When assessing a sexually active adolescent with abdominal pain and vaginal bleeding, what is a recommended interview practice?

• A. Inquire about the possibility of pregnancy in private, if possible.
• B. Obtain information from parents.
• C. Avoid questions they will feel uncomfortable answering.
• D. Treat them as adults in the exam.

Answer: (A)

Privacy during the interview is essential. When a sexually active adolescent presents with abdominal pain and vaginal bleeding, speaking with the teen alone helps them share information about pregnancy risk, sexual activity, contraception, and potential risks more honestly. This private conversation builds trust, reduces fear of judgment, and leads to a more accurate history, which is crucial for identifying possible pregnancy and guiding urgent evaluation and care. Involving parents can inhibit disclosure and delay care, asking only about non-sensitive topics can miss important details, and treating the teen as if they were an adult can overlook developmental and communication needs. So, ask about pregnancy in private, if possible, to ensure a safe and comprehensive assessment.