Publications by authors named "Janice Bacon"

27 Publications

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Maintenance of Knowledge.

Obstet Gynecol Clin North Am 2017 06;44(2):xiii-xiv

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, 983255 Nebraska Medical Center, Omaha, NE 68198-3255, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ogc.2017.03.001DOI Listing
June 2017

The Menopausal Transition.

Authors:
Janice L Bacon

Obstet Gynecol Clin North Am 2017 Jun;44(2):285-296

Women's Health and Diagnostic Center, 2728 Sunset Boulevard, Lexington Medical Park 1, Suite 106, West Columbia, SC 29169, USA. Electronic address:

A clear understanding of the physiology of the menopausal transition, clinical symptoms, and physical changes is essential for individualized patient management, maximizing benefits and minimizing risks for the present and the future. Menopause, defined by amenorrhea for 12 consecutive months, is determined retrospectively and represents a permanent end to menses. Many physical changes occur during the menopausal transition and beyond. Knowledge of symptoms and findings experienced by women undergoing the menopausal transition allow individualized care- improving quality of life and enhancing wellbeing for years to come.
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http://dx.doi.org/10.1016/j.ogc.2017.02.008DOI Listing
June 2017

Abnormal Uterine Bleeding: Current Classification and Clinical Management.

Authors:
Janice L Bacon

Obstet Gynecol Clin North Am 2017 Jun;44(2):179-193

Women's Health and Diagnostic Center, 2728 Sunset Boulevard, Lexington Medical Park One Suite 106, West Columbia, SC 29169, USA. Electronic address:

Abnormal uterine bleeding is now classified and categorized according to the International Federation of Gynecology and Obstetrics classification system: PALM-COEIN. This applies to nongravid women during their reproductive years and allows more clear designation of causes, thus aiding clinical care and future research.
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http://dx.doi.org/10.1016/j.ogc.2017.02.012DOI Listing
June 2017

Clinical Recommendation: Labial Adhesions.

J Pediatr Adolesc Gynecol 2015 Oct 24;28(5):405-9. Epub 2015 Apr 24.

Department of Obstetrics and Gynecology, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, Michigan.

Labial adhesions, also known as labial agglutination, are a common finding in prepubertal adolescents. They are defined as fusion of the labia minora in the midline or are termed vulvar adhesions when they occur below the labia minora (inner labia). Patients are often asymptomatic but might present with genitourinary complaints. The decision for treatment is based on symptoms. The mainstay of treatment in asymptomatic patients is conservative, with careful attention to vulvar hygiene and reassurance to parents. In symptomatic patients, topical treatment with estrogen and/or steroid cream is often curative. Less often, corrective surgery is necessary. Recurrence is common until a patient goes through puberty. These recommendations are intended for pediatric and gynecologic health care providers who care for pediatric and adolescent girls to facilitate diagnosis and treatment.
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http://dx.doi.org/10.1016/j.jpag.2015.04.010DOI Listing
October 2015

Physical activity during pregnancy is associated with reduced fasting insulin--the Pilot Pregnancy and Active Living Study.

J Matern Fetal Neonatal Med 2010 Oct;23(10):1249-52

Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.

Objective: To examine the relationship between physical activity during pregnancy and fasting plasma insulin measured in the second trimester.

Study Design And Methods: We conducted a pilot prospective cohort study of 69 overweight or obese women who were enrolled before 20 weeks of gestation at an obstetric clinic in Columbia, South Carolina in 2006-2007. At 24-28 weeks of gestation, fasting blood samples were collected and physical activity from the 3 months prior to the visit was assessed using a validated Pregnancy Physical Activity Questionnaire.

Results: Total energy expenditure (EE) in this population was attributable to sedentary activities (24.4%) and to physical activities of different intensities (light: 44.8%, moderate: 30.2%, and vigorous: 0.6%). By type, total EE mainly came from household/caregiving activities (58.9%) with a small proportion from exercise (3.8%). After adjusting for confounders, the mean fasting insulin values across the quartiles of total EE (least to most) were 17.3, 13.0, 12.1, and 9.6 uIU/ml (P for trend=0.01).

