Decidual bleeding is a term for a partial shedding of the uterine lining during the first few months of pregnancy. This bleeding can be similar to a menstrual period and can occasionally prevent women from realizing that they are pregnant until other signs develop. Although this kind of bleeding is usually harmless, most experts recommend that pregnant women inform their doctors about any form or amount of vaginal bleeding as it can be a sign of more serious conditions.
During early pregnancy, quick hormonal shifts in the body can cause ovulation or the thickening of the uterine lining despite the presence of a fertilized egg. Around the time of a women’s normal menstrual period, the lining can shed, resulting in bleeding. For some women, the amount of blood released can resemble an normal period. For this reason, some experts recommend that anyone with other pregnancy signs, such as regular nausea, increased breast size or tenderness, or sudden weight gain, take a pregnancy test even if menstrual cycles appear normal. If an over the counter test proves positive despite the presence of bleeding, consider consulting a doctor for a more accurate confirmation of pregnancy.
Decidual bleeding is sometimes confused or used synonymously with implantation bleeding, another phenomena of early pregnancy. Implantation bleeding is characterized as a light spotting that is the result of the egg implanting in the uterus. Like decidual bleeding, implantation bleeding can cause women to believe they are not pregnant and are experiencing a normal menstrual period. Because of this similarity, and the fact that both types of bleeding are considered largely harmless, both implantation and decidual bleeding are often referred to collectively as first-trimester bleeding.
In most cases, this condition is not harmful to either the mother or fetus. Although figures vary, some experts suggest that harmless vaginal bleeding occurs in up to 30% of pregnancies. Most women who experience this type of bleeding during pregnancy go on to have healthy pregnancies and deliveries.
Despite the relative harmlessness of this type of bleeding, most experts urge that women experience any bleeding during pregnancy inform a health care provider immediately. Bleeding can be a sign of several conditions that can adversely affect health, such as cervical cancer, impending miscarriage, ectopic or molar pregnancies, or cervical or vaginal infections. If bleeding continues longer than a day or is heavy, a doctor may request an examination to check the health of both mother and fetus and rule out possible complications.
How Do I Know If I Have Decidual Bleeding?
Decidual bleeding presents differently for every woman because it looks and feels a lot like a normal period. Some women may experience minimal spotting while others have moderate bleeding, though most notice more clots than they get with a typical period. Women may also experience cramping and abdominal pain.
The only way to know for sure that a woman is experiencing decidual bleeding instead of a normal period is to take a pregnancy test. It’s advisable to see a general physician or OB/GYN for evaluation to ensure that the woman and fetus are both healthy.
Women who experience heavy bleeding should see a physician as soon as possible. Excessive bleeding can be a symptom of other health conditions, like a vaginal infection, ectopic pregnancy, or early signs of miscarriage.
What Color Is Decidual Bleeding?
Decidual bleeding is typically light red to crimson, though some have brownish-colored blood. Women who experience other colors of discharge or who notice an odd or foul smell should seek medical attention as soon as possible to rule out other conditions.
How Long Does Decidual Bleeding Last?
Decidual bleeding can last anywhere from a few days up to a few weeks. It’s important to see a physician for evaluation and guidance, especially if the bleeding becomes heavy.
How Often Does Decidual Bleeding Occur?
It can occur monthly, like a normal menstrual cycle. Since decidual bleeding is the uterine wall shedding, it looks and feels like a regular period. Consequently, decidual bleeding can prevent women from knowing they are pregnant for the first several months.
How Do You Stop Decidual Bleeding?
There is no treatment because decidual bleeding usually resolves itself when the uterine wall stops shedding. Depending on the individual and their underlying conditions, a physician may prescribe hormonal treatments to correct an imbalance.
What Is Decidual Cast?
Decidual cast, or membranous dysmenorrhea, refers to the body shedding a large, solid clump of tissue. During a normal menstrual cycle, the body gradually sheds the uterine lining over several days, but with a decidual cast, it happens all at once. The body passes the entire lining in one piece, so it looks like a replica of the woman’s uterus.
Passing such a large amount of solid tissue can be extremely painful with overall bodily discomfort, vaginal bleeding, and cramping. However, once the cast passes, the symptoms should resolve quickly. The decidual cast should appear shiny and fleshy with pinkish coloring with mucus and blood mixed in with the tissue.
While decidual bleeding is common, a decidual cast is extremely rare. Due to the lack of known cases, there is little information about the condition or what causes it to happen. Currently, the medical community believes that ectopic pregnancy and hormonal birth control pills are the leading causes.
What Should You Do If You Pass a Decidual Cast?
Passing a decidual cast is extremely rare, but it’s important to not panic. Contact a physician or go to an urgent care facility soon. It’s also a good idea to collect the tissue for testing to confirm a diagnosis and check pathology.
Women taking contraceptives should continue to take them to avoid other complications.
Does Decidual Cast Mean Miscarriage?
Though the symptoms appear similar, a decidual cast does not necessarily mean a woman is having a miscarriage. Most reported cases are women who were on contraceptives and not pregnant at the time of the passing. However, since membranous dysmenorrhea typically looks like a gestational sac, a medical team needs to rule out a miscarriage.
Notably, other conditions can cause women to pass large, solid masses, including neoplasms and polyps. Younger women and girls have also had sarcoma botryoides and fibroepithelial polyps.
Can You Prevent a Decidual Cast?
No, there is no way to prevent a decidual cast. It is a relatively rare condition that currently appears to have some association with certain contraceptives. However, there’s not enough information to suggest women should stop taking their birth control pills to avoid passing a decidual cast.
Can You Still Get Pregnant With a Decidual Cast?
Given the lack of cases and subsequent research, it is unknown whether or not a woman can still get pregnant during or after passing a decidual cast.
