{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:15:56Z","timestamp":1768403756890,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006388","name":"H\u00f4pitaux Universitaires de Gen\u00e8ve","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006388","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["P400PM_199338"],"award-info":[{"award-number":["P400PM_199338"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to describe the clinical features and investigations of vaginal bleeding in prepubertal children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective case series of children under the age of 10 who presented with vaginal bleeding to our institution between 2018 and 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 32 cases identified during the timeframe, with a mean age of 5.5\u2009years (standard deviation 3.2\u2009years, range 5.5\u2009days to 9.6\u2009years). Vulvovaginitis was the most common diagnosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a012, 37.5%), followed by precocious puberty (<jats:italic>n<\/jats:italic>\u00a0=\u00a05, 15.6%). Uncommon but serious causes were vaginal rhabdomyosarcoma (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), and sexual abuse (one patient presenting with gonorrhoea and one with a non\u2010accidental injury). Vaginoscopy was performed in nine patients (28.1%) for various reasons, and a vaginal foreign body was identified in two patients (6.3%). All the patients who had a serious cause of bleeding (neoplasm or sexual assault) or who required specific treatment (precocious puberty, lichen sclerosus, urethral prolapse) presented with red flags on history and\/or examination: recurrent episodes of vaginal bleeding, heavy bleeding, associated general symptoms (poor feeding and growth), presence of thelarche, abdominal mass, associated profuse vaginal discharge and abnormal genital examination (skin changes, urethral prolapse or protruding mass from the vagina).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A thorough history\u2010taking and clinical examination aiming at identifying red flags may help to discriminate between benign causes of vaginal bleeding, where no further investigations are indicated, and alternative diagnoses with a poor outcome and\/or requiring specific treatment and additional investigations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16366","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T09:59:20Z","timestamp":1675763960000},"page":"653-659","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Vaginal bleeding in children: A retrospective audit at a tertiary paediatric gynaecology service"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-8769","authenticated-orcid":false,"given":"Natalie","family":"Drever","sequence":"first","affiliation":[{"name":"Department of Paediatric and Adolescent Gynaecology The Royal Children's Hospital Melbourne  Melbourne Victoria Australia"},{"name":"College of Medicine and Dentistry James Cook University  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Peek","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescent Gynaecology The Royal Children's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6987-4916","authenticated-orcid":false,"given":"Dehlia","family":"Moussaoui","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescent Gynaecology The Royal Children's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amira I","family":"Dkeidek","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescent Gynaecology The Royal Children's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5183-2892","authenticated-orcid":false,"given":"Sonia R","family":"Grover","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescent Gynaecology The Royal Children's Hospital Melbourne  Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0000000000000290"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000398"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1989.tb02424.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2018-316218"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2019-0494"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2018.08.003"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2022-251303"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2019.03.007"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2015.10.017"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2020.01.152"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2019.11.009"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(94)02305-I"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.76.1.43"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1978.tb15590.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-3500"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2015.05.004"},{"key":"e_1_2_8_18_1","first-page":"871","volume-title":"Textbook 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