Conclusion: Our findings suggest that increased total physical activity is associated with reduced fasting insulin levels in overweight or obese pregnant women.
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http://dx.doi.org/10.3109/14767051003677970DOI Listing
October 2010

Hyperprolactinemia-related adverse events associated with antipsychotic treatment in children and adolescents.

J Adolesc Health 2009 Jul 9;45(1):70-6. Epub 2009 Mar 9.

Department of Neuropsychiatry, University of South Carolina School of Medicine, 3555 Harden Street Ext., CEB 301, Columbia, SC 29203, USA.

Purpose: To characterize factors related to the development of hyperprolactinemia and the ensuing reproductive/sexual adverse events in children and adolescents treated with antipsychotic and other psychotropic agents, and the additional risk posed for those with comorbid obesity, metabolic, or endocrine disorders.

Methods: A retrospective cohort design evaluating medical and pharmacy claims from South Carolina's Medicaid program was used to compare incidence rates for sexual/reproductive adverse events in 4140 children and adolescents who were newly prescribed one of six atypical or two conventional antipsychotic medications, and a random sample of 4500 children not treated with psychotropic medications, January 1998 to December 2005. Logistic and Cox Proportional Hazards regression and Kaplan-Meier survival analysis were performed.

Results: The treated cohort was not significantly more likely to evince hyperprolactinemia-related disorders than the control sample, but females and adolescents 13 and older were. Incident reproductive/sexual conditions were more likely for females (odds ratio [OR] = 9.52; confidence interval [CI] = 7.63-11.90), adolescents (OR = 3.91; CI = 3.25-4.70), those also taking selective serotonin reuptake inhibitors (SSRIs) (OR = 2.04; CI = 1.56-2.37) or valproic acid derivatives (OR = 1.29; CI = 1.03-1.64), and those with comorbid obesity/weight gain (OR = 1.92; CI = 1.56-2.37), metabolic (OR = 1.41; CI = 1.12-1.78), or endocrine disorders (OR = 2.76; CI = 1.98-3.84).

Conclusion: In this treated cohort, female adolescents exposed to SSRIs or valproic acid derivatives and those with comorbid obesity, metabolic, or endocrine disorders while taking antipsychotics were at higher risk of developing hyperprolactinemia and ensuing sexual/reproductive adverse events.
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http://dx.doi.org/10.1016/j.jadohealth.2008.11.010DOI Listing
July 2009

Cervical cytology screening and management of abnormal cytology in adolescents.

J S C Med Assoc 2009 Feb;105(1):16-9

The consensus guidelines recognize adolescents as a special group and allow for more conservative follow- up of abnormal cytology and histology. The guidelines recognize the role of high rates of HPV infection and reinfection in teens, along with high rates of clearance of HPV and low rates of invasive cervical cancer. Risks of treatment are balanced with risk for disease progression. The cervical cancer vaccine is now recommended for teens. The approved vaccine protects against HPV related disease caused by four subtypes of HPV 6, 11, 16, and 18. The Food and Drug Administration has approved the vaccine as routine for 11- and 12-year-old girls. The vaccine is most effective prior to HPV exposure or before the sexual debut. In South Carolina only 4.8% of high school girls indicate having sexual intercourse before age 13. Vaccination provides an opportunity to review risky behaviors with adolescent patients and to encourage healthy, safe lifestyles. Vaccination is not protective for sexually transmitted infections and this can be emphasized at vaccination visits as well. The importance of cancer screening can also be reviewed with patients at vaccination visits.
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February 2009

Prepubertal Skene's abscess.

J Pediatr Adolesc Gynecol 2009 Feb;22(1):e21-2

University of South Carolina, Columbia, South Carolina 29203, USA.

Background: Skene's glands are believed to be homologues of the prostate gland derived from the urogenital sinus.(1) Complications of Skene's glands occur most often in the third and fourth decades and are rarely seen in premenarchal females.

