Ectopic (extrauterine) decidual tissue can be a site of bleeding during pregnancy.


Types of ectopic decidual tissue:

(1) endometriosis

(2) molar-pregnancy implants

(3) ovarian stroma

(4) other progesterone-responsive mesenchymal cells


Triggering hormone: progresterone


Bleeding may range from minor to severe. Massive bleeding may occur within the peritoneal cavity. Hemoptysis may occur with pulmonary endometriosis.


A woman with a concurrent coagulopathy or anticoagulant therapy would be more likely to have greater bleeding.


A biopsy taken from the bleeding site will show decidualized tissue.


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