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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Special Article

Genital Findings in Prepubertal Girls Selected for Nonabuse: A Descriptive Study

John McCann, Robert Wells, Simon and Joan Voris
Pediatrics September 1990, 86 (3) 428-439;
John McCann
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Robert Wells
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Simon
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Joan Voris
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Abstract

This project was designed to collect normative data on the genital anatomy from a sample of nonabused prepubertal girls. A total of 114 girls between the ages of 10 months and 10 years were examined and photographed with a colposcope. After screening for the onset of puberty and the possibility of undetected abuse, 93 subjects remained. Examination techniques included a supine labial separation approach, a supine labial traction method, and a prone knee-chest position. Common genital findings included erythema of the vestibule (56%), periurethral bands (50.6%), labial adhesions (38.9%), lymphoid follicles on the fossa navicularis (33.7%), posterior fourchette midline avascular areas (25.6%), and urethral dilation with labial traction (14.9%). The hymenal orifice opened more frequently during the knee-chest (95.2%) and the labial traction (90.5%) methods than with the supine separation (79.3%) approach. Hymenal findings included mounds (33.8%), projections (33.3%), and "septal remnants"/midline hymenal tags (18.5%). Intravaginal findings of vaginal ridges (90.2%) and rugae (88.7%) were found primarily through the labial traction approach. The cervix was visualized without the use of a speculum in 69% of the children during the knee-chest examination. Unusual findings included posterior fourchette friability (4.7%), anterior hymenal clefts (1.2%), and notches of the hymen (6%). One child had an imperforate hymen (1.2%) and 2 (2.5%) had hymenal septa. A vaginal discharge was detected in 2 (2.6%) and a foreign body in 1 (1.3%). Tables that include the vertical and horizontal hymenal orifice diameters by age group and by method are presented.

  • Received June 19, 1989.
  • Accepted October 13, 1989.
  • Copyright © 1990 by the American Academy of Pediatrics

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Pediatrics
Vol. 86, Issue 3
1 Sep 1990
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Genital Findings in Prepubertal Girls Selected for Nonabuse: A Descriptive Study
John McCann, Robert Wells, Simon, Joan Voris
Pediatrics Sep 1990, 86 (3) 428-439;

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Genital Findings in Prepubertal Girls Selected for Nonabuse: A Descriptive Study
John McCann, Robert Wells, Simon, Joan Voris
Pediatrics Sep 1990, 86 (3) 428-439;
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  • Demographic characteristics of labial adhesion in South Korea: a population-based study from 2010 to 2014
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  • Healing of Hymenal Injuries in Prepubertal and Adolescent Girls: A Descriptive Study
  • Healing Patterns in Anogenital Injuries: A Longitudinal Study of Injuries Associated With Sexual Abuse, Accidental Injuries, or Genital Surgery in the Preadolescent Child
  • Use of Hymenal Measurements in the Diagnosis of Previous Penetration
  • The Medical Evaluation of the Sexually Abused Child: Lessons From a Decade of Research
  • Influence of the History on Physicians' Interpretations of Girls' Genital Findings
  • Landmarks in Child Abuse and Neglect: Three Flowers in the Desert. The Whiplash Shaken Infant Syndrome, by J. Caffey,Pediatrics, 1974;54:396-403; Covert Video Recordings of Life-threatening Child Abuse: Lessons for Child Protection, by David P. Southall et al, Pediatrics, 1997;100:735-760;Preventing Child Abuse and Neglect: A Randomized Trial of Nurse Home Visitation, by David L. Olds et al, Pediatrics, 1986;78:65-78
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