Journal of pediatric and adolescent gynecology最新文献

{"title":"Providing contraception to trans youth: a qualitative study investigating the acceptability of DMPA-SC and prior experiences with contraceptive counseling.","authors":"Nicholas R W Cleland, Charlie E Graves, Lauren M Reade, Natalie J Nokoff, Ryan P O'Connell, Nancy Z Fang","doi":"10.1016/j.jpag.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.008","url":null,"abstract":"<p><strong>Introduction: </strong>The transgender and gender diverse (TGD) population continues to face unmet healthcare needs, especially when pertaining to sexual and reproductive health (SRH). When receiving care, TGD individuals may face discrimination or receive care that does not affirm their gender identity or is rooted in cisgender, heteronormative assumptions. This qualitative study sought to understand the experiences and perspectives of TGD youth surrounding contraceptive use and counseling, and investigate acceptability of self-administered subcutaneous depot medroxyprogesterone acetate (DMPA-SC).</p><p><strong>Methods: </strong>We conducted semi-structured focus groups and individual interviews to understand what drove initiation and discontinuation of contraceptives, specifically DMPA-SC. We recruited 35 TGD individuals assigned female at birth, with median (IQR) age of 17.5 (2.75) years. Twenty-one participants completed focus groups and 10 completed individual interviews. Interviews were conducted virtually and analyzed using rapid thematic analysis.</p><p><strong>Results: </strong>We identified four themes: (1)Dysmenorrhea and dysphoria associated with menses that were alleviated by DMPA; (2)DMPA seen as the best method for menstrual suppression; (3)Negative experiences with previous primary care providers (PCPs); the importance of language and a desire for individualized care regarding SRH.</p><p><strong>Discussion: </strong>The SRH needs of TGD individuals differ from their cisgender counterparts. Historically, the primary endpoint for contraceptive studies focused on preventing pregnancies. Assuming this as the primary goal for TGD individuals can be harmful to the provider-patient relationship and lead to avoidance of care. When providing contraceptives at the intersection of gender identity and sexual orientation, counseling should be tailored towards an individual's unique SRH needs.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility Attitudes of Adolescents and Young Adults with Turner Syndrome and Their Parents/Guardians: A Pilot Cross-Sectional Survey Study.","authors":"Tazim Dowlut-McElroy, Victoria O Hyunh, Lauren Roth, Madeline Ross, Anne-Marie Priebe, Jacqueline C Yano Maher, Veronica Gomez-Lobo","doi":"10.1016/j.jpag.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.002","url":null,"abstract":"<p><strong>Study objective: </strong>To compare differences in attitudes between adolescents and young adults with Turner syndrome (AYA with TS) and their parents regarding future fertility and fertility preservation.</p><p><strong>Design: </strong>1) FertilityConcepTS survey development with a two-staged Delphi procedure. 2) Cross-sectional survey study.</p><p><strong>Setting: </strong>1) Web-based focus groups. 2) Survey dissemination during the multidisciplinary Turner syndrome clinic at a tertiary care children's hospital and via the social media platform of the Turner Syndrome Global Alliance.</p><p><strong>Participants: </strong>Members of the Turner syndrome community.</p><p><strong>Main outcome measures: </strong>Attitudes about 1) Interest in understanding the effects of TS on fertility and pregnancy, 2) Opinions of having children that are genetically similar, 3) Alternative methods of building a family, and 4) Medical/surgical fertility preservation procedures with unknown outcomes.</p><p><strong>Results: </strong>28 participants were included in the analysis. The median age of AYA with TS was 17.5 (IQR 10.5) years and of parents was 48.0 (IQR 9.3) years. AYA with TS and their parents differed in their consideration for adoption (p=.005), use of donor egg (p<.001), use of a gestational carrier (p<.001) and raising a child as a single parent (p=.002). Although all parents agreed/strongly agreed with oocyte cryopreservation (OC) and ovarian tissue cryopreservation (OTC), 18.8% and 43.8%, of AYA with TS, respectively, disagreed/strongly disagreed with OC (p=.042) and OTC (p=.021).</p><p><strong>Conclusions: </strong>In this pilot study, AYA with TS and their parents have differing attitudes about fertility and fertility preservation. Counselling should include consideration of the needs of AYA with TS alongside parent priorities.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of No-Test Medication Abortions in Primary Care: A Roadmap from an Adolescent and Young Adult Medicine Clinic.","authors":"J R, A B, C G, L M, S B, M Rf","doi":"10.1016/j.jpag.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.014","url":null,"abstract":"<p><strong>Study objective: </strong>Over two years post-Roe, 22 states have banned or significantly limited abortion access, exacerbating existing structural barriers to abortions for adolescents and young adults (AYA) including cost, transportation, parental notification requirements, and confidentiality concerns. We provide a roadmap and demonstrate the feasibility of implementing no-test medication abortions (MABs) to expand abortion access in an adolescent-focused pediatric primary care setting.