Utilization of a shared decision-making tool in a female infant with congenital adrenal hyperplasia and genital ambiguity

Author:

Chawla Reeti1,Weidler Erica M.2,Hernandez Janett2,Grimbsy Gwen3,van Leeuwen Kathleen2

Affiliation:

1. Attending Physician, Division of Pediatric Endocrinology , Phoenix Children’s Hospital, Clinical Assistant Professor – Child Health, UA College of Medicine – Phoenix , 1920 East Cambridge Ave, Suite 301 , Phoenix , AZ 85016 , USA

2. Division of Pediatric Surgery , Phoenix Children’s Hospital , Phoenix , AZ , USA

3. Division of Pediatric Urology , Phoenix Children’s Hospital , Phoenix , AZ , USA

Abstract

Abstract Background Shared decision-making (SDM) is the process by which patients/families and providers make healthcare decisions together. Our team of multidisciplinary disorders of sex development (DSD) has developed an SDM tool for parents and female patients with congenital adrenal hyperplasia (CAH) and associated genital atypia. What is new Elective genital surgery is considered controversial. SDM in a patient with genital atypia will allow patient/family to make an informed decision regarding surgical intervention. Case presentation Our patient is a 2.5-year-old female with CAH and genital atypia. Initially, her parents had intended to proceed with surgery; however, after utilizing the SDM checklist, they made an informed decision to defer urogenital sinus surgery for their daughter. Conclusions We successfully utilized an SDM tool with parents of a female infant with CAH and genital atypia, which allowed them to make an informed decision regarding surgery for their daughter. Future directions include a prospective enrolling study to determine the generalizability and applicability of SDM with families of children diagnosed with CAH.

Publisher

Walter de Gruyter GmbH

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism,Pediatrics, Perinatology, and Child Health

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