How to Make Certain Your Blighted Ovum Is Not Misdiagnosed

Far too many sites, eHow included, give misinformation in diagnosing a blighted ovum. I talk to many women each day going through this scare and would like to share what I have learned. Although many blighted ova are often blighted ova, they are also somewhat frequently misdiagnosed. Many women end their pregnancies too early due to a misdiagnosis and this article may help you determine if you do, in fact, have a true blighted ovum.

Difficulty: Moderately Challenging

Instructions

Things You'll Need:

• Patience
• Possibly a second opinion as well

1. Avoid The Ultrasound If Possible Until Later.
   
   The easiest way to prevent a misdiagnosed blighted ovum (or miscarriage) is wait until you are entering your 11th or 12 weeks for an ultrasound. Of course, if you show signs of complications such as infection or pain, an earlier ultrasound may be needed.
   
   Take-home message on this step: If you are reading this article, however, chances are good that you've already had an early ultrasound so proceed to the next step.

2. Don't Sweat the hCG Levels
   
   You can monitor hCG levels. Although hCG levels and pregnancy symptoms can appear normal with a blighted ovum (due to the rise in hCG), many women have numbers which start slowing dramatically.
   
   Two things to keep in mind according to the medical literature:
   
   - Once a gestational sac is seen on the ultrasound, hCG levels can do many different things in a viable pregnancy. So, after the gestational sac is seen, hCG levels are a poor predictor of miscarriage (unless they suddenly start dropping rapidly).
   
   - Once hCG levels reach 6,000, they can easily take four or more days to double. This is normal. Also, once you reach week seven or eight, they start to plateau and then will begin declining. This is also normal.
   
   Take-home message on this step: hCG levels are a very poor indicator of a blighted ovum, misdiagnosed or otherwise.

3. Keep an Open Mind About the Gestational Sac Size
   
   Many doctors will worry women unnecessarily if their gestational sac looks one to two weeks behind. A quick search of the internet will show that many women look a couple weeks behind during the first trimester but go on to carry their babies.
   
   Why is this? Many of the women who look one to two weeks behind report having a tilted (AKA retroverted or tipped) uterus. During the second trimester, their measurements are often dating correctly again but, then again, their uterus is no longer tilted.
   
   How the sac measures is not really that important. Rather, you'll want another ultrasound a week out to see if the gestational sac is growing appropriately (approximately 1 mm a day). If there is at least five days worth of growth (5mm) on that next ultrasound, there may very well still be hope.
   
   Conversely, some women will be told they have a blighted ovum because their gestational sac is 13 to 18mm with no visible baby. Many women report their gestational sac size as being even larger before the baby was seen. At 21.5mm, we could not see my baby. A week later, at 28.5mm, a baby was seen (at nearly nine weeks gestation).
   Take-home message on this step: One ultrasound is not enough to diagnose a blighted ovum. Have another ultrasound one week out and then as necessary.

4. Make Sure You Really Have a Completely Empty-Looking Gestational Sac
   
   A blighted ovum diagnosis cannot be made if a yolk sac is seen. An embryo is needed for a yolk sac to be visible. Often, a baby will be seen one week after the yolk sac is viewed. Keep in mind, just because you may see the yolk sac and not have a true blighted ovum, miscarriage is still a real possibility. It is just not due to blighted ovum.
   
   Take-home message on this step: If the yolk sac is viewed, even though is not a blighted ovum, ask for an ultrasound one week out to see if you can find the baby.

5. Don't Assume the Worst with Bleeding
   
   Many women who have had true blighted ovums had no bleeding until their miscarriages and many women who have gone on to find their babies have had bleeding and/or spotting. Up to 1/3 of all women will bleed during viable pregnancies. For those women who have had bleeding or spotting before finding out they had a true blighted ovum, there is no 'standard' bleeding symptoms. Some women have dark brown spotting. Some women have bright red spotting. Some women bleed and bleed. Some women do not.
   
   Take-home message on this step: Bleeding does not necessarily mean a blighted ovum or a miscarriage.

6. Do Not Read too Much Into Pregnancy Symptoms
   
   Some sites will tell you that if you lose pregnancy symptoms, this probably is a blighted ovum or miscarriage. Again, this is not necessarily true. Many women who are misdiagnosed tell me they lost all their symptoms when they believed they were going to miscarry only to have them return later. With a true blighted ovum, pregnancy symptoms may persist until you have a true diagnosis. This is a result of the hCG and not the empty gestational sac. The hCG is what triggers symptoms and, as stated, hCG can rise even with empty sacs.
   
