RT Journal Article
SR Electronic
T1 Fifteen-minute consultation: Apparent vaginal bleeding in the pre-pubertal girl
JF Archives of disease in childhood - Education & practice edition
JO Arch Dis Child Educ Pract Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 142
OP 148
DO 10.1136/archdischild-2018-316218
VO 106
IS 3
A1 Julie-Ann Collins
A1 Julie-Ann Maney
A1 Alison Livingstone
YR 2021
UL http://ep.bmj.com/content/106/3/142.abstract
AB A parent or carer’s observation of blood in a child’s nappy or underwear can be quite alarming for both parent and child and may indicate vaginal bleeding. At first glance, it may be difficult to ascertain whether the bleeding is from the skin, genital tract, urinary tract or anus. Confirmed vaginal bleeding in a pre-pubertal girl is rare but always abnormal and requires comprehensive assessment to determine the cause. Recognition of normal female pre-pubertal anatomy is essential to detect any abnormalities. Appropriate action should be taken according to findings on initial inspection of the ano-genital area. The possibility of child sexual abuse and the need for specialist paediatric sexual offences medicine examination by an FME (Forensic Medical Examiner) or specialist paediatrician should always be considered. This article offers a systematic approach to assessment in pre-pubertal girls with apparent vaginal bleeding which will benefit general paediatricians, emergency department practitioners and GPs.