Promoting awareness of neonatal menstruation

Paola Bianchi, Giuseppe Benagiano, Ivo Brosens
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2017 · vol. 33(3) , pp. 173–178 · doi:10.1080/09513590.2016.1259408 · PMID:28079409 · W2571881054
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This review explains neonatal uterine bleeding as an indicator of fetal distress caused by progesterone resistance and its potential link to later-life conditions like endometriosis.

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Abstract

Neonatal uterine bleeding (NUB) has been carefully studied in the past through case reports, small series, clinical cohort studies, pathology investigations of fetal and neonatal. Following a historical recount, this review summarizes biological mechanisms conditioning NUB, starting from the persistence till birth of an 'ontogenetic progesterone resistance' (OPR), causing decreased responsiveness of target tissues to bioavailable progesterone. Several pregnancy-related conditions, such as preeclampsia, fetal growth restriction, prematurity, post-maturity and even Rhesus or ABO incompatibility, influence the occurrence of NUB. It seems therefore that the phenomenon is precipitated by chronic fetal distress. When present, OPR may persists until telarche; as a consequence, if pregnancy occurs in early teenage, the disorder known as "defective deep placentation" may ensue, increasing the risk of obstetrical syndromes. In the presence of NUB, retrograde shedding into the peritoneal cavity of endometrial stem/progenitor and niche cells may occur. There, given the right environment, these cells can survive and become activated at the time of telarche, causing the specific phenotype of early-onset endometriosis. In conclusion, neonatal menstruation is a fetal distress indicator and can alter the incidence of a variety of pathological conditions later in life. For this reason, it should be carefully recorded and the parents informed.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Menstruation Disturbances Models, Biological Neglected Diseases Uterine Hemorrhage Age of Onset Endometriosis Endometriosis Endometrium Endometrium Endometrium Female Fetal Diseases Fetal Diseases Fetal Distress Fetal Distress Humans Infant, Newborn Menstruation Disturbances Menstruation Disturbances

Citation neighborhood

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References (24)

Cited by (16)

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License: CC0 · commercial use OK