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Re: An Intersting CaseFrom: Braun, R. Daniel (rbraun@iupui.edu)Sat Mar 20 05:09:58 1999
Sounds to me like she is anovulatory. Check prolactin, and start clomid if PRL is nl. And husband has sperm. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN -----Original Message----- From: Dr. M. P. Shrivastava [SMTP:mpshrivastava@healthnet.org.np] Sent: Friday, March 19, 1999 11:06 PM To: Multiple recipients of list Subject: An Intersting Case From: Veena Shrivastava < mpshrivastava@healthnet.org.np > Subject: Interesting case A young lady aged 24 years had TOP ( Termination of pregnancy) at 12 weeks period, 2 years back. 6 months after TOP , she came back to me with the complaints of Sec. amenorrhoea and excessive vaginal bleeding. She had period once after TOP, after that she is not having her regular period. After two courses of antibiotics keeping in mind that she may be suffering from "Asherman's Syndrome" , Hysteroscopy and D & C was performed and CuT was put inside the uterine cavity. She was put on oestrogen & progesterone for 3 months. As long as she was on hormone she had regular period ,but she is again amenorrhoic and is having excessive muco-purulent vaginal discharge after discontinuing the hormonal therapy. The investigations done were: 1. HVS Smear: ( Gram's stain) :- Plenty of epetheloid cells, pus cells and few gram's negative bacilli seen. 2. HVS Culture:- No growth 3. VDRL & HIV Antibiotics:- Negative 4. Blood count:- within normal limits. Unfortunately I have not checked her for Tuberculosis and hormonal profile. The lady is nulliparous and keeps going to Hongkong with her husband for business. Any suggestion for treating this patient would be highly appreciated. DR. VEENA SHRIVASTAVA CONSULTANT GYNAECOLOGIST POST BOX- 5813 KATHMANDU, NEPAL.
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