Neonatal Uterine Bleeding and Adolescent Endometriosis

In: Endometriosis in Adolescents · 2020 · pp. 359–366 · doi:10.1007/978-3-030-52984-0_18 · W3102218440
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Neonatal uterine bleeding, occurring in 3.3–61.3% of female neonates, is influenced by fetal hypoxia and features endometrial morphology that may predispose to endometriosis via retrograde shedding.

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This chapter reviews neonatal uterine bleeding occurring on postpartum days 3–7, drawing on incidence data from German, French, and Serbian literature and on an autopsy description of newborn endometrium. It reports that visible bleeding occurs in 3.3–5.3% of female neonates and occult bleeding detected via hemoglobin testing in 25.4–61.3%, with lower incidence in preterm infants than in postmaturity and higher incidence reported in preeclampsia, and it proposes that fetal hypoxia may influence bleeding. The authors note that newborn uterine morphology may favor retrograde dissemination of menstrual shedding and references hypotheses that endometrial stem/progenitor cells present in neonatal menstruation could be linked to early-onset endometriosis, while the evidence is largely drawn from secondary literature and historical autopsy findings. This paper is centrally about endometriosis — it links neonatal uterine bleeding and neonatal endometrial physiology to the early onset of endometriosis in adolescents.

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Abstract

Neonatal uterine bleeding occurs in the 3rd–7th day postpartum. Little attention is paid to it. Data are available in the German, French, and Serbian literature. The reported incidence of visible vaginal bleeding occurs in 3.3–5.3% of the female neonates, while the incidence of occult bleeding by testing Hgb was 25.4–61.3%. The incidence of 0.78% in preterm newborns was statistically lower than the incidence of 9.10% in the case of postmaturity and the reported incidence of 42% in the case of preeclampsia. It is likely that fetal hypoxia influences the occurrence of a neonatal uterine bleeding. The autopsy study by the Harvard pathologists Ober and Bernstein (1955) has shown that in 5% of the newborns the endometrium is progestational (decidual or menstrual), 27% secretory, and 68% proliferative. The morphology of the uterus in the newborn with a small corpus and a long cervical channel, blocked by a mucus plug, favors retrograde spreading of menstrual sheddings. It has been suggested that stem/progenitor cells are present in neonatal menstruation and may be linked to the early onset of endometriosis. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2020 Springer Nature Switzerland AG About this chapter Cite this chapter Gordts, S., Gordts, S., Puttemans, P., Campo, R., Brosens, I. (2020). Neonatal Uterine Bleeding and Adolescent Endometriosis. In: Nezhat, C.H. (eds) Endometriosis in Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-030-52984-0_18 Download citation DOI: https://doi.org/10.1007/978-3-030-52984-0_18 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-52983-3 Online ISBN: 978-3-030-52984-0 eBook Packages: MedicineMedicine (R0)

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