Ambiguous Genitalia

Country‐based reference values and international comparisons of clitoral size in healthy Nigerian newborn infants

“…It is well established that for normal mammalian reproductive tract development to occur, a number of specific molecular events must occur in an orderly sequence at specific gestational stages .…”

“…During embryogenesis, the foetus contains both female (müllerian) and male (wolffian) genital tracts . Müllerian ducts give rise to the fallopian tubes, uterus and the upper third of the vagina, while the wolffian ducts develop into the vas deferens, epididymides and seminal vesicles .…”

Clitoral size in term newborns in Kumasi, Ghana

“…Congenital adrenal hyperplasia (CAH) is the most common cause of virilization of a female foetus. Failure to identify and treat this disorder results in potentially fatal adrenal crisis, an avoidable outcome if the endocrine emergency is correctly diagnosed and treated [ 2 ]. Since the technique of analyzing 17-hydroxyprogesterone (17-OHP) in filter paper blood samples was developed by Pang et al [ 3 ] in 1977, the utility of newborn screening for CAH has been amply demonstrated and several developed countries have established a newborn screening programme [ 4 – 7 ].…”

“…Propitiously, females with classical CAH usually have ambiguous genitalia or clitoromegaly which may be readily detected by genital examination [ 2 ]. Hospital statistics at the study site indicate that about 9000 - 12,000 babies are delivered annually in the hospital, with about 16 - 18% of these being preterms.…”

Gender assignment: whose decision is it?

“…Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders which are attributed to be the commonest cause of virilization in a girl (1). 21hydroxylase deficiency accounts for approximately 95% of CAH of which about 75% are of the salt losing type or classic CAH (2).…”