Blighted ovum: when your ovum gets damaged

Violet, a Pregnant reader was unfortunate to lose her pregnancy through what the doctor termed as a blighted ovum. She asked Pregnant to elaborate more on this condition. Her question went like this.

I had a miscarriage at nine weeks pregnant and upon seeking medical advice was told it was a ‘blighted ovum’. What causes it? Is it because I had taken long (five years) before getting a child? It all started with light dark spotting until the ‘thing’ came out itself. When I went for a scan I was told there was nothing in the gestational sac. Am I capable of getting another normal child soon? Please elaborate on this issue for me to understand.

Dr. Blassio Omuga expounds:
Blighted ovum is a fairly common type of early miscarriage in pregnancy(approximately 45 per cent to 55 per cent of air miscarriages are thought to be due to blighted ovum). This miscarriage may occur even before the woman confirms that she is expectant. With this condition, the placenta and membranes are developed from a fertilized  egg that can even implant and show uterine changes of pregnancy. However, the embryo that forms the foetus  body parts is absent. It does not develop.

Causes of blighted ovum
It is thought to be due to chromosomal abnormalities. Older women are more affected, and it is more of an egg than sperm problem. It is usually considered to be a one time event, a fluke of nature that need not recur again. However, few cases have had a recurrence.

Diagnosis of blighted ovum
Women with blighted ovum may miss periods with positive pregnancy results after a test. They may also have symptoms of early pregnancy like fatigue and breast tenderness. However, the following factors are unique to blighted ovum:

o The gestational sac seen by an ultrasound is very small even though the fluid is present. The sac may be  incomplete, absent or have irregular margins.
o The gestational sac in advanced first trimester has no demonstratable embryo.
o The uterus is too small as compared to the duration of the pregnancy.
o The pregnancy hormone (HCG) may decrease in level resulting to spotting or bleeding, with or without abdominal cramping.

Treatment of blighted ovum
A mother may wait for natural expulsion for a month or two. This is when she has no fever or excessive abdominal bleeding. Medication may be taken to trigger off the miscarriage. Dilation and curettage (emptying of uterus by evacuation) can also be done.

After this the patient is often given pain killers. Excess bleeding and infection must be prevented at all costs while managing blighted ovum.

Recurrence
Most women with blighted ovum carry full term pregnancies successfully in their subsequent pregnancies. Although there exists the risk of miscarriage in subsequent pregnancies, this incidence is not increased due to past experience with a blighted ovum. Neither is the miscarriage necessarily due to a repeated blighted ovum.

Prevention
Occurrence of blighted ovum cannot be prevented. It is an incident. When it happens without complications, it does not add to infertility rates. Neither is it associated with newborn malformations in future pregnancies.

END: PG22/41