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Re: decidual cast?

From: anonymous (anonymous@obgyn.net)
Fri, 17 Mar 2000 15:44:22 -0600 (CST)

First off, thank you for putting on your thinking cap Dr. Marchbein. Your answers are helping me put things into perspective. Forgive me but I still have some questions. 1) Is it normal or possible to shed a decidual cast after a D and C procedure? 2) If the pathology report states that there were no placental or fetal cells detected in my uterus can I be reasonably assured that I had an ovarian ectopic pregnancy? 3) Is it and should it be normal procedure to send an ovarian cyst to pathology in order to determine what kind of cyst it is or if it contained products of conception? In my case it was simply "burned". 4) Would the difference between a corpus luteum cyst and an ovarian ectopic pregnancy be very obvious to a surgeon doing a laparoscopy? Are they visually different or similar? 5) Would placental and fetal tissues look different or similar to a decidual cast once expelled from the uterus?

BTW... You are right in assuming that I have a specific purpose here. I need as much information as possible to be able to understand exactly what happened to me and my pregnancy. I really want to put all of this behind me and start again, however I need to understand it all before I can do so. My gut feeling is that my ob-gyn is not telling me the whole story. Perhaps he is, I don't know. Rest assured, the reason I am here is for educational purposes only.

At Fri, 17 Mar 2000, Harvey S. Marchbein, M.D. wrote: >
>At Fri, 17 Mar 2000, anonymous wrote:
>>
>>What's a decidual cast?
>
>OK. Put on your thinking caps. The lining of the uterus when one is
>pregnant, other than the area taken up by the placenta, is called the
>decidua. The appearance of the normal liningof the uterus, by the
>effect of progesterone, becomes DECIDUALIZED. When an area of decidua
>is shed, it is called a decual cast because it frequently comes out in
>the shape of the uterine cavity, hence cast.
>
>>When does it occur?
>
>It can occur with a normal pregnancy as well as an ectopic pregnancy.
>
>>What causes it?
>
>It is felt to be lack of stability of the integrity of the lining.
>
>>Is it always
>>related to an ovarian ectopic pregnancy?
>
>Actually, tubal ectopics are much more common than ovarian ectopics
>(I've seen 1 in 24 years) but the answer to your question is, as noted
>above, no.
>
>>How big would an ovarian
>>ectopic pregnancy be at 7.5 weeks LMP?
>
>Varies. I have this sneaking suspicion you're asking all this in a very
>roundabout way for a very specific reason.
>
>>Could it be in a cyst that is 2.5
>>cm?
>
>Possible. But ovarian cysts are more likely corpus luteum cysts than
>ovarian ectopics.
>
>>Thank you.
>
>--
>Harvey S. Marchbein, M.D. FACOG, FACS
>Great Neck, New York
>
>**Note: Opinions expressed here are for educational purposes only
>and, as such, do not constitute a physician-patient relationship.
>This information is not intended to supplant the need for you to
>consult with your physician prior to choosing therapeutic options
>and/or interventions.
>
>**Private emails cannot be entertained due to time constraints,
>consequently no private emails will receive a response.
>
>**Thank you for your understanding ;-)
>

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