Prepubertal Vaginal Bleeding: Etiology, Diagnostic Approach, and Management

  title={Prepubertal Vaginal Bleeding: Etiology, Diagnostic Approach, and Management},
  author={Jennifer O. Howell and D E Flowers},
  journal={Obstetrical \& Gynecological Survey},
Importance Prepubertal vaginal bleeding outside the neonatal period is always abnormal and is very alarming to parents. A variety of practitioners, including obstetrician-gynecologists and pediatricians, may be asked to see patients with this presenting complaint, yet many do not receive adequate training in pediatric gynecology. Evidence Acquisition Review of the published literature in PubMed, focusing on the last 20 years, regarding the incidence, etiologies, diagnosis, and management… 

Current review of prepubertal vaginal bleeding

Careful history taking and targeted examination may lead to diagnosis in the case of prepubertal vaginal bleeding, and practitioners should not hesitate to examine a patient in the operating room using general anesthesia to elicit the cause.

Prepubertal Vaginal Bleeding:an inpatient series from a single center in Fujian China.

Vaginal bleeding in prepubertal females: a case of Shigella vaginitis and review of literature

This case prompted review of the indicated evaluation and differential diagnosis of prepubertal vaginal bleeding, including infectious aetiologies such as Shigella vulvovaginitis, with the authors’ goal to expedite diagnosis and treatment in paediatric patients.

Vaginal bleeding in pre-pubertal females.

Importance of Doppler ultrasound in vaginal foreign body: case report and review of the literature

The case of an infant who consulted for vaginal bleeding and foul-smelling discharge and the ultrasound revealed signs of vaginal distension due to heterogeneous-hematic contents and parietal thickening, which represents a first-line complementary method when this entity is suspected.

[Recurring genital bleeding in an extreme premature infant].

Mini-puberty in preterm newborns can present exaggeratedly, simulating precocious puberty and even presenting, exceptionally, recurrent genital bleeding, in order to carry out adequate management.

Small spherical foreign bodies in the genitourinary tract and their management

Minimally invasive endoscopy remains the first-line approach for the diagnosis and removal of genitourinary spherical FBs, which are clinically rare and sometimes difficult to detect by imaging examinations and can be easily overlooked.

Gynecological Problems in Newborns and Infants

The most frequent gynecological issues in the neonatal period are discussed.

Genitale Blutung im Vorschulalter

The case of a 4-year-old girl with a painless, bleeding tumor on the genitals is presented, and genital bleeding in prepubertal girls is a red flag.



Evaluation of vaginal bleeding in the preadolescent child.

  • D. Merritt
  • Medicine
    Seminars in pediatric surgery
  • 1998

Urethral prolapse: An often misdiagnosed cause of urogenital bleeding in girls

Treatment modalities based on 24 patients seen at a major children’s hospital during an 11-year span of urethral prolapse and the high rate of misdiagnosis are described are described.

Vaginal bleeding in premenarchal girls: a review.

Vaginal bleeding in prepubertal girls is uncommon but warrants careful evaluation because of the special status of the young patient and requires careful medical investigation followed by appropriate sociologic and psychologic support.

Recurrent vaginal discharge in children.

Premenarchal vaginal discharge: findings of procedures to rule out foreign bodies.

Benign vaginal bleeding in 24 prepubertal patients: clinical, biochemical and imaging features

Isolated prepubertal vaginal bleeding is typically benign and self-limited, in the absence of sexual precocity signs or other vaginal pathology.

Has this prepubertal girl been sexually abused?

Vaginal discharge as well as posterior hymenal transections, deep notches, and perforations raise the suspicion for sexual abuse in a prepubertal girl, but the findings do not independently confirm the diagnosis of nonacute sexual abuse.

Retrospective Review of Unintentional Female Genital Trauma at a Pediatric Referral Center

Most injuries are minor, and in this cohort, only 48.57% received gynecologic consultation and 19.05% required operative management, so future prospective studies would be useful to better evaluate the efficacy of surgical choices.

A Case of Atypical McCune-Albright Syndrome with Vaginal Bleeding

Considering that clinical manifestations of McCune-Albright syndrome appear later in the course of recurrent periods of ovarian activation and cyst formation, a careful clinical observation and follow up of patients is necessary and the diagnosis of MAS must be kept in mind in cases with gonadotropin-independent precocious puberty.