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The blighted ovum (egg) – called as an anembryonic pregnancy in medical terms – is a typical mainspring of an untimely stillbirth. This genetic error occurs during the first eight weeks of gestation before the ovum has been ejected and conception takes place.
In general, around 20% of all pregnancies end up in miscarriages (3rd of those are early miscarriages which happens before the 8th week – due to blighted ovum), then the remaining 80% happens during the first 12 weeks of gestation.
How does it occur?
An anembryonic gestation is a one – time circumstance (while some woman experience it multiple times) which marks as the biological or an unexpected end of gestation where a fetus has not developed well due to the following step – by – step errors:
- Primarily, an anembryonic gestation begins in a normal process where the sperm fertilizes the ovum right after the ovary has released it.
- Within the next hours, the fertilized egg implants itself inside the amniotic sac.
- The fertilized egg begins to divide and form a number of cells (cells that will soon be the fetus, placenta, embryo, and membranes) suddenly stops.
- After 10 days, the growing cluster of cells begins to form a fetal pole (precursor to embryo).
- Then by the 7th week of pregnancy, the embryonic cells fail to grow and transform into an embryo due to having too many or too few chromosomes during fertilization. By the same token, the amniotic sac will be empty since there is no embryo visible via a 7th week ultrasound test scan.
- The fertilized egg has stopped developing into an embryo. However, it still continues to implant itself inside the gestational sac.
- The ovum goes along with the membranes. All of which continues to grow and support itself even without a fetus for a short span of time.
- The amniotic sac also continues to grow as the placenta (baby’s life support) begins to form.
- The fetus does not recognize that there is no embryo inside the sac.
- Because of that, the levels of pregnancy hormones (progesterone and estrogen) continue to increase which would lead an expectant mom to believe that she is pregnant.
With that being said, did you know that some women who have been diagnosed with an anembryonic pregnancy consider it as a very early loss? They feel a combination of mixed emotions such as being confuse, upset, numbness, disbelief, anger, guilt, difficulty in concentration, or even grieve over the unborn baby even though he has not been formed yet; and it is absolutely natural to feel that way.
Some women even suffer with physical symptoms such as the following below:
- Over – fatigue
- Sleepless nights
- Loss of appetite
- Frequent episodes of crying due to the strong sense of between the mother and the unborn baby
Even though that an anembryonic gestation can be depressing, there is nothing to worry about it since this case will not affect a woman’s fertility rate of conceiving healthily again.Pregnancy week by week
As a matter of fact, a 2009 research study shows that 80% women who underwent with early miscarriages and experienced a spoiled ovum went on to give birth to a healthy baby.
By the same token, the abovementioned treatments following the biological loss did not affect the fertility rate nor ruin the female reproductive system.
Signs and symptoms of an anembryonic pregnancy
An anembryonic occurs even before a woman knows that she is pregnant and most women do not even know it already occurred. To be able to identify if she is having or have had an infected egg, enlisted below are the following signs and symptoms:
- Missed or delayed menstrual period
- Dwindling hCG (human chorionic gonadotrophin) levels (increasing and decreasing amount of hCG which confuses a pregnancy) – If an expectant mother gets a positive result on her pregnancy test kit then after a few days the result becomes negative, this only means that the uterus is carrying a frustrated ovum.
- Signs of early pregnancy symptoms such as nausea, tender breasts, and body swelling will occur until the hormone levels begin to descend
- An ultrasound scan which shows an empty womb during the 7th week of gestation is a sure sign of a undeveloped egg. If the gestational sac stretches for about 1 inch or 25 millimeters without an embryo and/or fetal pole, a woman is required to take another scan after 1 – 2 weeks. If no fetal pole is visible, the diagnosis can be confirmed
- Heavy vaginal bleeding – If an expectant mother experiences heavy vaginal bleeding like that of a menstrual period. Though bleeding can be normal in some pregnancies, heavy bleeding still requires an immediate medical attention
The causes of an anembryonic gestation
An anembryonic gestation affects about 50% of expectant mothers which is a result of chromosomal problems such as the following enlisted below:
Abnormal cell division (poor quality of egg or sperm cells)
In 2007, researchers analyzed that more than 2/3rd out of a hundred cases of blighted ovums are caused by the increased levels of chromosome (a chromosome serves as the structure of human cells that contain genes) abnormalities – wherein the eggs or embryo had an extra or missing chromosome rather than the usual 46 chromosome count.
