SlNDROMA POLIKISTlK OVARIUM

7/25/2019 SlNDROMA POLIKISTlK OVARIUM

1/42

SlNDROMA POLIKISTlKOVARIUM

Dr. Lenny M. Lisal, SpOG

SUB.BAGIAN FERTILITAS ENDOKRIN REPRODUKSIBAGIAN OBSTETRI & GINEKOLOGI FAKULTAS

KEDOKTERAN UNIVERSITAS HASANUDDINMAKASSAR


2/42

Pendahuluan

Sinonim:

sindrom S!"in#L"$"n!%' o$ri(m

)oi*is!i*' o$ri(m s*"ro*is!i*')"n+*i!)oi*is!i* o$ri(m' no$(si

d"n,n %i)"rndro,"nism"

P"r!m *i di*"m(**n S!"in#L"$"n!%-/012


3/42

B(*n )"n+*i! m"in*n *(m)(n

,"3

P"n+"44 )s!i 4"(m di*"!%(i' dimn

o$ri(m m"m4"sr dn m"m)(n+i

4n+* *n!on, !( *is! +n, 4"risi

5irn


4/42

1#61 7 8ni! )d r"n!n, m"nrs#

)"rim"no)(s" *n m"n,mi si*(s

+n, !d* 4"ro$(si

91 7 dri si*(s +n, !id* 4"ro$(si i!(4"r*"m4n, m"n3di no$(si *ronis

dm 4"n!(* o$ri(m )oi*is!i*


5/42

; 7 dri *"inn o$ri(m )oi*is!i* inis"5r *inis !m)i s"4,i )"n+*i!

o$ri(m )oi*is!i*

Pd 1#; 7 8ni! (si r")rod(*si')"n+*i! o$ri(m )oi*is!i* ini *n

4"r,"3 I"n,*) s"4,i sindrom

o$rin )oi*is!i*


6/42

Er! *i!nn+ d"n,n )"ris!i8 no$(si'

s"%in,, s"!i) *ondisi !( *"dn +n,

d)! m"n+"44*n !"r3din+ no$(si*roni* *n m"n+"44*n !"r3din+

sindrom o$ri(m )oi*is!i*


7/42

Insiden K"inn "ndo*rin +n, (m(m )d

8ni! (si )rod(*!i


8/42

Patofosiologi

>ni! d"n,n o$ri(m )oi*is!i*' *dr

LH !in,,i dn FSH r"nd%.

Ini !"r3di *i4! m"*nism" (m)n 4i*

"s!ro,"n +n, !in,,i m"n+"44*n s"*r"si

LH dn s()r"si FSH.


9/42

Po ,ondo!ro)in -LH !in,,i don FSHr"nd%2 !"r3di *r"n )"nin,*!n

s"*r"si GnRH

K"ni*n GnRH dis"44*n o"% !on(sO)ioid s"n!r m"n(r(n -O)ioid

%i)o!m(s d% in%i4i!or2.


10/42

Ton(s o)ioid +, *(rn, dis"44*n o"%

*dr r"nd% )ro,"s!"ron +n, m"n"!).

H ini 4"r%(4(n,n d"n,n )"nin,*!n

)d m)i!(d dn


11/42

A*i4! *dr FSH m"n(r(n' P"r!(m4(%n( !id* !(m4(% )"n(%' r"n!n, %id()


12/42

Foi*" ini di*"iin,i s" !"* %i)"r)s!i*'+, m"n,mi (!"nissi *rn LH !in,,i

A*(m(si 3rin,n


13/42

Kondisi ini 4"r3n !"r(s' *"!i*


14/42

Foi*" !r"!i* *n m"n,"(r*nndros!"n"dion dn !"s!os!"ron

A*i4!n+ !im4( in,*rn s"!n' dimn

ndro,"n +, m"nin,*! m"nim4(*nms% "8! *on$"rsi "*s!r ,nd("r

dn %m4!n sin!"sis SHBG'

m"n+"44*n "s!ro,"n m"nin,*!


