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Chapter 6 - Paediatric and Adolescent Gynaecology

from Section 2 - Menstrual Disorders

Published online by Cambridge University Press:  24 November 2021

By
Eveline J. Roos ,
Ivonne A. Bedei  and
Paul L. Wood
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Children and adolescents presenting with common and rare gynaecological conditions are described in this chapter. Communication needs to be sensitive and appropriate for age and development to retrieve as much information as possible.

Puberty heralds the development of secondary sexual characteristics, gonadal maturation, and start of reproductive capacity. Pubertal disorders can be divided into precocious and delayed puberty. Menarche is an important marker of puberty and menstruation should be seen as a vital sign. Oligomenorrhoea is pathological over time and most girls with oligomenorrhoea develop polycystic ovary syndrome (PCOS).

Sex development in the human is the result of a complex interaction involving production and response to sex hormones which is regulated by genetic and environmental factors. Disorders of sex development occur when an individual’s sex development takes a different path.

Keywords

adolescent gynaecologyvaginal dischargepubertyamenorrhoeaheavy menstrual blood lossPCOSdisorders of sexual developmentlabial hypertrophy
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 47 - 54
Publisher: Cambridge University Press
Print publication year: 2021

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References

Goldenring, JM, Rosen, DS. Getting into adolescent heads: an essential update. Contemp Pediatr 2004;21:64–90.Google Scholar
Wood, PL. Cosmetic genital surgery in children and adolescents. Best Pract Res Clin Obstet Gynaecol 2018;48:137–146.Google Scholar
Ibáñez, L, Oberfield, SE, Witchel, S, et al. An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Horm Res Paediatr 2017;88:371–395.CrossRefGoogle Scholar
Teede, H, Misso, M, Costello, M, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril 2018;110:364–379.CrossRefGoogle ScholarPubMed
Sultan, C, Gaspari, L, Maimoun, L, Kalfa, N, Paris, F. Disorders of puberty. Best Pract Res Clin Obstet Gynaecol 2018;48:62–89.Google Scholar
Carel, JC, Eugster, EA, Rogol, A, et al. Consensus statement on the use of gonadotropin-releasing hormone analogs in children. Pediatrics 2009;123:e752–e762.Google Scholar
Consortium on the Management of Disorders of Sex Development. Clinical guidelines for the management of disorders of sex development in childhood, 2006. Available at: www.dsdguidelines.org.Google Scholar
Hughes, IA, Houk, C, Ahmed, SF, et al. Consensus statement on management of intersex disorders. Arch Dis Childhood 2006;91:554–563.Google Scholar
Witchel, SF. Congenital adrenal hyperplasia. J Pediatric Adolesc Gynecol 2017;30:520–534.Google Scholar
Phyllis, W, Speiser, R, Azziz, L, et al. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2010;95:4133–4160.Google Scholar
Hughes, LA, Davies, JD, Bunch, TI, et al. Androgen insensitivity syndrome. Lancet 2012;380:1419–1428.Google Scholar
Hayes, L, Creighton, SM. Review: prepubertal vaginal discharge. TOG 2007;9:159–163.Google Scholar
Kirtschig, G, Becker, K, Günthert, D, et al. Evidence-based (S3) guideline on (anogenital) lichen sclerosus. J Eur Acad Dermatol Venerol 2015;29: e1–e43.CrossRefGoogle ScholarPubMed
Lewis, FM, Tatnall, FM, Velangi, SS, et al. British Association of Dermatologists guidelines for the management of lichen sclerosus, Br J Dermatol 2018;178:839–853Google Scholar
Van Eyk, N, Allen, L, Giesbrecht, E, et al. Pediatric vulvovaginal disorders: a diagnostic approach and review of the literature. J Obstet Gynaecol Can 2009;31:850–862Google Scholar
Gallion, HR, Milram, LJ, Littrel, LL. Genital findings in cases of child sexual abuse: genital vs vaginal penetration. J Pediatr Adolesc Gynecol 2016;29:604–611.Google Scholar
Adams, JA, Kellogg, ND, Farst, KJ, et al. Updated guidelines for the medical assessment and care of children who may have been sexually abused. J Pediatr Adolesc Gynecol 2016;29: 81–87.Google Scholar
Adams, JA, Farst, KJ, Kellogg, ND. Interpretation of medical findings in suspected child sexual abuse: an update for 2018. J Pediatr Adolesc Gynecol 2018;31:225–231.Google Scholar
Ebert, AD, Fuhr, N, Metthias, D Histological confirmation of endometriosis in a 9-year old girl suffering from unexplained cyclic pelvic pain since the eighth year of life. Gynecol Obstet Invest 2009;67:158–161.Google Scholar
Dun, E, Kho, K, Morozov, V, et al. Endometriosis in adolescents. J Soc Laparoendoscopic Surg 2015;19:1–8Google Scholar
Simpson, JL, Ekias, S, Malinak, LR, Buttram, VC Jr. Hereditable aspects of endometriosis. 1. Genetic studies. Am J Obstet Gynaecol 1981;137;327–331.Google Scholar
Santos, X, Cass, D, Dietrich, J. Outcome following detorsion of torsed adnexa in children. J Pediatr Adolesc Gynecol 2015;28:136–138.Google Scholar
Leserman, J, Li, Z, Drossman, DA, Hu, YJ. Selected symptoms associated with sexual and physical abuse history among female patients with gastrointestinal disorders: the impact on subsequent health care visits. Psychol Med 1998;28:417–422.Google Scholar
Salama, M, Isachenko, V, Isachenko, E, Rahimi, G, Mallmann, P. Updates in preserving reproductive potential of prepubertal girls with cancer: systematic review. Crit Rev Oncol Hematol 2016;103:10–21.Google Scholar

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