2025 – PAGE 98 – OB/GYN AND SOME STDs

VAGINAL DISCHARGE AT BIRTH

In an otherwise well baby, if you note pink or white vaginal discharge in the perinatal period, that is OKAY. It’s probably due to mom’s ESTROGEN. If, however, you note signs of bleeding or petechiae, consider VITAMIN K DEFICIENCY.

LABIAL ADHESIONS (PENILE ADHESIONS for boys)

LABIAL ADHESIONS (or PENILE ADHESIONS for boys) usually resolve without intervention. If they are present in a girl and she has dysuria, treat using ESTROGEN cream.

BARTHOLIN GLAND CYSTS

In patients with Bartholin gland cysts, look for a large and tender vulva, along with a sebaceous cyst. The cyst will look flesh-colored and arise from the skin. This is painful but is not associated with discharge, bleeding, or STDs.

SEXUAL ABUSE IN GIRLS

If you diagnose an STD in a child, consider SEXUAL ABUSE.

• PEARL: Look for clues in the question that the patient has been abused—perhaps something about a child who has a babysitter or even a relative who acts as the caretaker during the day.
• PEDICULOSISPUBIS = CRABS = LICE
• GONORRHEA
• CONDYLOMA ACUMINATA (HPV)
• CHLAMYDIA
• NOTE: Chlamydia can be due to vertical transmission and can be culture positive up to 3 years of age