{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:48:04Z","timestamp":1782888484681,"version":"3.54.5"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:p>Vaginal bleeding is a common reason for the referral of young girls for pediatric endocrinology and\/or gynecology consultations. A physical examination should be performed, with particular attention paid to breast development and growth acceleration suggestive of precocious puberty. In the absence of pubertal signs and a vulvovaginal cause of bleeding on physical examination, pelvic ultrasound is a reasonable, cost-effective first choice for imaging. We report here 2 rare cases of prepubertal uterine bleeding in young girls with an enlarged uterus on ultrasound, highly suggestive of precocious puberty but completely discordant with the concentration of estradiol, which was undetectable. Pelvic magnetic resonance imaging (MRI) and a dedicated ultrasound examination with a high-frequency probe made it possible to diagnose the rare condition of uterine venous malformation. In this clinical setting, discordance between conventional ultrasound features suggestive of precocious puberty and negative hormonal assessment results should lead to MRI. Indeed, MRI is the gold standard imaging tool for the diagnosis and evaluation of the extension of such venous malformations, which can be suggested using a high-frequency probe demonstrating venous myometrial ectasia.<\/jats:p>","DOI":"10.1542\/peds.2025-071026","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T20:02:22Z","timestamp":1751486542000},"source":"Crossref","is-referenced-by-count":2,"title":["Uterine Venous Malformation as a Rare Cause of Prepubertal Vaginal\u00a0Bleeding"],"prefix":"10.1542","volume":"156","author":[{"given":"Kevin","family":"Perge","sequence":"first","affiliation":[{"name":"1H\u00f4pital Femme M\u00e8re Enfant, Service d\u2019Endocrinologie P\u00e9diatrique et P\u00e9diatrie G\u00e9n\u00e9rale, Hospices Civils de Lyon, Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Storey","sequence":"additional","affiliation":[{"name":"2Pediatric Endocrinology-Diabetology Department, Reference Center for Rare Growth and Development Endocrine Diseases, Assistance Publique-H\u00f4pitaux de Paris, Universit\u00e9 de Paris Cit\u00e9, Robert Debr\u00e9 University Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Fraissenon","sequence":"additional","affiliation":[{"name":"3Departement of Fetal and Pediatric Imaging, Centre de R\u00e9f\u00e9rence des Anomalies Vasculaires Superficielles, Hospices Civils de Lyon, Universit\u00e9 Claude Bernard, Lyon, France"},{"name":"4Departement of Pediatric Imaging, Nord University Hospital, Universit\u00e9 Jean Monnet, Saint Etienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabel","family":"Paye-Jaouen","sequence":"additional","affiliation":[{"name":"5Department of Pediatric Surgery and Urology, Maladies Endocriniennes de la Croissance et du D\u00e9veloppement, Assistance Publique-H\u00f4pitaux de Paris, Universit\u00e9 Paris Cit\u00e9, Robert-Debr\u00e9 University Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cabet","sequence":"additional","affiliation":[{"name":"3Departement of Fetal and Pediatric Imaging, Centre de R\u00e9f\u00e9rence des Anomalies Vasculaires Superficielles, Hospices Civils de Lyon, Universit\u00e9 Claude Bernard, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Alison","sequence":"additional","affiliation":[{"name":"6Department of Pediatric and Fetal Imaging, Robert-Debr\u00e9 University Hospital, Assistance Publique-H\u00f4pitaux de Paris, Universit\u00e9 de Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Guibaud","sequence":"additional","affiliation":[{"name":"3Departement of Fetal and Pediatric Imaging, Centre de R\u00e9f\u00e9rence des Anomalies Vasculaires Superficielles, Hospices Civils de Lyon, Universit\u00e9 Claude Bernard, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9mence","family":"Delcour","sequence":"additional","affiliation":[{"name":"7Department of Obstetrics and Gynecology, Assistance Publique-H\u00f4pitaux de Paris, Universit\u00e9 de Paris Cit\u00e9, Robert Debr\u00e9 University Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"issue":"5","key":"2025091113132896500_r1","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jpag.2023.06.002","article-title":"Clinical review: prepubertal bleeding","volume":"36","author":"Bloomfield","year":"2023","journal-title":"J Pediatr Adolesc Gynecol."},{"key":"2025091113132896500_r2","doi-asserted-by":"crossref","first-page":"l6597","DOI":"10.1136\/bmj.l6597","article-title":"Precocious 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