This type of genetic disorder is caused by the wrong mix of genetic material in the fertilized eggs and the embryonic cells fail to transform. Because of that, the female body recognizes the abnormal process in a fetus and naturally discontinues the pregnancy since the fetus will not develop into a healthy and normal baby.
A chromosomal duplication (also called as gene duplication or gene amplification) is a process where a DNA (deoxyribonucleic acid) which contains a gene is duplicated during a molecular evolution.
A chromosome deletion (also called as gene deletion, deficiency, and deletion mutation) is a genetic abnormality in which a part of a chromosome or a DNA sequence is lost during a replication process.
A genetic mutation (also called as hormonal imbalance) is a process where a gene mutation is permanently altered in the DNA sequence that makes up a gene.
Severe abdominal cramping
Severe abdominal cramping which can also be a reason of other pregnancy complications such as:
- Ectopic pregnancy – where the fetus is implanted and develops itself outside the uterus, typically in the fallopian tube
Treating an underdeveloped egg
A medical practitioner diagnoses a wrecked egg using the following treatment options enlisted below:
Expectant management is when the Ob – Gyne recommends a trying – to – conceive woman to wait for a few days or weeks to see if the body will naturally expel the anembryonic pregnancy, even though the blighted ovum has already been detected.
A misoprostol (sold under the brand name of Cytotec) is a type of oral medication which aids the uterus to clear the byproducts of conception.
Dilation and curettage
Dilation and curettage (abbreviate as D&C) is a brief surgical procedure which typically lasts for about 15 – 30 minutes. D&C is recommended to undergo after a miscarriage usually right before the 20th week of gestation.
A D&C is only required to take if the uterus failed to completely empty the remains of conception, so that the upcoming menstrual cycle will have a normal flow. Furthermore, here is the following step – by – step procedures on how a D&C is performed:
- The medical practitioner will let a woman lay flat on her back with her legs up in stir – ups
- The medical practitioner will inject a combination of numbing medication (particularly anesthesia)
- To access the uterus, the practitioner will open up the labia minora
- Then gently dilates (opens up) the cervix – a cylindrical neck of tissue which connects the vagina to the uterus
- Then the practitioner will insert a slender rod and small medical instruments in the vaginal opening
- Once the cervix is ½ inch dilated, the practitioner will likely use a curette (a scraping instrument) and a micro – suction device to completely clear out the contents of conception inside the gestational sac
If a pregnancy is on its early stages and the cervix is partially or loosely dilated, here is how a D&C will go:
- The surgery will likely be performed in the doctor’s office
- The practitioner will inject some local numbing agents (same anesthetics that is used by a dentist when he fills up a cavity)
- Afterwards, he will provide her with pain relievers
On the other hand, if a pregnancy is on its latter weeks and the cervix is tightly sealed here is how a D&C will go:
- The surgery is suggested to perform within the center premises or hospital
- The practitioner will inject a woman with sedatives and general anesthesia
Since the remains dilated after the brief surgical procedure, a woman must consider avoiding the following for the next few weeks to prevent bacteria and germs from infecting the uterus:
- Sexual intercourse
- Use of tampons
A regular menstrual cycle will likely resume within 4 – 6 weeks. Most medical practitioners recommend waiting for at least 1 – 3 menstrual cycles before trying to conceive again since the cervix still cures itself after the following operations.
To ease the pain and discomfort of the aftermath of dilation and curettage, take ibuprofen (sold under the brand name of Advil).
Evacuation of retained products of conception
Evacuation of retained products of conception (abbreviated as ERPC) is a minor operation which involves the widening of the cervix.
ERPC is performed by the following step – by – step procedures below:
- A medical practitioner will insert a suctioning instrument in the vaginal opening
- The suctioning instrument is passed into the uterus
- The uterine lining together with the abnormal tissues will be removed
- The retained products may then be sent to the pathologist for tests
- ERPC usually lasts for 1 whole day
As a matter of fact, this type of stillbirth requires no treatment since the female body automatically expels the contents of the uterus which contains the underdeveloped fertilized egg – a vaginal discharge that is similar to a menstrual period.
In addition to that, women who have undiagnosed cases of blighted ovum had mistaken this early miscarriage as a late menstrual period.