tailieunhanh - Gynecology in children and adolescents

In this chapter the following common gyneco- logical problems of children and adolescents will be described: fusion of the labia, vulvovaginitis, lichen sclerosus, condylomata acuminata, sexual abuse, prepubertal bleeding, abnormal bleeding after menarche, trauma and genital tumors. | 24 Gynecology in Children and Adolescents Heleen van Beekhuizen INTRODUCTION In this chapter the following common gynecological problems of children and adolescents will be described fusion of the labia vulvovaginitis lichen sclerosus condylomata acuminata sexual abuse prepubertal bleeding abnormal bleeding after menarche trauma and genital tumors. The chapter starts with history taking and examination of children and adolescents and normal development. HISTORY AND EXAMINATION IN CHILDREN AND ADOLESCENTS History taking is the most important tool in children and adolescent gynecology. Approaches should be chosen according to the maturity of the child in young children history taking is done with the parents. Older children and adolescents may be able to describe their complaints themselves. The first contact with healthcare providers will set the tone for all future consultations be patient empathic and gentle and give the child the chance to be in control. Examination of children can be done in several positions frog-leg position in small children on mother s lap for toddlers on the side in knee-chest position in lithotomy position for older adolescents. Start with general examination height weight nutritional status and examination of the abdomen masses and inguinal area possible hernias or gonadal masses and classify the breasts and pubic region according to Tanner to assess sexual development Figure 1 . During inspection of the vulva look at the size and shape of the clitoris and labia the presence of vaginal discharge signs of trauma and lacerations the hymen pubic hair and hygiene. In case of Figure 1 Stages of development according to Tanner. Illustration by Michal Komorniczak vaginal discharge you can obtain a specimen with a cotton swab an Oze or a small neonatal feeding catheter. Make sure that during examination the mother or a chaperone is present. In prepubertal and virgin children and adolescents a vaginal examination is generally not indicated and if

• Y khoa - Dược
• Gynecology in children
• Gynecology in adolescents
• Fusion of the labia
• Condylomata acuminata
• Sexual abuse
• Prepubertal bleeding
• Obstetrics and Gynecology
• Prepregnancy Body
• Gestational Weight
• Birth Weight
• Maternal Immunity