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性发育障碍患者向成人医疗的过渡:妇科医生的作用。

Transition to Adult Care in Persons With Disorders of Sexual Development: The Role of the Gynecologist.

作者信息

Amies Oelschlager Anne-Marie, Muscarella Miriam, Gomez-Lobo Veronica

机构信息

University of Washington School of Medicine, Seattle, Washington; the Accord Alliance Advocacy Advisory Network/Disorders of Sex Development Translational Research Network, Los Angeles, California; and MedStar Washington Hospital Center/Children's National Medical Center, Washington, DC.

出版信息

Obstet Gynecol. 2015 Oct;126(4):845-849. doi: 10.1097/AOG.0000000000001034.

Abstract

Disorders of sexual development (DSD) are a spectrum of conditions diagnosed in infancy resulting from atypical development of the external genitalia, in adolescence resulting from atypical pubertal development, or in adulthood as a result of infertility. Obstetricians may be the first health care providers to identify a disorder of sexual development in the fetus or newborn and should be part of the interdisciplinary team assembled to best care for these patients. Gynecologists must be familiar with the diagnosis and management of these conditions in late adolescence and adulthood. The creation of DSD "centers of excellence" may provide optimal care for individuals with these conditions but many will live too far from such centers and need to be followed by local gynecologists. The purpose of this commentary is to emphasize important medical and psychological issues so gynecologists can provide optimal care for their patients with DSD conditions.

摘要

性发育障碍(DSD)是一系列在婴儿期因外生殖器发育异常而被诊断出的病症,在青春期因青春期发育异常而出现,或在成年期因不孕不育而引发。产科医生可能是最早识别胎儿或新生儿性发育障碍的医疗保健人员,应成为为这些患者提供最佳护理的跨学科团队的一员。妇科医生必须熟悉这些病症在青春期晚期和成年期的诊断和管理。设立DSD“卓越中心”可为患有这些病症的个体提供最佳护理,但许多人居住的地方离此类中心太远,需要由当地的妇科医生进行跟踪治疗。本评论的目的是强调重要的医学和心理问题,以便妇科医生能够为患有DSD病症的患者提供最佳护理。

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本文引用的文献

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Exome sequencing for the diagnosis of 46,XY disorders of sex development.外显子组测序用于诊断46,XY性发育障碍
J Clin Endocrinol Metab. 2015 Feb;100(2):E333-44. doi: 10.1210/jc.2014-2605. Epub 2014 Nov 10.
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Practice changes in childhood surgery for ambiguous genitalia?小儿两性畸形手术的实践有变化吗?
J Pediatr Urol. 2014 Oct;10(5):934-9. doi: 10.1016/j.jpurol.2014.01.030. Epub 2014 Mar 5.

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