Case: A 3-year-old presented to her pediatrician with a 9-day complaint of vulvar pain. Both pediatric and gynecologic office examination revealed an enlarged right labium majus and an erythematous area adjacent to the urethra. Examination under anesthesia revealed a Skene's gland abscess that was treated with incision and drainage. The patient experienced complete resolution of symptoms.

Conclusion: A Skene's gland abscess is rare among premenarchal girls. An abscess presenting in a patient complaining of pain can be successfully managed with incision and drainage.
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http://dx.doi.org/10.1016/j.jpag.2007.11.004DOI Listing
February 2009

Women in obstetrics and gynecology: appreciating the past, looking to the future.

Authors:
Janice L Bacon

Am J Obstet Gynecol 2008 Aug;199(2):171-6

Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, Columbia, SC, USA.

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http://dx.doi.org/10.1016/j.ajog.2008.05.024DOI Listing
August 2008

Effects of ethinyl estradiol and ibuprofen compared to placebo on endometrial bleeding, cervical mucus and the postcoital test in levonorgestrel subcutaneous implant users.

Contraception 2008 Aug 9;78(2):106-12. Epub 2008 Jun 9.

CONRAD Clinical Research Center, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA 23507, USA.

Background: The study was conducted to evaluate ethinyl estradiol (EE) or ibuprofen (IBU) compared to placebo (PL) on spotting and bleeding (S/B) and a postcoital test (PCT) in women using the levonorgestrel subcutaneous implant. Women experiencing excessive S/B were enrolled in a multicenter prospective randomized study using EE, IBU or PL.

Outcome Measures: Duration of S/B and a PCT were evaluated. Statistical analysis used a general linear model procedure with Duncan's multiple range tests for individual variables.

Results: One hundred seven women were evaluated, and there was no difference in the duration of bleeding among the three therapies, while the mean number of spotting days were 1.8 for EE and 2.8 for PL (p=.04). There was no effect of IBU on S/B. No effect on cervical mucus or sperm was found between treatments.

Conclusion: There was a decrease in spotting but no effect on bleeding with EE compared to PL.
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http://dx.doi.org/10.1016/j.contraception.2008.04.003DOI Listing
August 2008

Predicting depressive symptoms and grief after pregnancy loss.

J Psychosom Obstet Gynaecol 2008 Dec;29(4):274-9

University of South Carolina School of Medicine, SC 29210, USA.

Women who experience pregnancy loss are at high risk for depression and grief. We conducted a prospective cohort study to identify antenatal predictors of depressive symptoms and grief following pregnancy loss. Particular emphasis was given to the potential role of religiosity and spirituality. In multivariable linear regression models, depressive symptoms were significantly positively associated with baseline depression score and a history of mental illness. Depression scores were significantly inversely associated with age. Increasing age was also protective against post-pregnancy loss grief, as was participation in organized religious activities. Clinicians should be particularly alert to signs of depression following pregnancy loss in younger women and in women with a history of mental illness during or before pregnancy. The inverse association between religious attendance and grief following pregnancy loss merits further study.
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http://dx.doi.org/10.1080/01674820802015366DOI Listing
December 2008

Do antenatal religious and spiritual factors impact the risk of postpartum depressive symptoms?

J Womens Health (Larchmt) 2008 Jun;17(5):745-55

Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina 29203, USA.

Objectives: Previous research has identified an inverse relationship between religiosity/spirituality and depressive symptoms. However, prospective studies are needed. This study investigates the association between antenatal religiosity/spirituality and postpartum depression, controlling for antenatal depressive symptoms, social support, and other potential confounders.

Methods: This is a prospective cohort study. Women receiving prenatal care were enrolled from three obstetrics practices. Follow-up assessment was conducted at the 6-week postpartum clinic visit. Four measures of religiosity and two measures of spirituality were assessed at baseline. A measure of overall religiosity/spirituality was also created using principal component factor analysis. Depressive symptoms were measured at baseline and again at follow-up using the Edinburgh Postnatal Depression Scale (EPDS). A cutoff score of >or=13 was used to identify women with significant depressive symptoms.

