Blighted Ovum

Blighted ovum is not a common term but it accounts for 45 to 55% of all miscarriages.

Blighted Ovum and its causes

The term ‘blighted ovum’, also known as an ‘anembryonic pregnancy’ (nonviable pregnancy) may not be as commonly known, but it is also termed as missed abortion or a silent or missed miscarriage. It occurs when a fertilised egg implants in the uterus but the embryo does not grow.
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A blighted ovum may also occur in a twin pregnancy. In this instance, it is called a blighted twin, one of the fertilised eggs fails to develop properly while the second develops normally, completely unaffected by the blighted twin.

What can cause a blighted ovum?

Once the egg is fertilised and implants in the uterus and the placenta and membrane begins to develop, the fetus fails to form or stops developing very early on causing the pregnancy to miscarry, usually between 7 and 12 weeks. A blighted ovum often happens so early in a pregnancy that the woman never knew she was pregnant. It happened because your body would recognise that there are abnormal chromosomes in a fetus and naturally does not try to carry on with the pregnancy because the fetus will not develop into a normal, healthy baby. This occurs because of abnormal cell division, or poor quality sperm or egg.

Miscarriage may also be caused by:

Signs of blighted ovum

Most of the time, blighted ovum occurs very early in pregnancy – before most women even realise they are pregnant.

  1. Just like with a normal pregnancy you may even begin to experience the early pregnancy signs and symptoms.
  2. Sometimes, symptoms of blighted ovum can be mistaken as dysmenorrheal symptoms because of some cramping and minor spotting or bleeding, and then ends with your body flushing out the uterine lining and you have a period which may be heavier than normal.
  3. In some cases, women simply assume that they are having early pregnancy, as everything appears to be normal. It is caused by Human chorionic gonadotrophin (hCG) levels which continue to raise and the placenta continues to grow and support itself.

This type of miscarriage is usually diagnosed using ultrasound that can be usually done on the 8th week of pregnancy. It will show a large gestational sac, but no embryo. Many doctors use the term “early pregnancy failure,” instead of “blighted ovum” to describe this common type of miscarriage that accounts for approximately 50 percent of first trimester miscarriages.

Click here to know more about miscarriage.

The Criteria For A Diagnosis Of Blighted Ovum Are:

  1. Failure to identify an embryo in a gestational sac measuring at least 20 mm via transabdominal ultrasound.
  2. Failure to identify an embryo in a gestational sac measuring approximately 18mm or more via transvaginal ultrasound.
  3. Failure to identify a yolk sac in a gestational sac measuring 13mm or more.

Diagnosis and misdiagnoses of blighted ovum

Miscarriage – It is needed to expel the gestational sac and accumulated tissue by the end of your first trimester, though it can happen sooner than that. The miscarriage process can take weeks, though, and once you find out you aren’t pregnant; you may be too emotional about it or would make you feel physically uncomfortable to wait for a spontaneous miscarriage.

You may be able to use medication to speed up the miscarriage process. It can be managed medically, using drugs which facilitate the expulsion of the uterine contents. The drugs are usually administered orally and vaginally. The oral tablet is usually taken first followed by the vaginal tablet 24 to 48 hours later. The miscarriage will conclude shortly after this.

If there are instances like significant bleeding or signs of infection, it is unsafe to wait for a miscarriage. You can also have a dilation and curettage (D&C) which can be carried out as a day procedure to remove the tissue. Though, most doctors do not recommend a D&C for an early pregnancy loss as it is believed that a woman’s body is capable of passing tissue on its own and there is no need for an invasive surgical procedure with a risk of complications.

Is misdiagnosis possible?

Majority of diagnosed miscarriages are in fact miscarriages. However, it is believe that there are few pregnant women that are misdiagnosed with a blighted ovum. Online testimonies show that most of them were misdiagnosed of early pregnancy failure when they consulted for a scan earlier that the eight week of their pregnancy.

