Author, Blogger, Educator

Tag: early miscarriage

The Blighted Ovum: Baby or Not?

I have been asked this question a few times. “When it comes to a blighted ovum, is it a baby or not? I was told I shouldn’t grieve the loss because it wasn’t really a baby, it had no soul.” This can be quite controversial but no matter what you believe, this loss is very real and worthy of grieving.

Blighted OvumLet’s talk about what a blighted ovum is first. The official definition from American Pregnancy is: “A blighted ovum (also known as “anembryonic pregnancy”) happens when a fertilized egg attaches itself to the uterine wall, but the embryo does not develop.” Many times, a blighted ovum occurs because of a chromosomal abnormality. The loss will typically occur before a woman knows she is pregnant but with advanced technology, more and more women are discovering they are pregnant very early and may learn they will experience a miscarriage due to a blighted ovum.

A blighted ovum IS a miscarriage. You were pregnant but something happened and the baby didn’t continue to develop. You might experience all the same pregnancy symptoms as any other woman with a normally developing pregnancy. It is okay to feel the loss and grieve.

First, explore what you feel. When you peed on the stick, you imagined a baby. That baby would turn into a child and your life would look very different with that baby/child within it. To have someone tell you that the baby didn’t exist can be very hurtful. It doesn’t matter if an actual embryo formed, the baby was very real in your mind and all the physiological processes that create a baby, had begun but there was a problem which stopped that growth.

Are you hurting?

Do you feel confused?

Are you unsure what to feel?

All of these feelings are normal and some of them can be compounded by a care provider that is less then empathetic to your situation.


That is what you had for this baby. A blighted ovum is worthy of grief.


But let’s talk briefly about blighted ovum and the diagnosis. It is very important to ensure that you have several ultrasounds to confirm there is no development of an embryo. Even with our advanced technology which allows us to peek inside the uterus very early and see our baby grow, some doctors may diagnose a blighted ovum when it is really too early to see much.

If you are uncertain of your conception date, this can make diagnosis even more troubling. Being off a few days can mean your baby hasn’t had a chance to grow enough to be seen on the ultrasound. If you are 5 weeks pregnant, you may likely only see the gestational sac which can be mistakenly diagnosed as a blighted ovum. Even though this is very hard, wait a week and return for another ultrasound. Ensure the ultrasound tech or doctor is utilizing the same machine at the same resolution. If there is still not evidence of a yolk sac and/or fetal pole, you may wait another week and try another ultrasound to confirm.

Blood HCG levels may not help you in determining the viability of this pregnancy as they may rise normally. Ultrasound is the best way to determine viability and growth of your baby. If there is no fetal pole by week 7, you have most likely experienced a blighted ovum. Your body may miscarry on it’s own or may need some help. I have a great post that helps explain all your miscarriage options. In addition, my book “It’s Not Just a Heavy Period; The Miscarriage Handbook,” can be extremely helpful.

Blighted Ovum

– Breaking the silence of First Trimester Miscarriage

The D&C for Miscarriage

I am often asked whether or not a woman experiencing a miscarriage should have a D&C (dilation and curettage). I almost always tell them…it depends. It depends on many factors but women must also understand the risks, which are high, when choosing a D&C for miscarriage. This post will discuss just one of the three most common miscarriage options.

It is important to note that if you are beyond 12 weeks gestation, the doctor will likely perform a D&E; which is discussed here. This is a different procedure although carries similar risks. Your doctor may still use the term D&C to describe the D&E procedure; however, these are not the same procedures.

First, why do you want the D&C? Is it to get the miscarriage over with? Maybe you don’t have time to wait for the miscarriage to start? Maybe you can’t spend another moment knowing you have a dead baby inside you? Maybe you want testing done and this is the only way to ensure it? And then maybe, you want to be sure you get the baby so you can bury or cremate the baby?

D&C’s do not come without risk. One of the biggest risks is infertility (primary or secondary) due to scarring which is also referred to as Asherman’s Syndrome. If Asherman’s Syndrome occurs, you will need to have another surgical procedure to remove the scar tissue in order for you to conceive otherwise you will be at risk for further miscarriages.