</p><p><strong>Methods: </strong>An interdisciplinary team in an AYA-focused primary care clinic developed and implemented a no-test MAB protocol. Iterative rounds of protocol development engaged stakeholders including hospital leadership, OBGYN consultants, nursing, and program directors for residency, fellowship, and nursing trainees. Frequent interdisciplinary debriefs identified facilitators, barriers, and solutions to optimize care.</p><p><strong>Results: </strong>Over 6 months, we identified clinic champions, built relationships with key stakeholders, developed clinic protocols, and disseminated MAB clinical training. In our first 6 months of implementation, we provided 4 MABs. Facilitators identified by staff included provider expertise in AYA development and patient and parent preferences for MABs in their medical home. System-level barriers (e.g. timely scheduling challenges), staff factors (e.g. fear of complications), and patient factors (e.g. ambivalence about pregnancy) were identified. Solutions developed included establishing scheduling procedures, formalizing consultative pathways with gynecology, and integrating social work support.</p><p><strong>Conclusion: </strong>It is feasible for adolescent primary care practices to provide no-test MABs. Through interdisciplinary planning and iterative design, barriers from the health system, clinic staff, and patient levels can be identified and addressed, expanding equitable access to safe, AYA-focused abortion care.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidradenitis Suppurativa in the Pediatric and Adolescent Population.","authors":"Natalie Hickerson, Hadar Lev-Tov, Sara Danker, Judith Simms-Cendan","doi":"10.1016/j.jpag.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.007","url":null,"abstract":"<p><p>Hidradenitis Suppurativa (HS) is a complex disease that manifests with nodules, abscesses, and tunnels in the intertriginous regions of the body. Symptoms often begin after adrenarche and may progress to severe disease with draining tunnels and permanent scars, leading to a significant reduction in quality of life and mental health. Diagnostic delays are common, increasing the risk of disease progression. Timely diagnosis and effective management are essential to the prevention of complications in the pediatric and adolescent population. This review will cover the currently available information on pathophysiology, risk factors, presentation, diagnosis, and management of HS in this population.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescents, Abortion, and Reproductive Justice: An Unpostponable Debt.","authors":"Marisa Labovsky","doi":"10.1016/j.jpag.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.015","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female Genital Mutilation/Cutting: A Systematic Review of Global Patterns, Sociocultural Drivers, and Health Consequences.","authors":"Xu Zihan, Chen Xinyue, Yu Jianping, Yi Hu","doi":"10.1016/j.jpag.2025.09.009","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.009","url":null,"abstract":"<p><strong>Study objective: </strong>This review aims to systematically examine the global distribution, health consequences, and sociocultural drivers of female genital mutilation/cutting (FGM/C), with the aim of informing targeted elimination strategies.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Web of Science, and Elsevier Science Direct from inception to July 2025 for studies examining FGM/C prevalence patterns, determinants, and health effects. Eligible studies were in English, addressed at least one of the review's thematic domains, and had ethics approval. Data from 329 articles were extracted and synthesized within the Socio-Ecological Model framework.</p><p><strong>Results: </strong>FGM/C is mainly practiced in Africa (with national prevalence exceeding 80% in some countries) and persists within immigrant diaspora communities in Europe, North America, and Australia. While prevalence has declined in regions such as East Africa, progress has stalled in parts of West Africa and Sudan. Key drivers include limited education, deep-rooted social and religious norms, marital and economic incentives, and poverty. Legal bans exist in over 80 countries, yet enforcement gaps, cultural resistance, and medicalization hinder elimination. Across all four WHO-defined types, FGM/C is linked to acute and chronic physical complications (e.g., hemorrhage, urogenital injury, obstetric morbidity), profound psychological sequelae (e.g., PTSD, depression, sexual dysfunction), and substantial economic burden on healthcare systems.</p><p><strong>Conclusions: </strong>Eliminating FGM/C requires integrated, context-specific strategies that combine strong legislation, community engagement, educational initiatives, and expansion of survivor-centered medical and psychosocial care. Linking these actions to broader Sustainable Development Goals could accelerate progress toward ending FGM/C by 2030.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perforated rotated mesenteric cyst presenting as acute abdominal pain in a female paediatric patient: a case report.","authors":"Valerie Josephine Dirjayanto, Astrid Indrafebrina Sugianto, Riana Pauline Tamba","doi":"10.1016/j.jpag.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.011","url":null,"abstract":"<p><strong>Introduction: </strong>While more than half of the cases are asymptomatic or mild in symptoms, mesenteric cysts can present clinically and radiologically similar to gynaecologic diseases.</p><p><strong>Case illustration: </strong>A female child presented with worsening episodes of abdominal pain 1 day before admission. Abdominal x-ray suggested mechanical obstruction of the small bowel, and CT scan suggested ileal abnormality.