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The Blighted Ovum: A Type of Miscarriage
Author: Dr. Anna Kaplan
The term “blighted ovum” refers to a type of miscarriage, or early pregnancy loss. Although an egg may have been fertilized by a sperm, the embryo did not survive. However, even without the embryo, in this case the egg sac is still there, along with the beginnings of a placenta (also called the afterbirth). Since the placenta makes HCG, the hormone that is measured to confirm pregnancy, a home or lab pregnancy test may be positive. A woman with a blighted ovum may feel pregnant because of the placental hormones, and she may even miss a period.
Much of the time, a woman with a blighted ovum will expel all the remaining tissue inside the uterus herself. In this case, she will have experienced a miscarriage. Often a woman will not even know she is pregnant and may simply have a heavy period.
On the other hand, if a woman is experiencing symptoms of pregnancy and has a positive home pregnancy test, finding out she has a blighted ovum will be a shock. How do you discover that you have a blighted ovum? Your levels of the HCG may decrease, rather than rise as expected. You would then feel less severe symptoms of pregnancy, and your uterus might not grow normally. Bleeding would indicate a possible miscarriage, at which time an ultrasound test would show the lack of an embryo. Or, at your first appointment with the obstetrician, the doctor would not be able to detect a fetal heartbeat with an ultrasound device. He or she might only be able to visualize an embryonic sac but no embryo.
If the diagnosis of blighted ovum is made early in pregnancy, the treatment may only be watchful waiting, since the uterus may expel all the products of conception on its own. However, patients and physicians often elect to surgically remove the tissue from the uterus since this can be scheduled and done safely. This means inserting an instrument through the cervix which can then scrape off the lining of the uterus and any remaining tissue (curettage), or remove the lining by suction. The cervix may need to be opened a little (dilated) with medication in order to remove everything. Dilation of the cervix is performed before curettage. Dilation and curettage is commonly called a “D and C.”
Many, if not most, blighted ova occur because of chromosomal abnormalities that are severe enough that a healthy embryo could not develop. This may be the body’s way of stopping the development of a fetus that could not survive. In that case, it is probably a normal and healthy reaction of the human body. That does not mean, however, that a woman who has lost a pregnancy in this way will not feel as sad as she would feel with any other kind of miscarriage.
There is no reason that a woman who has had a blighted ovum cannot have a normal pregnancy and a healthy baby in the future.
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