A D&C procedure is the same procedure used in abortions although the baby has already died. The first part of making your decision to have a D&C is to be certain of your diagnoses. Has the baby really died? Believe it or not, this can be misdiagnosed and you could actually be performing a D&C on your living baby. It is imperative that a vaginal ultrasound (not abdominal) is used and coupled with blood tests to ensure that your baby has, in fact, passed away before moving on to a D&C. Your care provider would note no visible heartbeat and falling HCG levels.

It is recommended that a minimum of two ultrasounds are performed on different days. Keep in mind that if you are very early in pregnancy (less than six weeks) your baby might not be detectable on an ultrasound (living or dead). HCG blood levels typically need to be above 1500mIU in order to see a gestational sac and/or fetal pole and even then, the heartbeat might not be detectable until six weeks three days or longer.

Waiting to find out is very difficult during this already stressful time but this is the time where mistakes are most frequently made. Bleeding can be considered normal during very early pregnancy so bleeding alone is not a good indicator of an impending miscarriage. Bleeding coupled with cramping isn’t even a good indicator, especially very early in pregnancy. It is recommended that you wait until at least seven weeks of pregnancy and have two ultrasounds (at least 1 week apart) to confirm pregnancy loss before proceeding to the D&C. Even so, a miscarriage can take place and you might not even be sure if you passed the baby and placenta due to how early it was.

Besides the D&C, there are other options for delivering a miscarried baby; such as expectant management  and medical management (miscarriage at home either naturally or using a medication to help speed things along).

Having a D&C is a surgical procedure. You will generally undergo a light form of general anesthesia. This procedure is done on an outpatient basis unless there are complications needing you to be admitted such as excessive bleeding. It is becoming more common for doctors to conduct a D&C in their own offices.

Risks to the D&C procedure are:

  • Risks associated with anesthesia such as adverse reaction to medication and breathing problems
  • Infection in the uterus or other pelvic organs
  • Perforation or puncture to the uterus
  • Laceration or weakening of the cervix
  • Scarring of the uterus or cervix, which may require further treatment
  • Incomplete procedure which requires another procedure to be performed
The above risks are located at American Pregnancy.

If you choose to have the D&C, it is highly recommended that the surgeon conduct an “ultrasound guided D&C” instead of the normal “blind D&C.” Using the ultrasound while performing this procedure helps the surgeon to see where they need to use the suction instead of just blindly scraping inside of the uterus and possibly damaging more areas. This also helps reduce the chances of needing a repeat procedure for failing to remove all of the “products of conception.”

Following the procedure, the surgeon may place a “balloon” inside the uterus for approximately two weeks. Some surgeons will refer to this as a splint. This is placed inside and has a catheter that runs out of the vagina allowing bleeding and fluids to come out. Placing this balloon inside the uterus may help prevent the layers of the uterus from binding to each other. The balloon helps to keep all the layers away from each other while they heal. If they are allowed to lay on top of each other, they will heal (scar) together causing Asherman’s Syndrome (which may cause recurrent miscarriage and usually requires surgical correction in order to conceive and carry a future baby to term).

In addition to the balloon, your surgeon may prescribe you estrogen therapy for 2-4 weeks. This helps encourage healing by slowing progesterone production, which builds the lining of the uterus. Normally, it is important to have progesterone to grow our uterine lining as it is an essential hormone needed to sustain a pregnancy but while the uterus is healing, it’s important to reduce the production of the uterine lining so that walls of the uterus do not scar together. Estrogen therapy is recommended in combination with the balloon/splint.

In summary, using the ultrasound while performing a D&C can help the surgeon “see” where they need to work inside the uterus; while adding estrogen therapy and placing a balloon/splint inside the uterus for 2-4 weeks following the procedure will help women have a better outcome and will reduce the chances of developing Asherman’s Syndrome.

Are you or someone you know battling with a miscarriage? Visit Dragonflies For Ruby for support!

– Breaking the silence of First Trimester Miscarriage

Was this post beneficial? Click the links below to share it on Facebook! Or buy my book by clicking here! Don’t forget to subscribe to my blog by entering your email in the box to the right.

The information presented here is intended to assist you with discussing your options with your doctor. Please seek medical attention if you believe you are having a miscarriage. Dr. Charles March reviewed the section in my book “All That is Seen and Unseen; A Journey Through a First Trimester Miscarriage” before print. The information presented here is from that Chapter.

Subscribe to this blog!