Gynecological Examination of a Newborn
The examination is conducted as described above. The genitalia are submitted to maternal estrogen effects. Estrogenization signs decrease as of the second week of life and disappear within 6–8 weeks. The labia minora are thick, protruding and sometimes longer than the labia majora. The mucosa is pink and covered with physiologic leukorrhea. The clitoral hood may also be relatively thick, and the size of the clitoris must be assessed by palpation after the clitoral hood has been pulled up. The hymen may be thick, pouting and fimbriated. The orifice is sometimes difficult to visualize and the physician must then use a small urethral catheter to confirm the presence of an opening. The vagina measures 4 cm in length. The vaginal mucosa is thick and covered with pH-acid white physiologic secretions including lactobacilli. Over the first 10 days of life, there may be neonatal vaginal bleeding.