{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T14:28:44Z","timestamp":1774535324168,"version":"3.50.1"},"reference-count":10,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,1,20]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>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 M\u00fcllerian 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.<\/jats:p>","DOI":"10.1136\/bcr-2022-251017","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T12:10:46Z","timestamp":1675771846000},"page":"e251017","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Vaginal bleeding in a newborn as initial presentation of uterus didelphys"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3704-3309","authenticated-orcid":false,"given":"Farrah","family":"Saleh","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Lou","family":"Gaeta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4234-996X","authenticated-orcid":false,"given":"Ilona","family":"Rost","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Villa Medica M\u00f6dling, M\u00f6dling, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alla","family":"Vash-Margita","sequence":"additional","affiliation":[{"name":"Section of Pediatrics and Adolescent Gynecology; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"2025082623572909000_16.2.e251017.1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmr028"},{"key":"2025082623572909000_16.2.e251017.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.02.044"},{"key":"2025082623572909000_16.2.e251017.3","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1038\/modpathol.2011.185","article-title":"Embryonal rhabdomyosarcoma of the uterine cervix: a report of 14 cases and a discussion of its unusual clinicopathological associations","volume":"25","author":"Dehner","year":"2012","journal-title":"Mod Pathol"},{"key":"2025082623572909000_16.2.e251017.4","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1108045"},{"key":"2025082623572909000_16.2.e251017.5","first-page":"1017","article-title":"The frequency of physiologic vaginal bleeding of newborn infants","volume":"98","author":"Huber","year":"1976","journal-title":"Zentralbl Gynakol"},{"key":"2025082623572909000_16.2.e251017.6","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det359"},{"key":"2025082623572909000_16.2.e251017.7","doi-asserted-by":"crossref","first-page":"51","DOI":"10.5301\/je.5000218","article-title":"Neonatal menstruation explains epidemiological links between fetomaternal conditions and adolescent endometriosis","volume":"7","author":"Brosens","year":"2015","journal-title":"JE"},{"key":"2025082623572909000_16.2.e251017.8","doi-asserted-by":"crossref","first-page":"2","DOI":"10.31488\/jjm.1000108","article-title":"Neonatal menstruation and its meaning","volume":"1","author":"Bianchi","year":"2018","journal-title":"Jpn J Med"},{"key":"2025082623572909000_16.2.e251017.9","unstructured":"Emans SJ , Laufer MR , DiVasta AD . Emans, laufer, goldstein\u2019s pediatric and adolescent gynecology: wolters kluwer. 2019."},{"key":"2025082623572909000_16.2.e251017.10","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.jpag.2008.07.018","article-title":"Imperforate hymen and urinary retention in a newborn girl","volume":"22","author":"Sharifiaghdas","year":"2009","journal-title":"J Pediatr Adolesc Gynecol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-251017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:57:41Z","timestamp":1756277861000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-251017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2,7]]},"published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1136\/bcr-2022-251017"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-251017","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2]]}}}