THE DISCUSSANTS began the round table with a few general comments concerning various phases of development of the female. At birth and for the first week or more of life, the effects of maternal hormones on the newborn infant may be evidenced by hypertrophy of the breasts, prominence of the genitalia with nonpurulent vaginal secretion and occasional uterine bleeding. Throughout the remainder of infancy, until late childhood, there are no changes in the genitalia, and the mucosa of the vagina remains shrunken, producing little or no secretion. From the period of late childhood to early adolescence—that phase extending from the first menstrual period until the onset of ovulation—secondary sex characteristics develop and the vaginal mucosa undergoes cornification, becomes succulent and produces an increased quantity of secretion. Late adolescence is defined as that phase from the first ovulation to full maturity. The phases of adolescence are never clearly demarcated.
Certain pathologic conditions commonly seen in female children were then described. The relative incidence of these conditions as seen in a special clinic reflects their incidence in a general pediatric practice.
The majority of children (75%) are referred to the gynecologic clinic because of vulvovaginitis. Of these, 75% are found to have nonspecific vulvovaginitis. Etiologic agents and their relative incidence in the remainder of patients are: monilia, 15%; foreign body, 5%; and infections due to trichomonas, gonococcus and pinworms, 5%. Children under 10 years of age are most commonly affected. Those found to have vulvovaginitis due to fungi have usually given a history of recent antibiotic therapy.
- Copyright © 1958 by the American Academy of Pediatrics