Early Pregnancy
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Sometimes, despite a positive pregnancy test, the announced pregnancy does not progress. Miscarriages (commonly called “fausses couches”) are the result of natural and spontaneous phenomena that unfortunately cannot be controlled. Today, we look at one of the possible causes of a non-viable pregnancy: the case of a blighted ovum (or anembryonic pregnancy, to use the more precise terminology).
What causes it? What medical care is provided after a blighted ovum? Let’s explain.
What is a blighted ovum?
A miscarriage occurs when there is a spontaneous termination of a pregnancy in progress. In other words, the pregnancy that began will stop developing naturally.
A blighted ovum is a particular case leading to miscarriage. Specifically: the membranes and placenta develop, but no embryo forms. Pregnancy hormones are therefore present, but the pregnancy cannot progress in the absence of an embryo.
It is the ultrasound image that gives its name to the blighted ovum: in the absence of an embryo, the sac appears empty and therefore “clear” in color on the scan.
What are the symptoms of a blighted ovum?
In the case of a blighted ovum, the pregnancy test is positive since, as we have seen, pregnancy hormones are present.
The symptoms experienced are exactly the same as in a normal pregnancy, such as:
- missed or delayed periods,
- breast swelling,
- nausea,
- heartburn,
- bloating,
- constipation,
- vaginal discharge called leukorrhea,
- weight gain or loss,
- acne,
- fatigue…
These early pregnancy symptoms vary greatly from one woman to another, so they are not entirely reliable. Only a medical consultation can confirm or rule out a pregnancy.
These initial symptoms are then usually followed by the classic signs of a miscarriage, namely:
- Bleeding: light or heavy, red, pink, or brown, fluid, or in the form of clots (small masses of coagulated blood).
❗In case of heavy bleeding (when sanitary protection is quickly soaked and needs to be changed several times within half an hour): go to the emergency room or call for help to be taken there quickly.
- Pelvic pain, similar to uterine contractions, which may resemble menstrual cramps.
- A sudden disappearance of symptoms such as nausea or breast pain.
Note that these symptoms can also occur during the normal course of pregnancy, and, likewise, some miscarriages occur silently. This is why it is essential to have regular medical follow-up and to consult a healthcare professional if you are concerned.
How is a blighted ovum diagnosed?
It is often the first ultrasounds that alert the healthcare professional monitoring your pregnancy (your gynecologist, GP, or midwife). The first ultrasound usually takes place between 11 and 13 weeks of amenorrhea, but it is possible to have an early dating ultrasound starting at 7 weeks.
The early ultrasound is not mandatory, unlike the first-trimester ultrasound at 11–13 weeks. Often, an anembryonic pregnancy will have caused a miscarriage before then, but it may still be discovered during this ultrasound.
During the early ultrasound, a transvaginal ultrasound is used (performed with a probe inserted into the vagina). This type of early ultrasound allows doctors to locate a pregnancy in the uterus, date it, and detect early embryonic cardiac activity—or, in the case of a blighted ovum, the absence of such activity.
It is thanks to this examination, repeated over several days if necessary, that it can be determined whether there is an ongoing pregnancy and whether it is developing or not.
If there is doubt during this ultrasound (particularly if the pregnancy is still very early), doctors may also monitor the progression of a key pregnancy hormone, beta-hCG, with a series of blood tests. In a “normal” pregnancy, beta-hCG levels double every 48 to 72 hours.
What are the causes of a blighted ovum?
As we have seen, a blighted ovum occurs spontaneously. It is therefore difficult to identify an exact cause.
Although the causes are still not well understood, it is known that it is often linked to a chromosomal abnormality (generally a one-off issue), which prevents the normal development of the embryo.
What medical care is provided in the case of a blighted ovum?
A pregnancy may end spontaneously: in this case, it ends on its own and you may experience uterine contractions and bleeding of varying intensity. An ultrasound is recommended after this event.
If an early pregnancy loss is diagnosed by ultrasound, doctors may suggest either waiting for spontaneous expulsion or medical assistance to clear the pregnancy. In the latter case, two options may be proposed:
- Surgical treatment: this involves suction of the pregnancy in the operating room under local or general anesthesia,
- Medical treatment: administered vaginally, it aims to induce uterine contractions to expel the pregnancy. An ultrasound about ten days later checks that the miscarriage is complete. If not, one of the two methods may be suggested again.
Want to learn more? Feel free to download the May app, where you’ll find plenty of resources to support and guide you throughout your pregnancy.
Does a blighted ovum affect fertility?
Rest assured: the chances that a blighted ovum (and miscarriages in general) will have an impact on fertility are nil.
In rare cases, a blighted ovum or miscarriage may happen repeatedly without a known cause. However, after 3 consecutive pregnancy losses, it is recommended to investigate possible causes such as an underlying medical condition.
Do not hesitate to consult a specialist to find answers and receive appropriate care.
What follow-up is recommended after a blighted ovum?
Whether your miscarriage occurred spontaneously or required treatment, don’t hesitate to ask for pain relief, as well as sick leave if you need it. The law of July 7, 2023 introduced, among other measures, sick leave without a waiting period for women who have experienced a pregnancy loss.
It is also advisable to have a follow-up ultrasound to ensure that the embryo has been fully expelled.
Unfortunately, medical care may seem insufficient compared to the psychological shock, or even trauma, caused by a blighted ovum. Don’t hesitate to consult a psychologist for support and to ask all your questions to the healthcare professional monitoring you.
What emotions are associated with the experience of a blighted ovum?
A blighted ovum, like any miscarriage, can leave a real psychological mark on the woman who experiences it. A pregnancy that ends, even early, is never trivial. Indeed, regardless of the stage of pregnancy at the time of interruption, parents may already have been projecting a lot, leading to what is often referred to as the “invisible grief” of the child who was expected.
You may experience a wide range of emotions, all valid, including apathy, anger, confusion, deep sadness, or isolation. Don’t face these feelings alone:
- Surround yourself with a trusted medical and paramedical team (doctor, midwife, psychologists) to ensure proper follow-up.
- Don’t be afraid to confide in your loved ones.
- If your close circle seems awkward or if confiding in them feels difficult, there are also support groups, including the Agapa association, which supports women who have experienced pregnancy loss.
- Additionally, more and more women share their stories on social networks or podcasts, helping to break the silence that traditionally surrounds this loss.
Finally: take care of yourself and your body, and work on rebuilding your confidence in it. Don’t hesitate to express your pain if it helps: write, draw, dance, create small or big projects—move forward in whatever way works for you!
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Photo: GaudiLab
This text was translated from French by an artificial intelligence. The information, advice, and sources it contains comply with French standards and may therefore not apply to your situation. Make sure to complement this reading by visiting the May US/UK app and consulting the healthcare professionals who are supporting you.
