Pediatric and adolescent gynecology

1108 Pages·2005·19.77 MB·English

by  Emans

Pediatric and
Adolescent Gynecology
Fifth Edition

Pediatric and
Adolescent Gynecology
Fifth Edition
S. Jean Herriot Emans, M.D.
Professor of Pediatrics
Harvard Medical School
Chief, Division of Adolescent/Young Adult Medicine
Vice Chair for Clinical Affairs, Department of Medicine
Children’s Hospital Boston
Boston, Massachusetts
Marc R. Laufer, M.D.
Associate Professor of
Obstetrics, Gynecology and Reproductive Biology
Harvard Medical School;
Chief of Gynecology
Children’s Hospital Boston;
Division of Reproductive Medicine
Department of Obstetrics and Gynecology
Brigham and Women’s Hospital;
David B. Perini Quality of Life Clinic
Dana Farber Cancer Instituite;
Boston, Massachusetts
Donald P. Goldstein, M.D.
Clinical Professor of
Obstetrics, Gynecology and Reproductive Biology
Division of Gynecologic Oncology
Department of Obstetrics and Gynecology
Brigham and Women’s Hospital
Boston, Massachusetts
Acquisitions Editor: Anne M. Sydor
Developmental Editor:Kerry Barrett
Marketing Manager: Kathy Neely
Project Manager:Nicole Walz
Senior Manufacturing Manager: Ben Rivera
Creative Director: Doug Smock
Cover Designer: Larry Didona
Compositor: Maryland Composition, Inc.
Printer: Edwards Brothers
©2005 by Lippincott Williams & Wilkins
530 Walnut St.
Philadelphia, PA 19106 USA
www.LWW.com
All rights reserved. This book is protected by copyright. No part of this book may be
reproduced in any form or by any means, including photocopying, or utilized by any
information storage and retrieval system without written permission from the copyright
owner, except for brief quotations embodied in critical articles and reviews. Materials
appearing in this book prepared by individuals as part of their official duties as U.S.
government employees are not covered by the above-mentioned copyright.
Printed in the United States of America
Fourth edition 1998, Lippincott Raven Publishers
Third edition 1990, Little Brown
9 8 7 6 5 4
Library of Congress Cataloging-in-Publication Data
Pediatric and adolescent gynecology / edited by S. Jean Emans, Marc R. Laufer, Donald
P. Goldstein.—5th ed.
p. ; cm.
Includes bibliogrpahical references and index.
ISBN 10: 0-7817-4493-8 ISBN 13: 978-0-7817-4493-5
1. Pediatric gynecology. 2. Adolescent gynecology. I. Emans, S. Jean Herriot.
II. Laufer, Marc R. III. Goldstein, Donald Peter.
[DNLM: 1. Genital Diseases, Female—Adolescent. 2. Genital Diseases, Female—
Child. 3. Genital Diseases, Female—Infant. WS 360 P37076 2005]
RJ478.E46 2005
618.92(cid:2)098—dc22
2004017947
Care has been taken to confirm the accuracy of the information presented and to describe
generally accepted practices. However, the authors, editors, and publisher are not
responsible for errors or omissions or for any consequences from application of the
information in this book and make no warranty, expressed or implied, with respect to the
currency, completeness, or accuracy of the contents of the publication. Application of this
information in a particular situation remains the professional responsibility of the
practitioner.
The authors, editors, and publisher have exerted every effort to ensure that drug
selection and dosage set forth in this text are in accordance with current
recommendations and practice at the time of publication. However, in view of ongoing
research, changes in government regulations, and the constant flow of information
relating to drug therapy and drug reactions, the reader is urged to check the package
insert for each drug for any change in indications and dosage and for added warnings and
precautions. This is particularly important when the recommended agent is a new or
infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug
Administration (FDA)clearance or limited use in restricted research settings. It is the
responsibility of the health care provider to ascertain the FDAstatus of each drug or
device planned for use in their clinical practice.
10 9 8 7 6 5 4
Dedication
To our spouses (John, Sue, and Connie), families, friends, and colleagues who
have encouraged us in our goals of improving health care for girls and young women.
This project could not have been completed without their love and support.
v