The beginnings of a developing baby typically become visible on a transvaginal ultrasound around 5 to 6 weeks of pregnancy and on an abdominal ultrasound as late as 6 to 7 weeks of pregnancy. And if the dates of the pregnancy are even a little bit off, a viable pregnancy could theoretically be misdiagnosed as a blighted ovum.

Tips to avoid blighted ovum misdiagnoses

  1. Wait until you are entering your 11th or 12 weeks for an ultrasound. Except if you show signs of complications such as infection or pain, an earlier ultrasound may be needed.
  2. Don’t get anxious with the hCG levels – hCG levels are a very poor indicator of a blighted ovum.
  3. Do not read too much about pregnancy symptoms – There are times that you can read in a site that if you lose pregnancy symptoms, this probably is a blighted ovum or miscarriage. Again, this is not necessarily true. As a matter of fact, pregnancy symptoms may persist until you have a true diagnosis. This is a result of the hCG and not the empty gestational sac. The hCG is what triggers symptoms and, as stated, hCG can rise even with empty sacs.
  4. Time Is The Only True Test of a Blighted Ovum – It is believed by most health care professionals that having a natural miscarriage before ten weeks is preferable. But most misdiagnosed blighted ova are seen by ten weeks.
  5. Get A Second Opinion – You can always find a new doctor. If you have no complications, you can ask to wait out the diagnosis. If you feel unsure to end your pregnancy or feel your doctor is not doing enough, find a new doctor who is willing to listen to your concerns.

FAQ (Frequently Asked Questions)

Can anything be done to prevent a blighted ovum?

Unfortunately, there is nothing that can be done to prevent a blighted ovum. A blighted ovum is often a one-time occurrence and rarely experienced by a woman again. It is believed that low progesterone may be a factor in early pregnancy loss and progesterone supplements have been shown to lower the miscarriage risk in some women with recurrent miscarriages. The importance of progesterone supplements during early pregnancy shows that it has saved some pregnancies. If you believe that progesterone may be a problem, try to have your progesterone tested as early as possible.

When can I be pregnant after a blighted ovum?

Most women might want to wait a couple of months just to give the body a rest, and to feel emotionally ready, before trying again for a baby. But after having a blighted ovum, you’ll probably get your period again in four to six weeks after you miscarry or have the tissue removed. Some doctors say you can start trying to conceive again after this first period, but others recommend that you wait until you’ve been through another menstrual cycle.

It is natural to be very anxious that you may have a miscarriage again. But statistically, most women have a high rate of successful viable pregnancy the next time they conceive. Early scan may be recommended to reassure you. When you get pregnant again, wait until you are more than six weeks pregnant, or better still, more than seven or eight weeks pregnant, if you want to avoid the uncertainty that very early scans may bring. Once a heartbeat has been seen, the pregnancy is said to be viable and the chance of a successful outcome is much better.

Is it possible to have a recurrent blighted ovum?

This question will probably be on your mind when you start trying to get pregnant again, having suffered a blighted ovum doesn’t mean that are at a higher risk of miscarrying again. Blighted ovum will have no bearing whatsoever on future pregnancies. The chances of a normal pregnancy, following a blighted ovum, are not diminished in any way.


Early pregnancy failure (Blighted ovum) is a traumatic experience to a woman when it comes to her life unexpectedly. Others may not understand why a woman grieves a blighted ovum though it may appear that there was never a baby. It is true that the baby did not develop enough to be visible on ultrasound, but a conception did occur and the pregnancy did exist — and it is OK to grieve the loss of the baby.

If diagnosed with a blighted ovum and feels unsure of the diagnosis. Consider postponing any treatment decisions until you check with your regular doctor or ask for a second opinion. If your doctor feels there is any uncertainty about the diagnosis, the doctor will most likely ask the woman to return for a follow up ultrasound in a few days or a week. Waiting can be frustrating and stressful, but it is a good way for doctors to avoid the possibility of misdiagnosis.

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