15/42


16/42

Hin,n+


17/42

K)s( s*"ro!i* +, !"4 ini 4"r!ind*

s"4,i )"n,%n, m"*ni* !"r3din+

o$(si. Kons") +n, "4i% *(r! d o$ri(m

)oi*is!i* %si dri *ons"*8"nsi no$(si

)"rsis!"n dn *"dn +, steady state


18/42

Kr"*!"ris!i* o$ri(m )oi*is!i*

m"n5"rmin*n *ondisi dis


19/42

?m


20/42

K"!"4n s!rom *or!"*s m"nin,*! 0; 7'

s!rom s(4*or!i* m"nin,*! 1 *i.P"nin,*!n s!rom dis"44*n *i4!%+)"r)si s" !%"* dn )"m4"n!(*n

s!rom 4r( +, 4"rs dri


21/42

P"r(4%n o$ri(m )oi*is!i* m"n3disindrom o$ri(m )oi*is!i* d%

,n,,(n


22/42

Kons"*("nsi *inis +, )o!"nsi *i4! s"*r"si

%ormon +n, m"n"!) )d sindrom o$ri(m

)oi*is!i* d %+)"rins(in"mi 4"r() %is(!ism",(*os !"r,n,,( sm)i di4"!"s m"i!(s'

%+)"rndro,"nism" 4"r() %is(!ism"' o)"si

dn 3"r8!' in


23/42

Ms% dis


24/42

M"(i


25/42

Ms% ini s"s(i d,n m"n(r(nn+

*!i


26/42

S" ,rn(os o$ri(m )oi*is!i* s,!

s"nsi!i< )d FSH s"dn, s" ,rn(os


27/42

A*i4! in dri )"nin,*!n ndro,"n

d% m"n5",% )"r*"m4n,n


28/42

D"n,n d"mi*in' ,4rn >si* o$ri(m

)oi*is!i* :d 4n+*


29/42

Retensi Insulin

B4r) )"n"i!in r"sis!"nsi ins(in )d

sindrom o$ri(m )oi*is!i* s"5r

")id"mioo,is !"rd)! )"nin,*!n

r"si*o DM !+)" II dn )"n+*i!*rdio$s*("r )d 8ni! d,n sindrom

o$ri(m )oi*is!i* r"sis!"nsi ins(in

!"r3di *i4! )"r(4%n i)id dn)ros"s


30/42

Ad 4"4"r) m"*nism" r"sis!"nsi

ins(in )d sindrom )oi*is!i* o$ri(m'

d% :

# R"sis!"nsi 3rin,n !r,"! di )"ri


31/42

Pr"s"n!si Kinis )si"n d"n,n r"sis!"nsi

ins(in -To"nrnsi ,(*os !"r,n,,( !(

di4"!"s m"i!(s2 !"r,n!(n, )d

*"mm)(n *om)"nssi )n*r"s d"n,nr"sisi!"nsi 3rin,n !r,"! ins(in.


32/42

Hiperandrogenisme

T"rd)! *or"si n!r d"r3!%i)"rins(in"mi d"n,n %i)"rndro,"nism".

Pd *dr +n, I"4i% !in,,i' ins(in m"n,i*!

receptor IGF tipe I (yang strukturnya serupadengan receptor insulin ). ?di 3i* r"5")!orins(in di%m4! !( 3(m% r"5")!or !id*5(*()' d)! di%r)*n ins(in *n m"n,i*!

r"5")!or IGF ri)" I.


33/42

M"n,in,! 4%8 "


34/42

Ge#ala klinis

Hi)"rndro,"nism"

no$(si

Gn,,(n %id -oi,om"nor" m"nor"2

Disi)id"mi

Hi)"r!"nsi

P?K

In


35/42

Sindrom S!"in#L"$"n!%

# O4"si!s

# Hirs(!ism"

# Gn,,(n m"ns!r(si

# S(4


36/42

Diagnosis

Am"nor"' oi,om"nor"' in


37/42

L)ros*o)i Kdr FSH' PRL' dn E norm

LH s"di*i! m"nin,,i -nis4% LHFSH02.

Sin!"sis T di o$ri(m m"nin,*!

S!rom o$ri(m m"n"4 -%i)"r!i*osis2.

Kdr T +n, !in,,i m"m4(!


38/42

Penanganan

Belum menginginkan anak- pilkontrasepsi

Hirsutismus - androgen mis.Siproteronasetat (SPA) atau pilkontrasepsi yang mengandung SPA

Spironolakton 2 : 50 mg!ari


39/42

Menginginkan anak

# P"mi5( o$(si mis. *omi


40/42

Pembedahan widereseksi tidak

dilakukan lagi

Laparaskopi - dilakukan "driling pada ovarium


41/42

Komplikasi

1. Infertilitas

2. Gangguan menstruasi

3. Hirsutisme, alopesia,akne

4. Peningkatan risiko kankerendometrium

5. Peningkatan risiko penyakit

kardiovaskuler. Peningkatan risiko dia!etes mellitius

pada pasien dengan resisitensi insulin


42/42

TERIMA KASIH

SlNDROMA POLIKISTlK OVARIUM

Documents

Transcript of SlNDROMA POLIKISTlK OVARIUM