Monday, November 14, 2011

Overanxious Parents

At a two-week visit, parents bring their newborn into your office, worried because she has had a few days of bloody mucoid vaginal discharge. A week later, this has resolved.

Challenge: What's the physiology?


city said...

normal bleeding 2/2 to withdraw from estrogen rich environment. maternal estrogen promoted fetal endometrial thickening, which is now sloughing off.

Anonymous said...

maternal estrogen withdrawal

Craig Chen said...

you are both right! well done
Overanxious Parents

This is neonatal withdrawal bleeding. During intrauterine life, maternal estrogen crosses the placenta and can cause growth of a female fetus’ endometrial lining. After birth, these hormone levels wane and the endometrial lining sloughs off.

Source: UpToDate.