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Prepubertal Vaginal Bleeding: Etiology, Diagnostic Approach, and Management

Jennifer O Howell1, Deborah Flowers2

  • 1Assistant Professor, Division of Women's Primary Health, Department of Obstetrics and Gynecology, and Medical Evaluator, Beacon Child and Family Program, Department of Pediatrics, University of North Carolina.

Obstetrical & Gynecological Survey
|April 12, 2016
PubMed

Insights

Prepubertal vaginal bleeding is abnormal and alarming. Accurate diagnosis relies on a thorough history and pediatric gynecological exam, with most causes being treatable and not indicative of abuse or malignancy.

Area of Science:

  • Pediatric Gynecology
  • Genitourinary Health

Background:

  • Prepubertal vaginal bleeding is a concerning symptom for parents.
  • Practitioners may lack adequate training in pediatric gynecology for this issue.

Purpose of the Study:

  • To review the incidence, etiologies, diagnosis, and management of prepubertal vaginal bleeding.
  • To provide guidance for practitioners managing this condition.

Main Methods:

  • Literature review of PubMed publications from the last 20 years.
  • Focus on common causes of prepubertal vaginal bleeding.

Main Results:

  • Effective assessment requires careful history taking and pediatric-specific gynecological examination.
  • Understanding normal pediatric genitourinary anatomy and identifying an estrogenized hymen are crucial.

Conclusions:

  • Prepubertal vaginal bleeding has diverse causes requiring a targeted history and examination.
  • Most cases are treatable and less commonly linked to sexual abuse or malignancy.
Abstract

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