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pseudomenses

We have a 4 day old female patient- with quite a bit of brown/red vaginal
drainage. Unremarkable pregnancy/delivery. This is not mucoid in appearance.
Initial labwork is normal (CBC, Pt/Ptt). There is very little in the
literature pertaining to pseudomenses.
The baby at 5 days is still having the same amount of vaginal secretion. She
is gaining weight, and appears normal in all other aspects.
Have any of you also seen this much vaginal secretion in a newborn? This is
more than the Peds and I have seen before.
Thank you for your input!
Diane Langton, RNC, MSN, PNP-C

pseudomenses

Message from Vicki L Soloniuk hidden@email-address

Yes, I've actually seen this enough over the last 18 years that I warn parents
about it on discharge. It happens due to withdrawal from mom's female hormones
after birth, anecdotally I think it is more common in bottle babies, is just like
a menstrual period and lasts about 3, sometimes 4, days. If it is really copious,
you may want to consider bleeding disorders but I've never seen one bad enough to
work up.

Vicki

Diane Langton wrote:

> We have a 4 day old female patient- with quite a bit of brown/red vaginal
> drainage. Unremarkable pregnancy/delivery. This is not mucoid in appearance.
> Initial labwork is normal (CBC, Pt/Ptt). There is very little in the
> literature pertaining to pseudomenses.
> The baby at 5 days is still having the same amount of vaginal secretion. She
> is gaining weight, and appears normal in all other aspects.
> Have any of you also seen this much vaginal secretion in a newborn? This is
> more than the Peds and I have seen before.
> Thank you for your input!
> Diane Langton, RNC, MSN, PNP-C
>

pseudomenses

Diane,
I have seen this on several occaisions and like Vicki I routinely
counsel families about it prior to discharge from the nursery. We will have
several parents each year who come within the first week or so with this
complaint, sometime worried that the baby has been injured in some way.

Stephanie Dewar, M.D.
Youngstown, Ohio

pseudomenses

At 08:02 PM 11/29/2001 -0500, hidden@email-address wrote:
>Diane,
> I have seen this on several occaisions and like Vicki I routinely
>counsel families about it prior to discharge from the nursery. We will have
>several parents each year who come within the first week or so with this
>complaint, sometime worried that the baby has been injured in some way.
>
>Stephanie Dewar, M.D.

I might have misinterpreted the initial post, but the impression I got was
that this wasn't the normal mild first-week vaginal bloody discharge we're
all familiar with, but such a copious amount that it seemed out of the
ordinary.

Michael K. Sachs, M.D.
General Pediatrician

re: pseudomenses

Thank you for your responses. Yes, the amount of pseudomenses is unusual.
This newborn literally looks like she's having her menses. The discharge
appears a reddish-brown. She appears healthy otherwise. Initial labs - a CBC
and PTT/PT were normal. I've worked with newborns for 15 years. The Peds in
my office haven't seen this amount either. Very interesting case.
Diane (PNP)

pseudomenses

I don't see it much because it's something I routinely warn parents about at discharge from the nursery. They will occasionally tell me that it happened when I see them at the 2 week visit. Usually stops within a few days.

Moshe Adler, MD

pseudomenses

Diane,
Just a few weeks ago I had a similar situation with a 6 day old,
except hers was bright red and obvious on EVERY diaper change for
about 4-5 days. I was concerned because it was so bright red and
didn't start until day 6. I also did a bleeding workup, posted the
question to my other list serve and had a few write back and say that
they had experience the same--although rare. She is now one month
old and never had reoccurance. Of course you also have to make sure
that you know exactly that the blood is from the vagina and that
there is no abuse. (horrible thought but important!)

Dianna Tolen, M.D.
hidden@email-address
Kids First Pediatric Care
Canfield, Ohio

pseudomenses => Normal

Al sorts of problems result from being hooked up to a pregnant woman for 9 months!
Withdrawal bleeding is a normal event in infant girls and no workup needed. Just
like both sexes can have breast milk, the girls can have menstruation. The
equipment is the same in infants and adults. Just needs the hormones that mom
provides. Same reason for neonatal acne.
-gb
----- Original Message -----
From: "Dianna Tolen"
To:
Sent: Thursday, November 29, 2001 8:59 PM
Subject: Re: pseudomenses

Diane,
Just a few weeks ago I had a similar situation with a 6 day old,
except hers was bright red and obvious on EVERY diaper change for
about 4-5 days. I was concerned because it was so bright red and
didn't start until day 6. I also did a bleeding workup, posted the
question to my other list serve and had a few write back and say that
they had experience the same--although rare. She is now one month
old and never had reoccurance. Of course you also have to make sure
that you know exactly that the blood is from the vagina and that
there is no abuse. (horrible thought but important!)

Dianna Tolen, M.D.
hidden@email-address
Kids First Pediatric Care
Canfield, Ohio

pseudomenses => Normal

Graham,
Normally I agree, I have seen lots of newborns with mild withdrawl
bleeding too, and yes, I also councel the parents to expect some as
being mormal. But in this case it wasn't just spotting, it was
RUNNING. When I did her exam it actually had a trickle out of the
vagina. That is what worried me, I don't usually see that much or
that bright red. I think that is what Diane was taking about also.

On 29 Nov 2001, at 21:27, Graham Barden wrote:

> Al sorts of problems result from being hooked up to a pregnant woman
> for 9 months! Withdrawal bleeding is a normal event in infant girls
> and no workup needed. Just like both sexes can have breast milk, the
> girls can have menstruation. The equipment is the same in infants and
> adults. Just needs the hormones that mom provides. Same reason for
> neonatal acne. -gb -----
>
>

Dianna Tolen, M.D.
hidden@email-address
Kids First Pediatric Care
Canfield, Ohio