Decidual Cast – Symptoms and Causes

Decidual Cast – Symptoms and Causes

8 Vaginal Bleeding Questions and Concerns Discussed

Pregnant women often experience unusual bodily changes that may at times worry them. From painfully sensitive breasts to abdominal pain and bloating, losing hair, or bad breath they cannot get rid of. These can all occur during pregnancy and are relatively harmless when taken care of. Nevertheless, they do cause discomfort and may interfere with daily activities.

Another more worrying symptom that some pregnant women get is decidual bleeding. Decidual casts followed by cramping are, and some mild pain is things that 20% to 30% of women usually get during their first trimester without any health implications.

Before visiting your doctor for an examination, you may want to do some research on the internet. Scientific publications state that you should do a pregnancy test when you experience vaginal bleeding or uterine bleeding that is not your period. Even if you are taking contraception, getting pregnant or having an ectopic pregnancy is still possible.

Once you confirm that your bleeding is a decidual cast, you should know that the leading cause for this is the decidua. It is material around the embryo known as maternal bed lining the embryo, helping it maintain position.

At some point in the first trimester, part of the decidua tissue is shed and causes something we know as a decidual cast. Shedding of the uterus lining is not something most women experience, so if you notice bleeding or a cast during your pregnancy, you should visit your gynecologist immediately.

They need to rule out ectopic pregnancy. Often, a decidual cast may mimic an intrauterine gestational sac and fetal pole in a patient with ectopic pregnancy, so getting an examination on time is vital.

What is Decidual Cast?


Going further in-depth into decidual casts, this is how it is defined in official internet scientific publications. The medical term for the symptoms related to a decidual cast moving from inside your uterus to outside your body is membranous dysmenorrhea. It is vital to understand that a decidual cast occurs when a large piece of tissue passes through your vaginal canal.

A decidual cast can also affect menstruating women, but it is usually more often recorded during pregnancies. But no matter at what stage of your life you get decidual cast, the experience can be highly uncomfortable. It causes cramping and pain as the piece of cast moves through your uterine cavity.

Because of the bleeding and the appearance of the decidua, some women mistake it for their periods when in reality, they should get immediate care from their physician.

Symptoms of the Decidual Cast

Generally, symptoms related to this condition go away after the decidual cast exits the body if it’s not related to another condition. There isn’t a single known cause of a decidual cast, but it may be related to hormonal contraception, elevated progesterone, or ectopic pregnancies.

The decidual casts are very similar to spotting or bleeding during the initial stages of pregnancy. This is why women are often confused and cannot tell the difference.

Since up to 30% of women will suffer from some form of bleeding during the first trimester, it is crucial to know the signs. When shedding the lining of the uterus, you will notice brown or pink discharge. If it’s new blood, the spotting will be lighter in color while old will give you thicker, brown discharge.

Another sign of the cast leaving your uterine cavity is bleeding, abdominal pain, and severe menstrual cramps. Once the symptoms of dysmenorrhea pass, you will expel a triangular mass and close to the shape of the uterine.

This mass used to be the uterus lining once, as was one piece before passing through your uterine cavity. So, it will feel fleshy as it is made of tissue. Some people report seeing fragments instead of as a single piece of tissue. This mass features small, fibrous clots passed through the cavity.

How Do the Symptoms of a Decidual Cast Differ From Those of a Miscarriage?

Photo of sad pregnant woman with painful feelings standing isolated over white background. Looking camera.

Dysmenorrhea is often mistaken for a miscarriage or vice versa because it takes the exact shape of the uterine and causes similar symptoms: cramping, pain, or vaginal bleeding, and significant tissue expulsion. Contact your doctor if you think you might be pregnant and experience these symptoms.

What Causes the Decidua Cast?

Data shows that hormonal changes in the body cause decidual cast. During pregnancy, a woman’s hormonal levels will fluctuate rapidly. All these changes in progesterone and human chorionic gonadotrophin help the body prepare for the growing child inside the womb. Experts state that women who took contraceptives may experience stronger cramps with the casts at any point in life.

Of course, the oral contraceptive pill isn’t a direct cause for shedding the uterus lining, but it is more prevalent in women who took it. After all, contraceptives do cause a hormonal imbalance.