</p><p><strong>Discussion: </strong>During open surgery, we found two rotated chylous mesenteric cysts, accompanied with adhesions and jejunal perforation 57 cm from the ligament of Treitz. Cysts excision, adhesiolysis, ileo-ileal resection, and anastomosis were performed.</p><p><strong>Conclusion: </strong>While rare and challenging to identify, mesenteric cysts should be kept in the differential diagnosis in female children presenting with abdominal pain.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond PCOS: An Unusual Presentation of Type A Insulin Resistance Syndrome.","authors":"Maja Cehic, Tatjana Milenkovic, Sladjana Todorovic, Katarina Mitrovic, Sanja Panic Zaric, Dimitrije Cvetkovic, Rade Vukovic","doi":"10.1016/j.jpag.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.013","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is commonly seen in adolescent polycystic ovary syndrome (PCOS). However, severe IR with polycystic ovaries in non-obese adolescent girls should prompt suspicion for causes other than typical PCOS.</p><p><strong>Case: </strong>A 16-year-old normal-weight girl presented with polyuria and polydipsia, along with irregular periods, hirsutism, and acanthosis nigricans. Her clinical presentation, laboratory results and ultrasound findings suggested severe PCOS with type 2 diabetes, but the pronounced degree of IR prompted further investigations. Genetic testing identified a heterozygous deletion in the INSR gene, confirming type A insulin resistance syndrome (TAIRS).</p><p><strong>Summary: </strong>This case highlights the importance of considering genetic insulin receptor abnormalities in atypical PCOS presentations, especially in non-obese adolescents with severe IR. Early recognition is crucial for appropriate management and genetic counselling.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving minimally invasive surgical approaches to large adnexal masses in pediatric gynecology: combining mini-laparotomy with single port laparoscopy.","authors":"Megan F Sumida, Olivia K Winfrey, Julie Hakim, Jennifer E Dietrich","doi":"10.1016/j.jpag.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.012","url":null,"abstract":"<p><p>In pediatric populations large ovarian cysts are often benign, and minimally invasive approaches are preferred to minimize perioperative pain and recovery, allow for same day discharge, and improve incision cosmesis. Ovarian preservation is also prioritized and cystectomy is preferred over oophorectomy. While tactile sensation and dexterity are improved in mini laparotomy cases, there are limitations with visualization that are improved with laparoscopy. We describe a technique that employs both diagnostic laparoscopy and mini laparotomy using the GelPOINT Mini™ Advanced Access Platform for single site laparoscopy in pediatric patients. This case series includes cysts ranging 7-24 cm with benign preoperative risk stratification, in patients aged 3 to 16 years, who underwent successful same-day, ovarian-sparing surgery with the benefits of both open and laparoscopic procedures.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitude, and practice of parents of children aged 9-15 years for human papillomavirus vaccine and vaccination in Guangdong Province, China.","authors":"Yijing Wang, Nuomin Sun, Binglin Chen, Mengfei Liu, Ruming Bu, Gang Liu","doi":"10.1016/j.jpag.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.09.010","url":null,"abstract":"<p><strong>Study objective: </strong>In China, HPV vaccination coverage among young girls is relatively low, with parental knowledge, attitude, and practice (KAP) significantly influencing their daughters' vaccination decisions. To enhance vaccination rates, Guangdong Province has implemented a free vaccination policy for the bivalent HPV vaccine for eligible girls. This study aimed to assess the KAP levels of parents in Guangdong with daughters aged 9-15 regarding HPV vaccine and HPV vaccination and identify associated factors.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted from April 21 to 29, 2022, recruiting 4,976 parents in Guangdong Province. Socio-demographic characteristics and KAP levels were analyzed using frequencies and percentages. The Chi-square test compared KAP differences across various socio-demographic groups, while multivariable logistic regression identified factors associated with KAP.</p><p><strong>Results: </strong>The sample included 1,837 fathers (36.98%) and 3,130 mothers (63.02%). The overall correct response rate of knowledge, attitude and practice questions was 80.91%, 79.05% and 66.26% respectively. 71.41% of parents demonstrated \"good\" knowledge, 40.69% exhibited \"positive\" attitude toward vaccination, and 56.79% reported \"favorable\" practice. Mothers, those aged 35 or older, and individuals with university/college -level education or above were more likely to show \"good\" knowledge and \"positive\" attitude, though they also exhibited \"unfavorable\" practice. Additionally, parents employed in public institutions and being married tended to have better KAP.</p><p><strong>Conclusion: </strong>While parents in Guangdong display high knowledge and positive attitude towards HPV vaccine and HPV vaccination, inconsistencies exist between their knowledge, attitude, and practice. Future interventions should focus on well-designed educational campaigns with clear messaging and timely, transparent communication through trusted sources, in order to promote favorable practice alongside improving parental knowledge and attitude.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}