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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Blighted ovum

blighted ovumA blighted ovum occurs when a fertilized egg attaches itself to the uterine wall (implants) but doesn't develop into an embryo. In a healthy pregnancy, an embryo should be present by 5 or 6 weeks gestation. During this time, the gestational sac (where the foetus develops), should be about 18mm wide. With a blighted ovum, the gestational sac forms and grows but the embryo fails to develop. This is why it is known as an anembryonic pregnancy or a silent miscarriage.

A blighted ovum occurs very early in pregnancy, before most women know that they are pregnant. Blighted ova are responsible for 50% of all miscarriages in the first trimester. A miscarriage is when a pregnancy ends on its own within the first 20 weeks. Any type of miscarriage may leave couples feeling confused, sad, angry and cheated. Unfortunately, anembryonic pregnancies cannot be prevented. The body recognizes the chromosomal abnormalities in the developing embryo and does not work to sustain the pregnancy. In most cases the body will expel the blighted ovum naturally as it will not develop into a healthy baby. If it is too painful and emotional to wait for a natural miscarriage, women may choose to have their uterine tissue surgically removed.

Symptoms

There are generally no specific symptoms of a blighted ovum and most women are unaware that something is wrong, until they have an ultra sound scan. The early stages of a blighted ovum are the same as any normal pregnancy. Following fertilization and implantation, a placenta develops. This results in the production of the human chorionic gonadotropin (HCG) hormone, which is responsible for symptoms of pregnancy. As a result, women with a blighted ovum may experience the signs of pregnancy including nausea, fatigue, tender breasts and the positive result on a pregnancy test.

Women with the condition may experience additional symptoms that are atypical of pregnancy, including:

  • Abdominal cramps
  • Slow growth of the uterus
  • Vaginal spotting or bleeding
  • A period that is heavier than usual

Causes

Blighted ova can sometimes be caused by low levels of hormones in the body. However, most cases are caused by chromosomal abnormalities. A blighted ovum is thought to occur, when the chromosomal cells making up the foetus become defective or distorted, resulting in severe genetic defects. A woman’s body recognizes these chromosomal abnormalities and does not try to continue with the pregnancy, as it will not develop into a healthy baby.
Chromosomal abnormalities can occur for many reasons. Sometimes, the egg or sperm that join during fertilization are of poor quality. In other cases, there may be problems in the structure of the chromosomes themselves or they may become improperly arranged due to abnormal cell division.

There is nothing anyone can do to save a blighted ovum and no fault to be found. Unfortunately, problems are part of pregnancy. In early pregnancy, if everything is perfect, the pregnancy will proceed but if something is wrong, the mother will miscarry naturally.

Diagnosis

An anembryonic pregnancy is diagnosed using an ultrasound scan. The scan will show an empty gestational sac, with no embryo or yolk sac. The gestational sac is usually first seen approximately 30 days after conception when it measures 2 - 3 mm. When the gestational sac is 8mm in diameter, a yolk sac should be visible.

If you are unsure about the date of your last menstrual period, ovulation or conception, or if there is any doubt regarding diagnosis, your doctor will order a follow-up scan. If the gestational sac is too small to ascertain viability, a follow-up scan in 10-14 days will differentiate early pregnancy from a blighted ovum. In a healthy pregnancy, the gestational sac increases by about 1mm in diameter per day.

Other features of a blighted ovum may include an irregular shaped yolk sac, an abnormally low sac position, and little or no growth of the gestational sac between interval scans.

Treatment

If you have been diagnosed with a blighted ovum, your doctor will advise you of your options. In most cases, it is a personal choice. Some women choose to have a surgical procedure known as dilation and curettage (D and C, or uterine scrapping). This involves dilating the cervix and removing the contents of the uterus. Because a D and C removes any remaining tissue, it may help some women with physical and mental closure. It also allows a pathologist to examine the tissue and determine the reasons for the miscarriage.

Other women prefer to use medication on an outpatient basis. However, it may take several days for your body to dispel the tissue. With medication you may also experience more bleeding and side effects. Both options can produce pain and cramping.

Your doctor may advise against a D and C for early pregnancy loss. It is believed that a woman’s body is capable of passing tissue on its own and that an invasive surgical procedure runs the risk of complications.
The third option is to allow your body to pass the tissue on its own. When a blighted ovum is diagnosed, it will eventually lead to a miscarriage. Unfortunately, this may not happen for some time. Each case is different depending on when you get diagnosed and the circumstances around it. For example, if you are already experiencing spotting, bleeding or cramping the miscarriage may have already started. In the early stages, it may take the body time to realise that there is no fetus or embryo contained in the gestational sac. By 12 weeks gestation, when the body catches up and the placenta starts to take over, the body will start to realise then that there is no embryo. However, the majority of blighted ovum pregnancies are diagnosed much earlier, between 6-9 weeks. The miscarriage process itself can take weeks occur and in some cases a D and C will still be required.

The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and/or infection. If you notice an increase in bleeding or the onset of chills or fever, it is best to call your health provider immediately.

Prevention

Unfortunately most cases of blighted ovum can’t be prevented. Any couple can experience a blighted ovum and there is simply no way of predicting whether or not you will experience this type of miscarriage.

Prognosis

Most women who miscarry due to a blighted ovum go on to experience healthy pregnancies in the future. As with all miscarriages, a blighted ovum can be very difficult to deal with emotionally. Allow yourself time to heal and seek the support you need to cope with your loss. Doctors generally recommend couples wait at least one to three menstrual cycles before trying to conceive again. Use birth control during this time to prevent possible pregnancies. It is unusual for a blighted ovum to occur more than once.

If you have experienced more than two consecutive miscarriages your doctor may order special blood and genetics tests to try find out what is going wrong. A reproductive specialist can help determine if there are any underlying issues complicating pregnancy. There are a number of treatments available to prevent future miscarriage and help you carry a baby to term.

Different couples and individuals will experience and cope with the loss of pregnancy in different ways, depending on their situation. A blighted ovum may come as a devastating shock as your body may have given you all the signs of pregnancy, except for embryo development. If you feel the need to grieve, take the time to do so before trying again. Remind yourself that blighted ova are the result of abnormal development and that nature has a role to play in eliminating problems.

http://www.womens-health.co.uk/blighted.html
http://www.yourparenting.co.za/fertility/difficulty-conceiving/what-is-a-blighted-ovum
http://radiopaedia.org/articles/anembryonic-pregnancy
http://www.lovenaturalbirth.com/natural-miscarriage.html
http://americanpregnancy.org/pregnancycomplications/blightedovum.html