{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T02:41:07Z","timestamp":1778553667462,"version":"3.51.4"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,2]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Decidualisation of the endometrium is a progesterone-mediated reaction that naturally occurs during a woman\u2019s menstrual cycle. The hyperproliferated tissue is then usually dissolved and passed in a menstrual period. Occasionally, the natural dissolution does not happen, and the tissue maintains the shape of the endometrium, forming a decidual cast. These casts are known to be formed secondary to the use and\/or cessation of various contraceptive methods. Here, we report a case of a patient presenting with passage of a decidual cast secondary to cessation of the Depo medroxyprogesterone acetate injection. This is the first reported case of the cast becoming infected, and also the first case of a decidual cast containing old products of conception.<\/jats:p>","DOI":"10.1136\/bcr-2020-238583","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T11:40:19Z","timestamp":1615808419000},"page":"e238583","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Delayed miscarriage inside an infected decidual cast: a rare complication of the Depo medroxyprogesterone acetate injection"],"prefix":"10.1136","volume":"14","author":[{"given":"Ryo","family":"Fukaura","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alistair","family":"Ward","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreelata","family":"Datta","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"2025082804212666000_14.3.e238583.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(03)00136-7"},{"key":"2025082804212666000_14.3.e238583.2","unstructured":"FSRH Clinical Effectiveness Unit . FSRH clinical guidance: Progesterone-only injectable 2014."},{"key":"2025082804212666000_14.3.e238583.3","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.jpag.2013.07.013","article-title":"Satisfaction with and intention to continue Depo-Provera versus the Mirena IUD among post-partum adolescents through 12 months of follow-up","volume":"26","author":"Howard","year":"2013","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2025082804212666000_14.3.e238583.4","doi-asserted-by":"publisher","DOI":"10.1016\/1054-139X(95)00322-J"},{"key":"2025082804212666000_14.3.e238583.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-139X(98)00014-7"},{"key":"2025082804212666000_14.3.e238583.6","unstructured":"National Institute for Health and Clinical Excellence (NICE) . Contraception \u2013 progesterone-only methods, 2019. Available: https:\/\/cks.nice.org.uk\/contraception-progestogen-only-methods [Accessed 28 May 2020]."},{"key":"2025082804212666000_14.3.e238583.7","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s10815-016-0658-8","article-title":"What about superfertility, decidualization, and natural selection?","volume":"33","author":"Coulam","year":"2016","journal-title":"J Assist Reprod Genet"},{"key":"2025082804212666000_14.3.e238583.8","doi-asserted-by":"publisher","DOI":"10.1210\/er.2014-1045"},{"key":"2025082804212666000_14.3.e238583.9","unstructured":"Oliver R , Pillarisetty LS . Anatomy, Abdomen and Pelvis, Ovary Corpus Luteum. In: StatPearls. 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