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Vaginal Bleeding in Pre-pubertal Females
Sze M Ng1, Louise J Apperley1, Swathi Upradrasta1
1Department of Paediatrics, Southport and Ormskirk Hospital NHS Trust, Southport, UK.
Journal of Pediatric and Adolescent Gynecology
|February 10, 2020
Summary
Pre-pubertal vaginal bleeding in girls is rare. In cases with normal hormonal tests, a genital examination under anesthesia is recommended to find causes like foreign bodies.
Area of Science:
- Pediatric Endocrinology
- Gynecology
Background:
- Precocious puberty involves early signs like breast development and pubic hair growth, followed by menarche.
- Vaginal bleeding in pre-pubertal females is uncommon and warrants investigation.
Purpose of the Study:
- To determine the causes of recurrent vaginal bleeding in pre-pubertal female patients.
- To investigate patients presenting with vaginal bleeding without other signs of precocious puberty.
Main Methods:
- Seventeen patients with pre-pubertal recurrent vaginal bleeding were studied.
- Investigations included gonadotropin-releasing hormone (GnRH) stimulation tests and pelvic ultrasound scans.
- Genital examination under anesthesia was performed when indicated.
Main Results:
- The average age of bleeding onset was 7.4 years.
- All patients showed pre-pubertal responses to GnRH tests and had pre-pubertal uteri on ultrasound.
- Two patients had vaginal foreign bodies, and their bleeding ceased after removal.
Conclusions:
- Recurrent vaginal bleeding in pre-pubertal girls was not linked to hormonal levels or ultrasound findings.
- A genital examination under anesthesia is crucial for diagnosing foreign bodies or other causes of bleeding in these cases.
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