Paediatrics and Adolescent Gynaecology

1. The PAG Unit accepts referrals of the following from within HCTM UKM / HPKK / from other hospitals in Malaysia (both government and private and NGOs) and internationally;
• Female patients between the ages of newborn till age 21 years old with gynaecological problems
• Female patients between the ages of 10-18 years with obstetric problems
• Patients with suspected Disorders / Differences of Sex Development of any age with or without gender issues
2. Patients attending the PAG clinics require a letter of referral from the referring doctor.
3. Every PAG patient attending the PAG clinics require their height and weight measurements recorded in the medical files at every visit and an ultrasound scan of their pelvis at least once.
4. Every new case referred to the PAG clinic can be clerked by the medical officer / Fellow, however the case needs to be discussed with the Consultant PAG in charge of the clinic to ensure the appropriate management is provided.
5. Follow up cases need to be discussed with either the Consultant or Specialist in the clinic.
6. All cases requiring surgery or referral to other disciplines need to be discussed with the Consultant PAG in charge of the clinic.
7. Any cases that are planned for discharge from the PAG clinics (no more follow ups) are required to be discussed with the Consultant in charge of the clinic.

1. Each case needs to be discussed with the Consultant PAG in charge prior to the surgery.
2. If possible and available, each patient under the age of 18 years should be admitted to an isolation ward in the O&G wards so the parent / guardian can accompany them during their hospital stay. The patients may also be warded in the general paediatric / paediatric surgical wards.
3. The intravenous fluids and medicines given to the patients has to be at the appropriate dosages according to the patients’ ages and weights, thus consultation with the paediatricians and paediatric surgeons should be done prior to administration and these to be recorded in the medical files.
4. The rules and regulations pertaining to each patient has to be in accordance with the rules and regulations of the hospital at that time, for example at present each patient admitted for surgery requires screening for covid infection.

1. Each case referred either from Emergency Department or SCAN team or other departments or within O&G department needs to be discussed with the Consultant PAG in charge.
2. If a police report has been / needs to be lodged, the perineal examination needs to be done in the presence of the investigating officer, the medical officer / fellow in charge needs to organize this.
3. The OSCC box should be made available during the examinations either in OT or treatment rooms to enable the necessary swabs / forensic specimens to be taken and forensic documents to be completed and signed by the Consultant and Specialist in charge.
4. Each case that requires a perineal examination should be done together with the Consultant / Specialist in charge.
5. The required consent forms signed by parents / guardians should be filed in the medical files.
6. Each case should be given a follow up appointment at the PAG clinic at the appropriate time to review results and be updated on the wellbeing of the patient and the progress of her case.