Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-06-16T14:26:10.481Z Has data issue: false hasContentIssue false

2 - Indeterminate genitalia

Published online by Cambridge University Press:  05 July 2014

Anne Garden
Affiliation:
University of Lancaster
Mary Hernon
Affiliation:
Leighton Hospital, Crewe
Joanne Topping
Affiliation:
Liverpool Women’s Hospital
Get access

Summary

Many people believe that the management of children born with disorders of sexual differentiation is the major management problem in paediatric gynaecology. In fact, it forms only a small part of the practice of a paediatric gynaecologist, occurring in about one in 4500 births. The paediatric gynaecologist is but one member of the multidisciplinary team involved in the care of such children and their parents that includes a paediatric endocrinologist, neonatologist, paediatric surgeon, paediatric urologist, clinical geneticist, clinical psychologist and, if available, social work, nursing and medical ethicist.

The first question asked by parents following delivery of their child is ‘What sex is it?’ Not to be able to answer that question is extremely distressing for all concerned and requires sensitive and informed care. Initial management should include giving the parents as full an explanation as possible but they should be warned that it may take some time before a complete answer can be given, although the information required to assign the sex of rearing is usually available within 48–72 hours.

Embryological development

A degree of knowledge of the development of the internal and external genitalia is required to understand the clinical appearance of the child at birth. Chromosomal sex is determined at fertilisation and depends on whether the ovum is fertilised by a sperm bearing an X or a Y chromosome. Until about 6–7 weeks of gestation, the embryo develops in the same manner, irrespective of gender, and both sexes have both wolffian and müllerian ducts.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×