed according to clinical profile, development and development of secondary sexual characters, physical examnination, pelvic examination, hormone profile, pelvic USG, MRI, cytogenic study for karyotype. RESULTS- 1. All the data of 60 cases of primary amenorrhoea are analysed on the basis of medical records available and diagnosis was made. Etiology of 60 cases as per table no.1 are shown.2. The common causes of primary amenorrhoea were mullerian anomalies (47 cases, 78.33 %), Gonadal dysgenesis (3 cases, 5 %) & Hypogonadotropic hypogonadism (2cases, 3.33 %) in decreasing order. There were 47 cases of mullerian anomalies with 30 cases of MRKH (Mayer-Rokitansky-Kuster-Hauser syndrome) and 17 cases of imperforate hymen. Pt with MRKH are treated with Mc Indoe’s vaginoplasty and laparoscopit davydov vaginoplasty. Those cases who had partially canalized vagina did not require surgery. Pt with absent uterus were counselled regarding the future fertility option of surrogacy or adoption.3. Cytogenetic study was available in three cases among these three cases one case had turner syndrome (46 x del (X) (q (13)). Pt with primary gonadal failure put on combined hormone therapy with estrogen and progestron in last 12 days of month and supplements with calcium and vitamin D to prevent bone loss.4. Androgen insensitivity syndrome (AIS, 46XY) was found in three cases. (5 %) In these cases bilateral gonadectomy done.5. There were two cases of Hyperprolactinemia. (3.33 %) Pt with low level of pituitary gonadotropins, decreased drive to ovaries for production for estrogens and progesterone, require exogenou