RESUMO
This review represents the author's personal style of practice in a new and evolving field, where the standard academic framework is still in its infancy. When there is no prior established practice to follow, good clinical care needs to come from listening very carefully to patients and empirically judging appropriate treatment by actual outcomes. The information provided here that is not cited represents 14 years of careful clinical listening and observation, as well as public health training in maternal and child care and epidemiology. Health care is more effective, thereby improving its quality, if the following principles are applied consistently to the pediatric or adolescent gynecologic patient. 1. The developmental stage of the patient dictates clinical practice. 2. Confidentiality is paramount in caring for adolescents and may necessitate referral. 3. Autonomy in medical choices leads to responsible self-care.
Assuntos
Doenças dos Genitais Femininos/diagnóstico , Doenças dos Genitais Femininos/terapia , Genitália Feminina/lesões , Ginecologia/métodos , Pediatria/métodos , Atenção Primária à Saúde/métodos , Adolescente , Criança , Abuso Sexual na Infância/diagnóstico , Confidencialidade , Diagnóstico Diferencial , Feminino , Humanos , Programas de Rastreamento , Guias de Prática Clínica como Assunto , Encaminhamento e ConsultaRESUMO
External and internal anomalies can result from enzyme or chromosome defects, and prenatal drug exposure. Major new developments in this field include better understanding of the genetics of enzymatic defects, laparoscopic and hysteroscopic modifications of older procedures, the advent of magnetic resonance imaging for diagnosis, and better understanding of the psychosocial impact and timing of therapy.
Assuntos
Genitália Feminina/anormalidades , Anormalidades Congênitas/classificação , Anormalidades Congênitas/diagnóstico , Anormalidades Congênitas/embriologia , Anormalidades Congênitas/genética , Anormalidades Congênitas/psicologia , Anormalidades Congênitas/terapia , Feminino , HumanosRESUMO
The epidemiology of complete molar pregnancy is dominated by two strong factors. The first is the wide geographic variation in incidence, from less than 1 per 1,000 deliveries in the United States and Canada to about 1 per 100 deliveries in Indonesia and other Asian countries. The second factor is maternal age, with an increasing risk of molar pregnancy with increasing maternal age. Both genetic and environmental factors may underlie these two risk factors. The genetic factors may include chromosomal defects that occur as a consequence of oocyte aging. The environmental factors probably include nutrition. Although many aspects of nutrition deserve further study, some new research suggests that a focus on vitamin A metabolism may be especially profitable.
