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Pediatric and Adolescent Gynecology Service Opens at Morgan Stanley Children's Hospital

NEW YORK (Apr 3, 2012)

Beth W. Rackow, M.D.
Beth W. Rackow, M.D.

Gynecologic problems can occur in infants, children and adolescents, and are often very different from the conditions that affect adult women. "Children and adolescents with gynecologic problems have unique needs and benefit from specialized evaluation, treatment and follow-up by a gynecologist with expertise in these disorders," notes Beth W. Rackow, M.D., Director of the new Pediatric and Adolescent Gynecology Service at NewYork-Presbyterian Morgan Stanley Children's Hospital, and Assistant Professor, Department of Obstetrics and Gynecology at Columbia University College of Physicians and Surgeons.

Dr. Rackow, who joined the Hospital in November 2011 from Yale University School of Medicine and Yale-New Haven Hospital, knew that she wanted to pursue obstetrics and gynecology while attending medical school. "During my residency in obstetrics and gynecology, I had two mentors who had a particular interest in helping the pediatric and adolescent population with their gynecologic disorders," says Dr. Rackow. "This is a distinct specialty in gynecology because most gynecologists are used to taking care of women well after puberty and into their reproductive years." Following her residency, Dr. Rackow went on to pursue a fellowship in Reproductive Endocrinology and Infertility at the Yale University School of Medicine.

"The first visit of a child or adolescent to the gynecologist should be a positive experience," says Dr. Rackow. "It's so important that gynecologic issues in young females are handled with special sensitivity and care." During an examination, Dr. Rackow ensures that the child or adolescent, as well as her parents, is comfortable and at ease. "I spend a great deal of time talking with parents to explain what's different with their child, and what the long-term implications may be, if any," she says. "I also want to make sure that they agree with the proposed treatment plan. We also provide educational resources for patients and their families."

The Pediatric and Adolescent Gynecology Service provides evaluation and management of a range of gynecologic disorders, and often works in consultation with other pediatric specialists. Specific disorders include:

  • Abnormal puberty – early or delayed sexual maturation
  • Androgen disorders – abnormal sexual hair growth (hirsutism), acne
  • Breast abnormalities
  • Chronic genital rashes, itching, vaginal discharge
  • Congenital anomalies of the female reproductive system involving the external genitalia, hymen, vagina or uterus
  • Disorders of sexual development – gonadal dysgenesis, androgen insensitivity syndrome
  • Endometriosis
  • Fertility preservation for young females with cancer
  • Genital trauma
  • Menstrual disorders
  • Ovarian cysts
  • Pelvic pain
  • Polycystic ovarian syndrome

Dr. Rackow notes that gynecologic problems in children and adolescents can be hormonal, structural or functional. "There is a range of conditions that presents in young females," she says, "and a number of these can be managed medically. Some disorders need a degree of evaluation that based on the patient's comfort – and generally for children prior to puberty – can only be accomplished while they're sleeping. These exams are performed under anesthesia in the pediatric operating room."

Some conditions, such as ovarian cysts, endometriosis, and birth defects of the reproductive tract, may require surgical intervention. "My care for these children and adolescents is focused on them having normal reproductive function, if possible, and preserving fertility," says Dr. Rackow, who is also a surgeon. "For example, if a patient has an ovarian cyst, we strive to preserve the ovary. As a specialist in reproductive endocrinology and infertility, I can care for these girls throughout their childbearing years.

"Our goal is to provide excellent evaluation and management of conditions for these young females using the multidisciplinary resources available at Morgan Stanley Children's Hospital," adds Dr. Rackow. "We have a wealth of experts in fields such as endocrinology, genetics, oncology and surgery. It's great to have so many wonderful colleagues to collaborate with and to care for these young patients."

Beyond patient care, Dr. Rackow also regards education as a key component of the mission of the Pediatric and Adolescent Gynecology Service. "I think it's critical to educate the upcoming generation of healthcare providers about the importance of early recognition and management of gynecologic disorders in children and adolescents," she says.

For more information about the Pediatric and Adolescent Gynecology Service, call the Center for Women's Reproductive Care at (646) 756-8282.

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