Before a woman gets her period, her hormones rise, and the uterus thickens. Then, once the egg in the uterus isn’t fertilized, shedding of the uterine lining leads to bleeding. If bleeding occurs at the expected time of menstruation during the first few months of pregnancy, you’re likely dealing with a decidual cast.

8 Questions and Concerns

Blood and pregnancy are always a cause for concern. A few concerns and questions you may have include:

Can You Shed Your Uterine Lining and Still Be Pregnant?

Yes, to an extent. The bleeding shouldn’t be overly heavy, and it’s something you want to discuss with your doctor immediately. Any bleeding is a concern, and a doctor is required to ensure your baby’s life isn’t at risk.

What happens is that the lining hasn’t had a chance to attach to the placenta fully. So, small parts of the mass will be expelled by the body, causing bleeding. This usually is not a cause for concern.

How Long Will the Bleeding Last?

The bleeding is short-lived and won’t last as long as your usual period. If you’re experiencing bleeding during the first few weeks of pregnancy, the condition is not a decidual cast. This may be due to progesterone imbalance, and you should take a pregnancy test just in case.

When Does Decidual Cast Occur?

Due to the nature of this bleeding, casts occur during the typical days of a menstrual cycle. If you’re supposed to have your period from January 1 until the 7th, bleeding might occur between the 1st and 7th.

Decidual bleeding occurs before the formation of the placenta. In most cases, this will only happen during the initial stages of pregnancy, and the area that’s being expelled usually isn’t a health risk for you or the baby.

Should Spotting be Concerning?

Yes. Before a woman’s first ultrasound, there is a chance of spotting or bleeding. The concern is that this bleeding is caused by an early miscarriage or an ectopic pregnancy. Since the ultrasound hasn’t been performed, there is a chance that an intrauterine pregnancy is occurring.

If you notice spotting or bleeding of any kind, it’s always best to see a medical professional.

You may be shedding your uterine lining, or there’s a chance you’re suffering from pregnancy complications or a miscarriage that might have an adverse health effect.

What Color is the Blood?

The uterus is already rich in blood, so when you begin to bleed, the color of the blood may be red, dark red, or brown. If you experience pink bleeding, it is often mixed with a bodily fluid that dilutes the blood’s color.

7.   Could I Be Having My Period?

Possibly. It’s a cause for concern any time you have bleeding when pregnant. Women may suffer from slight bleeding (as previously discussed), but if the decidual cast is heavy or extended, contact your doctor. Regular periods are not something a woman will have if she’s pregnant because of the high progesterone.

8.   Is Implementation Decidual?

No. Implementation bleeding occurs when the egg attaches to the uterine wall. It causes slight bleeding, which leaves behind spotting only. This happens much earlier than decidual bleeding, and it’s rare, too. Just one-third of women state they had implementation bleeding.

Treatment Options

belly of a pregnant woman and a flower

There are no over-the-counter treatment options available. Bleeding, especially during pregnancy, can be cause for concern. You need to seek medical treatment to ensure that the bleeding is not something more serious.

Your doctor may recommend things like:

  • Bed rest
  • Activity changes
  • Lifestyle changes
  • Dietary adjustments

If a hormonal imbalance is causing the issue, your doctor will recommend medicine or vitamins to balance hormones.

In case of bleeding, there is a chance that you’re suffering from:

  • Hormonal abnormalities
  • Lupus
  • Diabetes
  • Infections
  • Stress
  • Uterus abnormalities

Proper tests and diagnosis are recommended. A doctor will sit down and check the possible causes and risks for a miscarriage and if your family has a history of bleeding from the endometrium.

Most women don’t see their doctor when decidual bleeding occurs, and the symptoms go away in just a day or two. If the bleeding persists or gets heavier, you’ll want to call your doctor immediately because there might be a negative effect on your health.

Your doctor should monitor your health closely. Bleeding endometrium may be a sign of an early miscarriage. If you suspect that you’re having pregnancy complications, discuss these concerns with your doctor. Women with a history of miscarriages should consult with their physician to discuss ways to reach full term.