Results: Four hundred four women were enrolled, and 374 completed follow-up. Thirty women experienced pregnancy loss, leaving 344 with postpartum assessment; 307 women had complete data and were used for analyses. Thirty-six women (11.7%) scored above the EPDS screening cutoff. Controlling for significant covariates (baseline EPDS score and social support), women who participated in organized religious activities at least a few times a month were markedly less likely (OR = 0.18, 95% CI) to exhibit high depressive symptom scores. No other religiosity/spirituality measure was statistically significant.

Conclusions: Organized religious participation appears to be protective from postpartum depressive symptoms. Because this association is independent of antenatal depressive symptoms, we hypothesize that religious participation assists in coping with the stress of early motherhood.
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http://dx.doi.org/10.1089/jwh.2007.0627DOI Listing
June 2008

Religiosity, spirituality, and depressive symptoms in pregnant women.

Int J Psychiatry Med 2007 ;37(3):301-13

Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia 29203, USA.

Objective: Depression during pregnancy has potential repercussions for both women and infants. Religious and spiritual characteristics may be associated with fewer depressive symptoms. This study examines the association between religiosity/spirituality and depressive symptoms in pregnant women.

Method: Pregnant women in three southern obstetrics practices were included in a cross sectional study evaluating religiosity, spirituality, and depressive symptoms. Symptoms of depression were measured using the Edinburgh Postnatal Depression Scale (EPDS). The depression outcome was measured in two ways: the EPDS score as a continuous outcome, and a score at or above the recommended EPDS cutoff (> 14). A wide array of potential confounders was addressed. Special attention was given to the interplay between religiosity/spirituality, social support, and depressive symptoms.

Results: The mean EPDS score was 9.8 out of a maximum possible score of 30. Twenty-eight women (8.1%) scored above the recommended EPDS cutoff score. Overall religiosity/spirituality was significantly associated with fewer depressive symptoms when controlling for significant covariates, but there was a significant interaction such that the association became weaker as social support increased. Social support did not appear to be an important mediator (intermediate step) in the pathway between religiosity/spirituality and depressive symptoms.

Conclusions: Religiosity and spirituality may help protect from depressive symptoms when social support is lacking. Longitudinal research is needed to assess the directionality of the observed relationships.
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http://dx.doi.org/10.2190/PM.37.3.gDOI Listing
March 2008

Are married/cohabiting women less likely to experience pregnancy loss?

J S C Med Assoc 2007 Dec;103(9):266-7

USC School of Medicine, Columbia, SC 29208, USA.

Women who were neither married nor cohabiting were far more likely to experience pregnancy loss. The reasons for this association are unclear, and confounding due to medical, social or behavioral factors that are correlated with marital/relationship status is possible. On the other hand, our findings are consistent with a recent British study in which women who were neither married nor cohabiting had 73% greater odds of first trimester miscarriage. Based on these two studies, we recommend that clinicians who provide obstetrical care be especially vigilant to encourage healthy prenatal behaviors for patients who are not married or cohabiting.
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December 2007

Religiosity, spirituality, and tobacco use by pregnant women.

South Med J 2007 Sep;100(9):867-72

University of South Carolina School of Medicine, USA.

Background: Tobacco use during pregnancy is associated with adverse child outcomes. There is evidence that religiosity/spirituality is associated with less tobacco use. This study aims to investigate the association further, including an assessment of overall religiousness and specific aspects of religiosity/spirituality.

Methods: 404 pregnant women receiving prenatal care in three southern obstetrics practices were surveyed regarding religiosity/ spirituality, other psychosocial characteristics, and recent tobacco.

Results: Recent tobacco use was reported by 8% of study participants. In multivariable modeling, black race (OR = 0.32), social support (OR = 0.92), and overall religiousness (OR = 0.57) were significantly associated with lower odds of reporting recent tobacco use. Participation in organized religious activities and self-rated religiosity were the religious/spiritual measures most strongly associated with lower odds of tobacco use.

Conclusions: More religious/spiritual women appear to be less likely to use tobacco during pregnancy. Additional research is needed to investigate potential pathways for this association.
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http://dx.doi.org/10.1097/SMJ.0b013e318137a422DOI Listing
September 2007

A pure Sertoli cell tumor of the ovary in a 10-year-old female.

