Introduction: Disorders of sexual development (DSDs) are estimated to occur in 1 in 4500 births. This potentially represents one baby born every other day in the UK. We aim to explore how Mersey foundation and paediatric trainees deal with newborn babies with possible DSD and identify if there is a need for further training in this subject.
Methods: An online survey composed of 10 questions was distributed amongst foundation and paediatric trainees in Mersey deanery. The questions targeted history taking, examination, investigations and management.
Results: About 51 trainees completed the questionnaire. About 9(18%) were foundation and 42(82%) were paediatric trainees. Half of respondents (53%) were unaware of the local DSD pathway.
Only 18% reported that they would include all of the relevant points in history taking. About 14% reported that they would not know what questions to ask if they were faced with a baby with possible DSD. About 53% of trainees were unsure what to look for in their clinical examination. About 84% of trainees would refer the suspected DSD babies to urologist, 4% would refer to the general practitioner, 6% would arrange for follow up in general paediatric clinic and only 6% would refer to the DSD coordinator. About 75% of the trainees appropriately would not assign a gender until proper parental counselling and involvement from endocrine and urology teams. About 84% would also correctly monitor serum electrolytes until CAH excluded with 84% requesting an abdominal ultrasound. About 69% would check the 17-hydroxy-progesterone level after first 48 hours of babys life. However reassuringly, 90% would get their on-call consultant to be involved with parental counselling. About 94% expressed a need for more training in this subject.
Conclusion: This survey illustrates a gap in foundation and paediatric trainees knowledge about what to ask and what to look for in babies with suspected DSD and a worrying lack of knowledge of local policy on the management. It was reassuring that 90% of the trainees would seek advice from a senior. We plan to repeat this survey among other professionals who perform baby checks including senior doctors and to include information on DSD in our junior doctor teaching and training programme.
23 - 25 Nov 2016
British Society for Paediatric Endocrinology and Diabetes