Contents
Contributing Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix
1. Office Evaluation of the Child and Adolescent . . . . . . . . . . . . 1
S. Jean Emans
2. Ambiguous Genitalia in the Newborn . . . . . . . . . . . . . . . . . . . . 51
Ingrid Holm
3. Vulvovaginal Problems in the Prepubertal Child . . . . . . . . . . . 83
S. Jean Emans
4. The Physiology of Puberty . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Catherine M. Gordon and Marc R. Laufer
5. Precocious Puberty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Joan Mansfield
6. Delayed Puberty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
S. Jean Emans
7. Amenorrhea in the Adolescent . . . . . . . . . . . . . . . . . . . . . . . . . 214
S. Jean Emans
8. Dysfunctional Uterine Bleeding . . . . . . . . . . . . . . . . . . . . . . . . 270
S. Jean Emans
9. Androgen Abnormalities in the Adolescent Girl . . . . . . . . . . . 287
S. Jean Emans
10. Structural Abnormalities of the Female Reproductive Tract . . 334
Marc R. Laufer, Donald P. Goldstein, and W. Hardy Hendren
11. Gynecologic Pain: Dysmenorrhea, Acute and Chronic Pelvic
Pain, Endometriosis, and Premenstrual Syndrome . . . . . . . . . . 417
Marc R. Laufer and Donald P. Goldstein
12. Education of the Child and Adolescent . . . . . . . . . . . . . . . . . . . 477
Phaedra Thomas, Vicki Burke, and Anne Jenks Micheli
vii
viii CONTENTS
13. Pediatric Urology in the Pediatric and Adolescent Girl . . . . . . 494
Craig A. Peters
14. Vulvovaginal Complaints in the Adolescent . . . . . . . . . . . . . . . 525
Elizabeth R. Woods and S. Jean Emans
15. Bacterial Sexually Transmitted Infections: Gonorrhea,
Chlamydia, Pelvic Inflammatory Disease, and Syphilis . . . . . . 565
Lydia A. Shrier
16. Human Immunodeficiency Virus in Young Women . . . . . . . . 615
Cathryn L. Samples
17. Human Papillomavirus Infection in Children and Adolescents 649
Jessica A. Kahn and Paula A. Hillard
18. Benign and Malignant Ovarian Masses . . . . . . . . . . . . . . . . . . 685
Marc R. Laufer and Donald P. Goldstein
19. The Breast: Examination and Lesions . . . . . . . . . . . . . . . . . . . . 729
Marc R. Laufer and Donald P. Goldstein
20. Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 760
S. Jean Emans
21. Teen Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 844
Angela Maidi Nicoletti
22. Adolescent Sexuality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 879
Amy B. Middleman and Maurice Melchiono
23. Gynecologic Issues in Young Women with Chronic Diseases . 893
Marc R. Laufer and S. Jean Emans
24. Sexual Abuse in the Child and Adolescent . . . . . . . . . . . . . . . . 939
R. Ranee Leder and S. Jean Emans
25. Complementary and Alternative Medicine for Gynecology
Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 976
Wendy L. Wornham
26. Legal Issues in Pediatric and Adolescent Gynecology . . . . . . . 988
Richard Bourne and the Honorable Susan Ricci
Appendix 1: Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1002
Appendix 2: World Health Organization, Medical Eligibilty
Criteria for Contraceptive Use . . . . . . . . . . . . . . . . . . . 1010
CONTENTS ix
Appendix 3: Instructions for Cyclic and Continuous Birth Control
Pills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1020
Appendix 4: Definitions of Anatomical Terms Used in Child
Sexual Abuse Evaluations . . . . . . . . . . . . . . . . . . . . . . 1024
Appendix 5: Sexual Assault Forensic Medical Report . . . . . . . . . . . 1030
Appendix 6: Methods for Estimating Percentage Body Fat from
Skinfold Measurements in Girls . . . . . . . . . . . . . . . . . . 1037
Appendix 7: Percentages and Estimated Mature Heights for Girls,
Using Skeletal Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1039
Appendix 8: Calcium Information for Teens . . . . . . . . . . . . . . . . . . 1046
Appendix 9: Non-Steroidal Anti-Inflammatory Agents . . . . . . . . . . 1049
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1053