J Pediatr Adolesc Gynecol 2007 Aug;20(4):257-9

Department of OB-GYN, University of South Carolina School of Medicine, Columbia, South Carolina 29203, USA.

Study Objective: To document an unusual presentation of a pure Sertoli Cell tumor.

Design: Case report.

Results: We present a 10-year-old female who presented with abdominal pain and diarrhea with no symptoms of puberty. Surgical exploration revealed a metastatic pure Sertoli Cell tumor, which was treated with resection and chemotherapy.

Conclusion: Sertoli cell tumors are rare occurrences and should be considered in the differential diagnosis for a prepubescent girl with an abdominal mass.
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http://dx.doi.org/10.1016/j.jpag.2007.04.009DOI Listing
August 2007

Pregnancy after Essure placement: report of two cases.

Fertil Steril 2008 Mar 4;89(3):724.e9-11. Epub 2007 Jun 4.

Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, Columbia, South Carolina, USA.

Objective: To report two cases of pregnancy after placement of Essure micro-inserts.

Design: Case report.

Setting: University-based Department of Obstetrics and Gynecology.

Patient(s): Patient 1, a 38-year-old woman, presented with a positive pregnancy test 7 months after Essure hysteroscopic sterilization. Patient 2, a 35-year-old female, became pregnant approximately 1 year after undergoing the Essure procedure.

Intervention(s): Patient 1 received obstetric ultrasounds, a prophylactic cerclage, a cesarean section, and a tubal ligation. Patient 2 underwent a postprocedure hysterosalpingogram, an obstetric ultrasound, pregnancy termination, diagnostic pelvic ultrasound, and a hysterectomy.

Main Outcome Measure(s): Documentation of normal progress of pregnancy after Essure placement.

Result(s): Patient 1 carried an uncomplicated pregnancy to term with an Essure micro-insert in place. Patient 2 became pregnant despite an hysterosalpingogram showing tubal occlusion and was ultimately found to have a micro-insert perforating the uterine wall.

Conclusion(s): The presence of Essure micro-inserts in the fallopian tubes do not appear to interfere with implantation and pregnancy. Uterine perforation by an Essure micro-insert in proximity to the tubal ostia may mimic proper micro-insert placement and bilateral tubal occlusion on both hysterosalpingogram and saline infusion sonography.
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http://dx.doi.org/10.1016/j.fertnstert.2007.03.075DOI Listing
March 2008

Management quandary. Menstrual issues in a teenager with developmental delay.

J Pediatr Adolesc Gynecol 2006 Feb;19(1):53-5

University of Michigan Health Systems, Ann Arbor, Michigan, USA.

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http://dx.doi.org/10.1016/j.jpag.2005.11.008DOI Listing
February 2006

Translation squared: improving asthma care for high-disparity populations through a safety net practice-based research network.

J Asthma 2005 Jul-Aug;42(6):499-505

National Center for Primary Care at Morehouse School of Medicine, Atlanta, Georgia 30310, USA.

To assess the effectiveness of an intervention designed to increase compliance with national asthma care guidelines in primary care safety net health centers serving high-disparity patient populations, we conducted a group-randomized controlled trial (seven intervention sites and nine control sites) in federally funded community health centers in eight southeastern states. There were three components involved in the intervention: resources (asthma kits including peak flow meter, MDI spacer device, plus educational materials), training of all health center staff in asthma care guidelines, and tools or templates for practice-level systems change (asthma flow sheets and standing orders). Control group sites received only copies of the national asthma guidelines. Chart reviews were performed to determine practitioner's compliance with national guidelines for asthma care. Clinicians practicing in intervention health centers showed significantly (p < 0.01) greater improvement on some measures than did the control health centers, although postintervention compliance with guidelines was still suboptimal. Disseminating national guidelines is not enough. Providing training and guideline-specific resources, in combination with tools for practice change, improved care significantly even in safety net health centers serving high-disparity patient populations.
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http://dx.doi.org/10.1081/JAS-67598DOI Listing
December 2005

Hair thread tourniquet syndrome in adolescents: a presentation and review of the literature.

