The revised American Society for Reproductive Medicine (rASRM) classification of endometriosis is based on findings at laparoscopy. Which factor is weighted MOST HEAVILY in the scoring system?
- A Dense posterior cul-de-sac obliteration ✓
- B Superficial peritoneal implants on pelvic side wall
- C Ovarian endometrioma diameter >3 cm
- D Number of peritoneal implants
Correct answer: A. Dense posterior cul-de-sac obliteration
Explanation
In the rASRM scoring system, complete obliteration (dense adhesions) of the posterior cul-de-sac carries the highest single score of 40 points, immediately placing the patient in Stage IV (severe) disease. Partial obliteration scores 4. Ovarian endometriomas score based on size and whether right or left, up to 20 points for a >3 cm deep lesion. Superficial peritoneal implants score only 1–2 points each. The posterior cul-de-sac obliteration is the highest-weighted single criterion.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.