"Blighted ovum." It is an abnormal pregnancy where the egg and sperm have fused to form an embryo, which then implants itself in the early stages of pregnancy. However, the fetal portion disappears before developing into a fetus, leaving only the gestational sac that does not develop on its own. Therefore, it is necessary for the doctor to perform a procedure to remove it.
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Abdominal wind or molar pregnancy is a type of abnormal pregnancy that occurs when an egg and sperm combine to form an embryo. The embryo implants in the early stages, but the fetal tissue is lost before development, leaving only the gestational sac that does not develop on its own. Therefore, it is necessary for a doctor to perform a dilation and curettage procedure to remove it.
Causes of Blighted ovum
Approximately 50% of Blighted ovum cases are caused by abnormalities in the fetal chromosomes, which occur naturally. We find that in nature, abdominal wind can occur at any age of the mother. The chances of molar pregnancy occurring are as follows:
- Women under 35 years old have a 15% chance of having a natural molar pregnancy.
- Women aged 35-38 years have an increased risk of molar pregnancy, ranging from 20-25%.
- Women aged 39-40 years have a 30% risk of molar pregnancy.
- Women over 40 years old have a 35-40% risk of molar pregnancy.
As we can see, the likelihood of molar pregnancy is related to age. As women get older, the normal genetic characteristics of the eggs decrease. This means that when the egg is fertilized by sperm, the resulting embryo may have an abnormal number of chromosomes, either missing or having an extra pair or multiple pairs simultaneously.
From the image above, we can see that there is only an empty gestational sac without a visible fetus inside. This is because the fetal tissue has been lost prior to this stage, leaving only the placenta and the amniotic sac.
Blighted ovum is a natural condition that can occur.
The occurrence of flatulence is a natural phenomenon of human eggs that are not fully developed. Naturally occurring eggs with abnormal chromosomes can fertilize and develop into embryos, but they often miscarry early, leaving only the gestational sac and placental tissue. This can result in a missed period, similar to a normal pregnancy. However, when an ultrasound is performed to examine the fetus and the heartbeat around 6-7 weeks, we find only empty gestational sacs without an embryo inside.
How often does blighted ovum occur?
The likelihood of recurrent flatulence depends on the age of the woman. When it occurs in the first pregnancy, the second pregnancy still carries the same risk according to the woman’s age. However, when flatulence occurs for the second time, the risk of recurrence is much higher than before. This is because it may not be solely due to naturally occurring eggs with abnormal chromosomes. It could be discovered that one of the spouses has inherited a genetic abnormality that can be passed on to the embryo.
Artificial insemination can also cause flatulence.
Artificial insemination can also cause flatulence.
Flatulence can occur in both natural pregnancies and pregnancies resulting from artificial insemination. The likelihood of its occurrence depends on the woman’s age. Frequent flatulence increases the risk of chromosomal abnormalities in the embryo.
In general, we should investigate the causes of recurrent flatulence beyond two occurrences. For example, if one of the spouses has a genetic predisposition for chromosomal abnormalities that can be transmitted to the offspring, but that person does not exhibit any physical abnormalities, we call this condition “balance translocation.” We can examine the blood to assess chromosomes, as shown in the example image of chromosomes.
From the above image, Figure A and Figure B represent normal chromosomes. The middle image depicts a condition where there is a loss of chromosomes in both lower arms, and the right hand shows an example of balanced translocation chromosomes.
The image on the right-hand side shows chromosomes with missing parts joined together, but they are attached to the wrong chromosomes. In individuals with these rearrangements, the total number of chromosomes does not change; only their positions are altered. This does not have any impact on the body or cause any diseases. However, when having children, these rearranged chromosomes can undergo segregation to form egg and sperm cells, resulting in eggs or sperm with imbalanced chromosomal portions. This imbalance can affect the chromosomes of the embryo, leading to deficiencies or excesses. Ultimately, the affected embryos cannot sustain life and result in miscarriages.
Amniotic fluid resulting from the imbalance of chromosomes (balanced translocation).
When one of the couples has a problem with balanced translocation, there is a 50% chance of having an abnormal fetus out of all pregnancies, and a normal fetus is found in 1 out of 4 cases.
As for the remaining 1 out of 4 cases, it is found to be similar to the parent who carries the chromosomal abnormality. This can transmit the abnormality to future generations, just like the parent.
Preventing chromosomal abnormalities in embryos by performing chromosomal testing:
The occurrence of amniotic fluid is not preventable, and the risk of its occurrence is natural according to the woman’s age. However, in cases where preimplantation genetic testing or in vitro fertilization is performed, we can reduce the risk, especially in older individuals, repeated cases, or cases where one of the partners is a balance translocation carrier. By conducting detailed chromosome testing on every pair of chromosomes in the embryos, we can select embryos with a normal number of chromosomes for implantation.
Symptoms of Blighted Ovum in Pregnant Women
The symptoms of a blighted ovum in pregnant women are similar to those of a normal pregnancy because the body produces hormones (HCG) like in a typical pregnancy. However, the hormone levels are lower than usual, so some women with a blighted ovum may not experience typical pregnancy symptoms or may experience symptoms that differ from those of a normal pregnancy. Nonetheless, some women with a blighted ovum may experience symptoms similar to those of a normal pregnancy, such as missed periods, breast tenderness, and nausea. However, these symptoms are often milder due to the lower levels of HCG hormone.
Diagnosing Blighted Ovum
The diagnosis can be made through ultrasound examination during the 6th to 7th week of gestation. The doctor will observe the presence of a gestational sac in the uterus and measure its size, which should be larger than 17-20 mm. However, if there is no visible fetal pole, it is advisable to schedule a follow-up examination within 1-2 weeks. In the early stages of pregnancy, the developing embryo undergoes rapid changes, so a repeated examination within a week should show fetal growth and a visible heartbeat. If a follow-up examination still only shows an enlarged gestational sac without a visible embryo, it confirms the diagnosis of a blighted ovum.
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