Blighted ovum: diagnosis, treatment and recovery

What it is

A blighted ovum, or anembryonic pregnancy, is when a fertilised egg implants and the gestational sac develops but the embryo does not grow — leaving an empty sac on the scan.

The placenta continues producing hormones for a time, so pregnancy symptoms and positive tests continue and everything feels normal. That is why the diagnosis so often arrives at a routine scan with no warning at all.

The cause, in most cases, is a chromosomal error at conception. It is not caused by anything either partner did, and it does not usually recur.

How it is diagnosed

On ultrasound: a gestational sac above a certain size with no embryo visible. Because dating can be wrong, a firm diagnosis usually requires either specific size criteria or a repeat scan seven to fourteen days later showing no growth.

That repeat scan is standard practice and it exists to prevent a wrong diagnosis. Insisting on it is reasonable if you have any doubt about your dates.

hCG levels may also be checked, and typically plateau or fall.

Management and recovery

Three options, as with other early miscarriages. Waiting for it to pass naturally, which can take days to weeks and involves bleeding and cramping at home. Medical management with tablets. Or a surgical procedure under anaesthesia.

None is medically superior in every case; the choice depends on your situation, how long you are willing to wait, and your own preference. Ask what each involves, how long the bleeding lasts, and what the signs of a complication are.

Recovery: bleeding for one to two weeks, a follow-up to confirm the uterus is empty, anti-D if you are Rh-negative, and periods returning in four to six weeks.

Emotionally, this diagnosis carries a particular sting — the sense of having been pregnant with nothing, or of the body not having noticed. Neither of those is a failure of yours, and the grief is not proportional to what the scan showed.

When to see a doctor

Go to hospital immediately for: bleeding that soaks a pad an hour or more, severe or one-sided abdominal pain, dizziness or fainting, shoulder-tip pain, fever with chills, or foul-smelling discharge. A positive pregnancy test with one-sided pain and bleeding needs assessment the same hour — an ectopic pregnancy is life-threatening. Call 108 if you cannot travel quickly.

During expectant or medical management at home: heavy bleeding soaking a pad an hour, severe pain, fever, chills, foul-smelling discharge or fainting all mean going in immediately.

Grief after a pregnancy loss is real grief, at any number of weeks. If you are struggling — persistent low mood, hopelessness, panic, an inability to function, or any thought of harming yourself — that deserves help rather than endurance. Tele-MANAS on 14416 is free, confidential and answers round the clock in Indian languages.

This article is general information, not medical advice, and is no substitute for personal medical advice. For any decision about your or your child's health, please consult your doctor.

Frequently asked questions

Q: Could the dates be wrong and the baby just too small to see? — Possible, which is exactly why a repeat scan after one to two weeks is standard before any decision. If you are unsure of your dates, say so.

Q: Will it happen again? — Usually not. A blighted ovum is typically a one-off chromosomal event, and most women go on to have a normal pregnancy next time.

Q: Why did I still feel pregnant? — Because the placental tissue kept producing hormones. Symptoms are not a reliable guide to whether a pregnancy is progressing, in either direction.

Q: How long before we can try again? — Usually after one normal period, for straightforward dating. Ask your doctor about your specific case, particularly after a surgical procedure.