A decidual cast often presents as tissue passed per vaginum between menarche and menopause.
Features of a decidual cast:
(1) The tissue is a "cast" of the uterine cavity.
(2) It consists primarily of decidualized endometrium.
(3) There is no evidence of placental or fetal tissue.
Risk factors for a decidual cast:
(1) oral contraceptive or hormonal therapy
(2) ectopic pregnancy
(3) pregnancy in a didelphic uterus
In a patient with ectopic pregnancy the decidual cast needs to be distinguished from an intrauterine pregnancy on ultrasonography. An intrauterine pregnancy will show a gestational sac with a fetal pole.
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