A Pregnant Adolescence with an Intact Hymen

Abstract

Child sexual abuse is a public health problem due to both the act itself and its consequences, one of the most serious of which is adolescent pregnancy. Unfortunately, it is difficult to provide evidence of such sexual crimes by forensic gynecologic examinations based on only the visual inspection of genitalia. Moreover, anatomic variations of genitalia can make it quite difficult for a physician to make a diagnosis of rape. A 14-year-old pregnant girl presented at our hospital with the allegation of sexual abuse. Although her pregnancy was obvious due to shape of her abdomen, her hymen was determined to be intact after examination. She was examined in the gynecology department to check on the pregnancy and investigate her health status. Ultrasound imagining revealed that she was 4 months and 3 days pregnant. The goal of this presentation is to draw physicians’ attention to the anatomic variations of the hymen. Our findings indicate that it is not always easy to make a diagnosis of sexual intercourse; the practitioner must take a multidisciplinary approach and develop his/her genital examination knowledge and skills.