ABSTRACT
The gynaecological issues encountered in children and teenagers lay at the intersection of paediatric endocrinology and gynaecology. More than ten years ago, an outpatient clinic in paediatric endocrinology and gynaecology has been created. Here, we review the last 6 years. 214 girls were included, considering only the first visit for each patient. Collected data are initial concern for this consultation, age at first consultation and confirmed or suspected diagnosis. A classification is done according to the initial concern of patients in six categories. Principal queries concern pubertal development, precocious pilosity or abnormalities in menstrual cycles. Vulvovaginitis and morphologic abnormalities are also frequently encountered. This consultation suggests a paediatric approach with a child feeling confident and a gynaecological examination with a specialist knowing the anatomy particularities and the development of the children. This article focuses on the importance of specific gynaecological examination in children and reviews the main diseases encountered.
Subject(s)
Endocrinology , Gynecological Examination , Gynecology , Pediatrics , Referral and Consultation , Adolescent , Adolescent Health Services/organization & administration , Ambulatory Care Facilities/organization & administration , Belgium/epidemiology , Child , Child Health Services/organization & administration , Child, Preschool , Endocrine System Diseases/diagnosis , Female , Genital Diseases, Female/diagnosis , Genital Diseases, Female/epidemiology , Gynecological Examination/methods , Gynecological Examination/standards , Gynecological Examination/statistics & numerical data , Humans , Infant , Menstruation Disturbances/diagnosis , Menstruation Disturbances/epidemiology , Physical Examination/statistics & numerical data , Retrospective Studies , Vaginal Diseases/diagnosis , Vaginal Diseases/epidemiology , Vulvar Diseases/diagnosis , Vulvar Diseases/epidemiology , Young AdultABSTRACT
OBJECTIVES: To evaluate the predictive value of RHD fetal genotype in maternal plasma of Rh D negative mothers after 10 weeks of gestation in a clinical use. MATERIAL AND METHOD: Prospective, comparative study between fetal RHD genotyping in maternal plasma, with amplification of exons 4,5,10 of the RHD gene, by real-time multiplex PCR, and Rh D serology at birth, in 218 pregnancy and their 223 babies, between November 2002 and 2004. RESULTS: Combining the amplification of three exons, the concordance rate of fetal Rh D genotyping in maternal plasma and baby phenotyping at delivery was 100%. Four women whose the babies were Rh D negative were positive for RHD exon 10 during pregnancy. This positivity was, in three cases, correlated with the presence of RHDpsi pseudogene and in last case, with a haplotype Cdes (r's). RHD genotyping was performed for five twin pregnancies. CONCLUSION: Multiplex PCR using maternal plasma provides perfect prenatal prediction of fetal RHD gene. These results confirm that this non invasive procedure is the preferred method for assessing Rh D fetal status in Rh negative mothers. Using this method for two years in routine practice has led us to modify our management scheme for sensitized Rh D-negative pregnant women.
Subject(s)
Fetal Blood/immunology , Genotype , Gestational Age , Rh-Hr Blood-Group System/genetics , Female , Humans , Polymerase Chain Reaction , Pregnancy , Prenatal Diagnosis , Rh Isoimmunization/prevention & controlSubject(s)
Blood Group Incompatibility/complications , Erythroblastosis, Fetal/etiology , Kell Blood-Group System/immunology , Adult , Blood Group Incompatibility/immunology , Cerebral Hemorrhage/etiology , Erythroblastosis, Fetal/complications , Erythroblastosis, Fetal/therapy , Exchange Transfusion, Whole Blood , Female , Humans , Infant, Newborn , Isoantibodies/isolation & purificationSubject(s)
Arthrogryposis/genetics , Hydrops Fetalis/genetics , Muscular Atrophy/genetics , Ribs/abnormalities , Arthrogryposis/pathology , Connective Tissue/pathology , Female , Fetal Death/pathology , Humans , Hydrops Fetalis/pathology , Infant, Newborn , Muscles/pathology , Muscular Atrophy/pathology , Ribs/pathology , SyndromeABSTRACT
We report a 18 weeks old fetus with the typical limb reduction anomalies of SC phocomelia syndrome, associated with exencephaly and unilateral anophthalmia, a feature previously reported in only 2 cases of severe Roberts syndrome. This observation brings another argument for lumping both diseases in a unique Roberts-SC phocomelia syndrome. Diagnosis was settled by the observation of premature centromeric splitting.
