Decidual Bleeding

Definition - What does Decidual Bleeding mean?

Decidual bleeding refers bleeding that occurs during pregnancy due to the shedding of the inner lining of the uterus known as the decidua during pregnancy. The decidua gets relocated to an abnormal position outside the uterus such as in the ovary, cervix or the outer lining of the uterus and sheds during the period when a woman would normally expect her menstrual period. This decidual reaction is called deciduosis. It can put a pregnant woman at risk for premature labor and delivery.

Decidual bleeding is different from implantation bleeding, which occurs during pregnancy when the embryo attaches to the uterine wall.

FertilitySmarts explains Decidual Bleeding

Two factors have been shown to trigger decidual bleeding: Deciduosis and endometriosis, both characterized by the migration of the inner lining to an unusual location outside of the uterus. Hormonal disturbances like progesterone withdrawal are also believed to initiate decidual bleeding during pregnancy.

The bleeding may look like a brownish or pinkish discharge or may even resemble a normal menstrual bleeding. It may or may not affect the pregnancy. A woman may still carry the pregnancy to term despite the bleeding. However, in some cases, it may end up causing labor and delivery before its time. This may be because of the formation of a defective placenta or an imbalance in the formation of new blood vessels, both of which are associated with decidual bleeding and cause the placenta to separate prematurely.

These decidual blood vessels may also weaken and become more friable in response to trauma or increased pressure, culminating in a rare but life-threatening condition called hemoperitoneum, characterized by a sudden buildup of blood in the potential space lining the abdominal cavity.

An ultrasound is essential to evaluate the inner anatomy of a woman’s uterus. In most cases, a watch and wait approach is used. Complications will warrant treatment accordingly.

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