   Take-home message on this step: Pregnancy symptoms or loss of symptoms do not necessarily predict a blighted ovum

7. Remember, Time Is The Only True Test of a Blighted Ovum
   
   Unfortunately, time seems to be the only true test of a blighted ovum. Fortunately, much of the medical literature and most doctors agree that having a natural miscarriage before ten weeks is preferable. Most misdiagnosed blighted ova are seen by ten weeks. For this reason, many women choose to wait until 10 weeks to end their pregnancies. Yes, some women have been even further along before seeing their babies so, at ten weeks, you need to decide if there may still be hope and if you still want to wait this out. Many women do tell me they just want to wait for a natural miscarriage. The only caution is that many women after 10 weeks do end up having incomplete miscarriages and end up needing a D&C anyway. The choice is yours. Just stay monitored.
   
   Take-home message on this step: Time is the only true test of a blighted ovum. If you reach ten weeks and no baby is seen, you need to make the choice that is best for you. If you still would like to wait, talk to your doctor and stay monitored.

8. Get A Second Opinion
   
   Every so often a woman will tell me her doctor is trying to scare her into a D&C too early. If this is the case, find a new doctor. If you have no complications, you can ask to wait out the diagnosis.
   
   Take-home message on this step: if you feel pressured to end your pregnancy or feel your doctor is not doing enough, find a new doctor who is willing to listen to your concerns.

Tips & Warnings

• If you have been diagnosed with a blighted ovum, ask during your exam if you have a tilted uterus. Many women report finding their babies between 8 to 10 weeks with a tilted uterus (and a few even beyond 10 weeks)
• Find the support of other women (online or in real life) going through a miscarriage scare. Often, just having somebody who will listen can make the waiting that much easier. If you cannot find anybody, remember, my email box is always open. I went through 3 1/2 weeks of waiting to miscarry my blighted ovum before they found my baby. I remember the loneliness and just needing somebody who will listen. I am always honored to be there for women going through this scare.
• If you are having any complications such as infection, severe pain (may indicate an ectopic pregnancy), fever, etc... take those signs seriously and be seen immediately
• Don't drink! I have had a number of women who were misdiagnosed tell me they gave up on their pregnancies and indulged in a few drinks only to find out their pregnancies were viable! I know this time is emotionally trying but try not to turn to alcohol. If you are misdiagnosed, you may create more problems for your baby.
• Do not settle for doctors who do not listen to your concerns. Find a new doctor who makes you comfortable.

Resources

• The Misdiagnosed Miscarriage
• My Own Story - When A Blighted Ovum in Not a Blighted Ovum

[mgimkota]

on 10/22/2009 I have been told that my fetus has never developed. The doctor and nurse haven't told me it was a blighted ovum, maybe because they could see pretty easily the yolk sac alone. I was suppose to be at 10 weeks of pregnancy. My sac was pretty big in my view, the doctor doesn't even measured it. And I didn't have any nausea or tiredness during my pregnancy. And for 2-3 weeks ago I have been noticing a lot of brown "mucus". I think my chances of having a misdiagnosed pregnancy are quite low, am I right?

[eceller]

on 9/18/2009 I was diagnosed with a Blighted Ovum by a single sonogram. They sent me for HCG testing then called and had me come in for the Rubella Vacination as a precautionary. I was then sent again for an HCG level and from there sent home. I went several weeks with no call for my results so I went to there office to tell my my symptoms still exsist, sore breast, swollen hard stomach, tired, cranky, and the woman looked at me and said" congratulations!" I was still pregnant. My HCG was 5x higher. Did the Rubella Vac kill my baby? They then told me my Blighted Ovum was verified by sono and sent me home with a script for Misoprostal (an at home miscarriage kit) forces your body to pass the tissue. Well here I am two weeks after taking two Misoprostal scripts and my HCG level has barely dropped! I am confussed and I dont know what to do. Somebody help me please.

[toyab]

on 7/17/2009 my dr. called me and said that my hcg level went from 13000 to 11000 it dropped she's saying that its a blighted ovum i dont think its true because in the beginning she was ready to write my baby off quick. please comment

[FrazzledNanny]

on 6/11/2009 I wish I had read this article before my daughters miscarriage. It may have helped her understand better what was happening. Thanks for the well written and informative article on Blighted Ovum. 5*

[GreenMomma]

on 5/29/2009 Wow, this is a great article! Welcome to eHow!!!