pediatric gynecology

The child may complain of pain, itching, or vaginal discharge. There are several factors that place young girls at risk of developing this problem, known as vulvovaginitis.
Also, the external structures of the female tend to open when the child squats, uncovering the more sensitive internal structures. This normal discharge of the newborn tends to
A second instance of normal vaginal discharge occurs in the months just prior to the first menstrual period. In this case, the vaginal discharge is a gray-white, non-foul smelling, non-irritating fluid. This result of increasing estrogen activity is normal, although the sudden increase in discharge and staining on the child's underclothing often causes the young girl and her parents to become quite concerned.
Bacterial Infections
Vulvovaginal bacterial infections can also develop following an infection in the upper respiratory tract, throat, or ears. Skin infections in young children may also be a source of bacterial infection resulting in vulvovaginitis. Sexually transmitted diseases account for an unfortunately high percentage of vaginal discharges in the pediatric population. Gonorrhea in the prepubertal child usually results in a vaginal discharge. Foreign bodies may be a cause of vaginal discharge, which will probably be persistent, bloody, and foul-smelling. This child may be bathed with a bland, mild soap. The child should avoid tight-fitting clothing.
Vaginal Injuries
The vulva and the vagina have a large supply of blood vessels. The child will probably complain of intense pain. In most children this type of injury does not require special treatment. Most vaginal injuries occur as the result of a penetrating injury. Unless a major blood vessel is torn, there is little blood loss and the child will probably not complain of much pain.
Unfortunately, the incidence of child sexual abuse in the United States is alarmingly high. As a result, penetration usually involves tearing of the delicate vaginal tissues. It is evident that the diagnosis and treatment of gynecologic problems in children present a real challenge for the pediatrician.

Source: Pediatrics for Parents, Inc.

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