HELP. WHAT JUST EMERGED FROM MY VAG

apologizing in advance for the graphic

photo, but I went to the bathroom to change my tampon, and as I was inserting a new one I pulled THIS out of me. I have passed uterine lining and clots many times but never have seen anything like this. I currently take tri-linyah and have only one partner... is there any chance that this could have been a miscarriage? decidual cast? Maybe just excess uterine lining that was REALLY excessive?! I have had much more severe cramps the past few days than I normally do on bc. Any insight/advice would be wonderful so I could have some peace of mind. Thank you