Spontaneous and natural are lovely words, but not when they’re used to describe a blighted ovum, discovers Kim Richter.
Real life story
A blighted ovum sounds so dramatic and romantic in a delicate but overwrought Victorian kind of way. It’s when an egg is fertilised and a placenta and membrane form but no embryo develops. I only knew this because my dearest friend had 2 blighted ovums within 6 months of each other (a complete fluke, her doctor said).
And then there was I lying on my gynae’s table, staring up at the widescreen TV, with his words “blighted ovum” marching through my head.
After 2 missed periods and a positive pregnancy test, it was the first scan of my pregnancy and, being 9 weeks along, I’d expected to see a precious little heartbeat, 2 waving arms and 2 kicking legs. Instead, all I could see in the black and white image of my uterus was an empty egg sac.
My husband and my gynae were sympathetic yet, surprising, I didn’t feel terribly upset. I’d realised I might be pregnant at around 6 weeks but, unlike my first successful pregnancy, my breasts felt completely normal. There was no tenderness – something I remembered from my friend’s blighted ovums.
Thank goodness for good friends who give you the lowdown; mine had unknowingly prepared me. But I had felt that familiar low heaviness and allowed myself to feel the first glimmer of elation, the prospect of a baby growing inside me.
A common occurance
As with most first-trimester miscarriages, a blighted ovum is associated with chromosomal abnormalities. According to the American Pregnancy Association, blighted ovums account for 45-55% of all miscarriages.
“They are extremely common,” says Cape Town obstetrician and gynaecologist Dr Martin Puzey. “Your caregiver may appear clinical when diagnosing you because blighted ovums are seen frequently in any practice.”
In spite of this, most women have never heard of a blighted ovum. It usually occurs in the first few weeks of pregnancy and, in most cases, women spontaneously miscarry, often without ever knowing they were pregnant. They simply think they’re having a heavy period.
What happens after a blighted ovum has occurred
My gynae offered me a dilation and curettage (D and C or uterine scraping) or the option of waiting to miscarry “spontaneously”. I chose the D and C but not before one last scan a few days later to make absolutely sure there was no heartbeat. It was possible that the dates I believed I conceived were incorrect.
In those few days, nature played a nasty trick on me. My breasts started to feel tender and sore, and I thought maybe, just maybe, there was a baby after all. However, the second scan showed an identical picture to my first scan. That afternoon I had the D and C. It was quick and painless, and I was back at work the next day.
But not before coming home to my healthy, happy 18-month-old daughter and feeling overcome with gratitude for her. I’d also been spared the sadness of witnessing a heartbeat and kicking limbs and then losing a baby I’d actually seen. My blighted ovum certainly wasn’t romantic, but, fortunately, it wasn’t high Victorian drama either.
The experts explain
A blighted ovum (also known as a silent miscarriage or anembryonic pregnancy) is a pregnancy that develops abnormally. The fertilised egg embeds itself in the wall of the uterus but no embryo develops. An ultrasound will show an empty gestational sac, with no embryo or yolk sac.
Although the medical profession is not 100% certain what causes a blighted ovum, it seems the body naturally miscarries the fertilised egg on detecting a chromosomal abnormality.
“Unfortunately, problems are part of pregnancy and early pregnancies are an all-or-nothing phenomenon: if everything is perfect, the pregnancy will go ahead; if something is wrong, the mother will naturally miscarry,” says Dr Puzey.
There is nothing you can do to save a blighted ovum
“There is nothing anyone can do to save a blighted ovum, and there’s no use in looking for something to blame; it wasn’t the sex last night or the wine you had before you were pregnant. Simply, the pregnancy is not right.”
However, because the early stages of a blighted ovum are like any normal pregnancy, a placenta develops after fertilisation and implantation, producing the human chorionic gonadotropin (HCG) hormone, which is responsible for symptoms of pregnancy, including nausea, fatigue, tender breasts and the positive result on a pregnancy test.
If you are unsure of the first date of your last period, or the dates you ovulated or conceived, there is a possibility that a very early pregnancy is misdiagnosed as a blighted ovum. If there’s any doubt, your doctor will ask you to come back for a second ultrasound to establish whether you have a blighted ovum or not.
A blighted ovum is not a sign of future problems
It’s important that any woman who has had a blighted ovum understands that this is not a sign of future problems. It is unusual for a blighted ovum to occur more than once. Doctors advise waiting 1 to 3 normal menstrual cycles before trying to conceive again.
Midwife Sandy Standish says: “If you feel the need to grieve, then do so before trying again. Different couples will feel the loss of a pregnancy to different extents, depending on their situation. Remind yourself that blighted ovums are associated with abnormal development and that nature has a role to play in eliminating problems.”