The scope of pediatric and adolescent gynecological problems in Kuwait.

OBJECTIVE To establish an insight into pediatric and adolescent gynecological disorders encountered in a tertiary care center in Kuwait. SUBJECTS AND METHODS A retrospective case cohort review of 89 case records of patients under the age of 19 years who were admitted to the Maternity Hospital, Kuwait, from October 2002 through September 2003 was undertaken. For a variety of reasons, 35 patients were excluded and the remaining 54 patients constituted the study population. The patients were divided into 5 groups (A-E): group A = ovarian cysts, group B = disorders of pregnancy, group C = menstrual disorders, group D = gynecological infections and group E = miscellaneous. The clinical presentation and management of patients were analyzed. RESULTS The following spectrum of gynecological disorders was obtained: 13 ovarian cysts (24.1%), 28 disorders of pregnancy (51.8%), 4 menstrual disorders (7.4%), 2 infections (3.7%) and 7 miscellaneous cases (13.9%). Of the 54 patients, 36 (66.7%) were Kuwaitis and the remaining 18 (33.3%) were non-Kuwaitis. The mean age of the study population was 15.16 years, the median was 15.5 years, and the range was 8-19 years. The mean age of the patients with disorders of pregnancy was 17.52 +/- 1.16 years, which is significantly higher than that of groups A, C and E (p = 0.007, 0.0001 and 0.05). The main presenting symptoms at admission were vaginal bleeding: 31 (57.4%), abdominal pain: 17 (31.5%), abdominal mass: 10 (18.5%), and vomiting: 10 (18.5%). Ultrasonography revealed that dermoid cysts were the most frequently encountered ovarian cysts. Patients were hospitalized for 1-7 days. CONCLUSION Disorders of pregnancy and ovarian cysts were the most frequently encountered pediatric/adolescent gynecological disorders. It is recommended that there should be a dedicated specialized clinic to guarantee privacy and centralized discreet care for these patients.