P52Ultrasonographic diagnosis of an approach to a case with intrauterine clitoromegaly
Bibliographic record
Abstract
Introduction Adrenal androgens are one of the important determinants of sexual differentiation in fetal period. Increased circulating levels of adrenal androgens as seen in congenital adrenal hyperplasia, interact with genital skin androgen receptors and induce clitoral enlargement, fusion of labial folds and cause migration of the urethral‐vaginal perineal orifice resulting in ambiguous genitalia. We are reporting a female newborn with clitoromegaly from a nulliparous mother at term pregnancy. Case report The mother was followed up from 22 weeks of gestation with no signs of hyperandrogenism. Because of late application for antenatal follow up and since clitoromegaly was observed at 29 weeks of pregnancy, amniocentesis could not be done. During ultrasonographic evaluation at 29 weeks of gestation, clitoris with a size of 13 × 18 mm was detected and dexamethasone 1 × 0.5 mg orally was started to use. In reevaluation at 33 weeks of gestation clitoral size was measured as 4.8 × 6.8 mm and treatment was stopped. At 40 weeks of gestation a female neonate with 10–10 apgar scores, weighing 4040 g was delivered with caesarian section due to cephalopelvic disproportion. After delivery physical examination of the neonate revealed clitoral measurements consistent with clitoromegaly. Hyperandrogenic state of the case persists and evaluation of the newborn is going on in Pediatrics Clinic. Discussion Although adrenal androgen secretion starts at 6–8 weeks of gestation and dexamethasone therapy was shown to be effective in regression of virilization if it was used as early as 6–8 weeks of gestation, our case was diagnosed later in the course of pregnancy. But when similar regimen was applied similar result was obtained. So we propose that patients with intrauterine virilization signs like clitoromegaly and ones with risk of congenital adrenal hyperplasia should take glucocorticoid therapy whenever it is determined in order to ameliorate genital ambiguity in female fetuses.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".