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Case Reports: Unusual association of diseases/symptoms
Vaginal bleeding in a newborn as initial presentation of uterus didelphys
  1. Farrah Saleh1,
  2. Mary Lou Gaeta2,
  3. Ilona Rost3 and
  4. Alla Vash-Margita4
  1. 1Department of Obstetrics, Gynecology and Reproductive Science, Yale School of Medicine, New Haven, Connecticut, USA
  2. 2Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
  3. 3Department of Gynecology, Villa Medica Mödling, Mödling, Austria
  4. 4Section of Pediatrics and Adolescent Gynecology; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Dr Alla Vash-Margita; alla.vash-margita{at}yale.edu

Abstract

Vaginal bleeding of the newborn is described as a normal phenomenon, occurring physiologically in a subset of baby girls as a response to decreased oestrogen levels in the postnatal period compared with in utero exposure. Here, we present the case of heavy vaginal bleeding prompting an evaluation via transabdominal ultrasound, which was ultimately diagnostic for uterus didelphys. We suggest that neonates with uterus didelphys are predisposed to heavy bleeding due to relatively larger amount of the endometrial tissue in two cavities. While diagnosis of Müllerian anomalies is typically made in adulthood, an earlier diagnosis facilitates timely medical and surgical intervention and prompts screening for concurrent and associated conditions. In summary, we recommend routine consideration of transabdominal ultrasound to investigate abnormal vaginal bleeding in the newborn.

  • Reproductive medicine
  • Neonatal health
  • Congenital disorders

http://dx.doi.org/10.1136/bcr-2022-251017

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    Footnotes

    • Contributors Supervised by AV-M. Case written by FS. Intellectual input from IR and MLG. Patient was under the care of MLG and AV-M.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.