Pediatric and Adolescent Gynecology is often poorly taught because it is multidisciplinary and tends to fall between departments. Traditional teaching falls into rigid compartments with obstetric-gynecology trainees rarely seeing children and pediatric trainees often neglecting the female reproductive system having been inadequately taught what to look for. Nevertheless, the young ob/gyn patient presents unique problems which are different from the mature woman. This includes the spectrum of illnesses, development, approach, management, and effect on later life and fertility. Malignant tumors, for example, have different pathology, management and response to chemotherapy. The adolescent gynecology consultation is uniquely challenging and the quality of the advice and counselling the patient receives is of the utmost importance. Crucial issues at this time of life relate to the risks of sexual activity, teenage pregnancy, contraception and STDs. Accurate recognition and sensitive management of child sex abuse is also a highly problematic and challenging area.
The specialty certification boards in obstetrics-gynecology and pediatrics have recognized the historic problem of teaching and assessment in this field and now have examination questions on the subject. Consequently, a good textbook at trainee level is desperately needed which sets the context and explains the most important parts of the subject, without attempting to be an exhaustive reference for the sub-specialist as most of the other books are. This book is a practical and concise clinical guide to patient care which is user friendly and brings readily accessible help for common problems. It ranges form the commonest problem (vulvovaginitis) through to the less common but urgent problems including the newborn with ambiguous external genitalia, the prepubertal child with vaginal bleeding due to anovulatory dysfunctional uterine bleeding and possible vaginal rhabdomyosarcoma, and the adolescent with severe vaginal bleeding and pregnancy complications (miscarriages, ectopic pregnancy). It emphasizes diagnosis and management and each chapter has an outline and summary. Each chapter follows a clear structure: 1. outline of chapter 2. summary of chapter - quick review of essential details 3.
body of chapter for in depth review when there is time 4. fewer than 60 references, recent and reviews Separate section of "Quick-Takes" for instant diagnostic possibilities. It is designed for the obstetrician-gynecologist, pediatrician, and adolescent medicine and primary care physician. In short, for all doctors who are likely to come across gynecological problems in children and adolescents. It will also be of great value in related fields such as urology, general surgery, psychiatry, dermatology, public health, law and education. It will be a referral source for medical personnel including social service, nurse practitioners and physician's assistants.
Albert Altcheck, MD, Clinical Professor of Obstetrics, Gynecology and Reproductive Science; Chief of Pediatric and Adolescent Gynecology; Attending Obstetrician/Gynecologist, Mount Sinai School of Medicine, New York City, USA.