{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T20:49:20Z","timestamp":1760906960796},"reference-count":29,"publisher":"Springer Publishing Company","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neonatal Network"],"published-print":{"date-parts":[[2010,3]]},"abstract":"When recognized in the extremely premature infant in the delivery room, ambiguous genitalia is a devastating diagnosis. It can be even more so, if the diagnosis is made several weeks later. The case study reported here illustrates this point. A 24-week Twin B infant born with multiple congenital anomalies was originally thought to be a male. After two weeks, assessment by an astute bedside nurse revealed that the infant\u2019s genitalia were not consistent with those of other 24-week males. A complete workup followed. Twin B was indeed a female with ambiguous genitalia and a high cloacal anomaly. Faced with the uncertainty of ambiguous genitalia, many parents feel emptiness, grief, and guilt. This article differentiates among the various intersex disorders and their treatments, and discusses physical findings, embryologic development, incidence, and treatment plans for male pseudohermaphroditism, true hermaphroditism, gonadal dysgenesis, and female pseudohermaphroditism. Current management strategies are contrasted with protocols of the 1950s to show changes over time.<\/jats:p>","DOI":"10.1891\/0730-0832.29.2.63","type":"journal-article","created":{"date-parts":[[2011,11,16]],"date-time":"2011-11-16T14:39:53Z","timestamp":1321454393000},"page":"63-73","source":"Crossref","is-referenced-by-count":2,"title":["Ambiguous Genitalia: A Case Study Involving a 24-Week-Gestation Twin B"],"prefix":"10.1891","volume":"29","author":[{"given":"Robin","family":"Snyder","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"793","published-online":{"date-parts":[[2010,3,1]]},"reference":[{"key":"1","unstructured":"Intersex Society of North America. (2008). How common is intersex? Retrieved December 28, 2009, from http:\/\/www.isna.org\/faq\/frequency<\/a>"},{"key":"2","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.7863\/jum.2006.25.11.1489","article-title":"Two-and 3-dimensional sonographic diagnosis of a vesicorectal fistula in cloacal dysgenesis sequence.","volume":"25","author":"A. Dulay","year":"2006","journal-title":"Journal of Ultrasound in Medicine"},{"key":"3","first-page":"279","article-title":"Genitalia","volume-title":"Handbook of physical measurements","author":"J. Hall","year":"2006"},{"key":"4","first-page":"283","article-title":"Testosterone levels in plasma and testes of neonatal mice.","volume":"30","author":"I. 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Griffiths","year":"1995","journal-title":"Journal of Pediatric Surgery"},{"key":"8","doi-asserted-by":"crossref","DOI":"10.1385\/1-59259-421-2:231","article-title":"Neurogenic bladder and bowel","volume-title":"Pediatric urology","author":"Z. Al-Zuniga","year":"2003"},{"key":"9","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1056\/NEJMra022784","article-title":"Sex determination and differentiation.","volume":"350","author":"D. MacLaughlin","year":"2004","journal-title":"The New England Journal of Medicine"},{"key":"10","volume-title":"Before we were born: Essentials of embryology and birth defects","author":"K. Moore","year":"1993"},{"key":"11","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/S0889-8529(05)70049-9","article-title":"Disorders of sexual differentiation.","volume":"27","author":"G Warne","year":"1998","journal-title":"Endocrinology and Metabolism Clinics of North America"},{"key":"12","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1136\/adc.2002.011312","article-title":"Early assessment of ambiguous genitalia.","volume":"89","author":"A. Ogilvy-Stuart","year":"2004","journal-title":"Archives of Disease in Childhood"},{"key":"13","article-title":"Consensus statement on management of intersex disorders.","volume":"118","author":"P. Lee","year":"2006","journal-title":"Pediatrics"},{"key":"14","volume-title":"Essentials of genetics for nurses.","author":"B. Muir","year":"1983"},{"key":"15","unstructured":"Wilson, T. A. (2008). Congenital adrenal hyperplasia. eMedicine Specialties.<\/i> Retrieved October 28, 2008, from http:\/\/emedicine.medscope.com\/article\/919218-diagnosis<\/a>"},{"key":"16","unstructured":"American Academy of Pediatrics, Committee on Genetics. (2000). Evaluation of the newborn with developmental anomalies of the external genitalia. Pediatrics, 106<\/i>, 138\u2013142."},{"key":"17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.5144\/0256-4947.2000.49","article-title":"Male pseudohermaphroditism: etiological evaluation, surgical treatment and the incidence in relation to inguinal hernia.","volume":"20","author":"A. Al-Salem","year":"2000","journal-title":"Annals of Saudi Medicine"},{"key":"18","unstructured":"Brown, D. E. (2007). A singleword: STOP.<\/i> Retrieved September 12, 2009, from http:\/\/www.healthyplace.com\/gender\/inside-intersexuality\/ambiguous-genitalia-stop-gender-assignment\/menu-id-1432\/<\/a>"},{"key":"19","unstructured":"Tomasulo, J. P. (2007). Ambiguous genitalia.<\/i> Retrieved September 9, 2009, from http:\/\/yourtotalhealth.ivillage.com\/ambiguous-genitalia.html<\/a>"},{"key":"20","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1016\/j.juro.2008.03.110","article-title":"Complete androgen insensitivity: The role of the surgeon.","volume":"180","author":"J. Purves","year":"2008","journal-title":"The Journal of Urology"},{"key":"21","unstructured":"Encyclopedia of Genetic Disorders. (2006). Hermaphroditism. Retrieved June 11, 2009, from http:\/\/www.enotes.com\/genetic-disorders-encyclopedia\/hermaphroditism<\/a>"},{"key":"22","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/BF00215675","article-title":"The role of the sex-determining region of the Y chromosome (SRY) in the etiology of 46,XX true hermaphroditism.","volume":"88","author":"G. Berkovitz","year":"1992","journal-title":"Human Genetics"},{"key":"23","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1053\/j.sempedsurg.2005.01.008","article-title":"Evaluation and management of the abnormal gonad.","volume":"14","author":"S. Bidarkar","year":"2005","journal-title":"Seminars in Pediatric Surgery"},{"key":"24","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/pd.1371","article-title":"Neonatal outcome of a prenatally detected 46,XX\/46,XY true hermaphrodite.","volume":"26","author":"C. Chen","year":"2006","journal-title":"Prenatal Diagnosis"},{"key":"25","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1093\/bmb\/ldn015","article-title":"Turner syndrome and clinical treatment.","volume":"86","author":"B. Hjerrild","year":"2008","journal-title":"British Medical Bulletin"},{"key":"26","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/j.1471-0528.2008.01703.x","article-title":"Swyer syndrome: Presentation and outcomes.","volume":"115","author":"L. Michala","year":"2008","journal-title":"BJOG: An International Journal of Obstetrics and Gynaecology"},{"key":"27","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.jpedsurg.2005.11.070","article-title":"Rare association of female pseudohermaphroditism, phallic urethra, and posterior cloaca.","volume":"41","author":"M. Macarthur","year":"2006","journal-title":"Journal of Pediatric Surgery"},{"key":"28","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.beem.2007.11.001","article-title":"Disorders of sex development: A new definition and classification.","volume":"22","author":"I. 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