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- Title
Neonatal uterine bleeding as antecedent of pelvic endometriosis.
- Authors
Brosens, Ivo; Brosens, Jan; Benagiano, Giuseppe
- Abstract
We elaborate on a new theory to explain pelvic endometriosis, including endometriosis in premenarcheal girls, based on the finding that the neonatal endometrium can display secretory activity immediately after birth and, in some cases, changes analogous to those seen at menstruation in adults. The neonatal uterus is therefore capable of shedding its endometrium. Indeed, occult vaginal bleeding occurs in a majority of neonates, although overt bleeding is estimated to occur in only 5% of neonates. This may be due to functional plugging of the endocervical canal in the neonate, which in turn would promote retrograde flux of endometrial cells contained in menstrual debris. Ectopic endometrial implantation in a newborn with hydrometrocolpos has been documented. These data, coupled with the observation of a significantly increased risk of endometriosis in adolescents with cervical outflow obstruction and patent Fallopian tubes, indicate that endometriosis, especially in children and young adolescents, may originate from retrograde uterine bleeding soon after birth.
- Subjects
UTERINE hemorrhage; ENDOMETRIOSIS; NEWBORN infant care; MENSTRUAL cycle; HYDRAULIC measurements
- Publication
Human Reproduction, 2013, Vol 28, Issue 11, p2893
- ISSN
0268-1161
- Publication type
Article
- DOI
10.1093/humrep/det359