J Pediatr Adolesc Gynecol 2005 Jun;18(3):155-6

Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, 2 Medical Park, Columbia, SC 29203, USA.

Hair thread tourniquet syndrome has been recognized since the 1600s when a strangulating hair was reported around the glans penis. Since that time sporadic reports have appeared in the literature describing strangulation of appendages by human hair. Most often the constriction involves fingers, toes, or the penis. There are several reports of clitoral strangulation. Most cases present to their primary care provider or emergency department. A high index of suspicion is required for diagnosis in order to prevent prolonged devascularization. We describe a hair thread tourniquet syndrome of the labia minora in a 13-year-old. It was successfully treated with exam under anesthesia and resection of the devascularized tissue. We believe this is the oldest patient described as well as the only description of hair tourniquet syndrome of the labia minora. Prompt recognition of this unusual condition is essential for treatment of this potentially serious problem.
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http://dx.doi.org/10.1016/j.jpag.2005.03.010DOI Listing
June 2005

Communicating with the adolescent gynecology patient.

Obstet Gynecol Clin North Am 2003 Jun;30(2):251-60, v

Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, 2 Medical Park, Suite 208, Columbia, SC 29203, USA.

Providing health care to adolescents begins with good communication. Teens appreciate providers who are genuine and not parental. Guidelines to facilitate adolescent communication are presented. A good dialogue with teens can initiate a lifetime of care.
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http://dx.doi.org/10.1016/s0889-8545(03)00030-5DOI Listing
June 2003

Abnormal pap smears in adolescents.

J Pediatr Adolesc Gynecol 2003 Jun;16(3):157-66

Department of Obstetrics & Gynecology, University of South Carolina, Columbia, South Carolina 29203, USA.

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http://dx.doi.org/10.1016/s1083-3188(03)00045-7DOI Listing
June 2003

Management quandry. HPV in teenagers.

Authors:
Janice Bacon

J Pediatr Adolesc Gynecol 2003 Jun;16(3):147-8

University of Michigan Health Systems, Ann Arbor, Michigan, USA.

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June 2003

Prepubertal labial adhesions: evaluation of a referral population.

Authors:
Janice L Bacon

Am J Obstet Gynecol 2002 Aug;187(2):327-31; discussion 332

Department of Department of Obstetrics and Gynecology, University of South Carolina School of Medicine Columbia, 29203, USA.

Objective: The purpose of this study was to assess patient demographics, clinical presentation, response to previous treatment, and current evaluation of prepubertal girls referred for gynecologic care of labial agglutination.

Study Design: A retrospective chart review of all prepubertal female patients with labial agglutination referred from 1996 through 2001.

Results: Twenty-three girls were diagnosed with labial agglutination during the review period. All of the diagnoses were made by a primary care provider. At the time of referral, most patients had received medical therapy, but had not obtained resolution of their labial agglutination with topical estrogen. Twenty-two of the 23 patients required manual separation of the labial adhesions. Findings most frequently revealed a pinpoint opening and thick (3-4 mm) adhesions with >90% of the vestibule adhered in 21 of 23 girls. Nine of 23 girls had recurrence of adhesions. Four girls required a repeat manual separation because of recurrent thick adhesions. One of 4 girls required a third manual separation. Five of the 9 recurrences were treated successfully with topical estrogen.

Conclusion: Gynecologists who treat patients with labial agglutination frequently may encounter children for whom medical treatment has failed. Patients whose condition does not respond to topical therapy may have thick adhesions and require manual separation.
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http://dx.doi.org/10.1067/mob.2002.126201DOI Listing
August 2002

Advanced surgical techniques in the pediatric and adolescent patient. Roundtable discussion.

J Pediatr Adolesc Gynecol 2002 Jun;15(3):183-91

Baylor College of Medicine, Pediatric and Adolescent Gynecology, Houston, TX 77030, USA.

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http://dx.doi.org/10.1016/s1083-3188(02)00151-1DOI Listing
June 2002