empty gestational sac

(BLIGHTED OVUM, ANEMBRIONIC PREGNANCY)

Summary: Empty gestational sac (blighted ovum) is the pregnancy state in which the embryo is not observed, although there is a gestational sac seen in the early pregnancy months. Although there is no embryo, the placenta and membranes continue to develop, pregnancy hormones increase, and this is understood as a pregnancy still continuing. Diagnosis is made only by seeing an empty gestational sac on ultrasonography. 50% of miscarriages in the first trimester are due to blighted ovum due to chromosomal problems.
Empty Pregnancy Pouch Definition
It is also known as empty gestational sac, blighted ovum, anembryonic pregnancy. It is usually diagnosed in early pregnancy months. Although a fertilized egg attaches to the inner wall of the uterus and the cells form the gestational sac, the embryo cannot develop; The fertilized ovum cannot grow for more than six weeks and is absorbed in the uterus and disappears. Thus, fetal pole and yolk sac are not seen in the resulting blighted ovum. But the placenta and membranes continue to grow, and pregnancy development slows down.
A blighted ovum can be seen very early in pregnancy, before many women even know they are pregnant. In this case, delayed menstruation, positive pregnancy test results, vaginal drip bleeding or more severe menstrual bleeding than usual can be observed. Since beta HCG levels increase in blood and urine, women get the impression that the pregnancy is continuing.
Causes of an Empty Pregnancy Pouch
20% of diagnosed pregnancies end in miscarriage. Chromosomal abnormalities in a highly fertilized ovum can cause this condition. The most common causes of recurrent miscarriages are:
Poor quality of eggs and sperm
-Structural disorders in the uterus
– Immune responses that prevent implantation of the embryo
-Hormonal imbalance
-Blood coagulation problems.
Changes Encountered in an Empty Pregnancy Pouch
The belief that those diagnosed with a brighted ovum never have a pregnancy is false. In these cases, it is difficult to know how long the embryo lives and when it is absorbed. Women with a brighted ovum definitely have an embryo in the beginning. In early pregnancy loss, the pregnancy test still gives a positive result, as the placenta will continue to develop and secrete human chorionic gonadotropin (HCG). Pregnancy symptoms such as fatigue, nausea and breast pain are observed in the early period. Since the HCG hormone will continue to decrease in the late period, these symptoms gradually disappear and drip or normal vaginal bleeding begins. In the meantime, while the hormones are withdrawn, cramp-like pains may occur over time along with brown and red vaginal discharges. Since the uterus has not grown and developed, an empty gestational sac is observed in the ultrasound where the embryo and heartbeats are not observed.
In a normal pregnancy, gestational sac can be seen at 4.5 weeks at the earliest in ultrasonic examination, Yolk sac can be observed at around 5 weeks and embryo at 5.5 weeks. The pregnancy hormone HCG, made by the cells that make up the placenta, can be detected for the first time in the blood 11 days after conception, and in the urine 12-14 days later. Generally, the HCG level doubles every 48-72 hours. HCG level 8-11. peaks during pregnancy weeks. This level decreases during the remainder of pregnancy, but an early decrease may confirm pregnancy loss or the possibility of a blighted ovum. When the brighted ovum is determined, the next pregnancy will go up to 80-85% term. On average, 50% of all miscarriages result in a brighted ovum.
Empty Pregnancy Sac Treatment
In practice, especially the progesterone level should be followed closely so that the empty gestational sac, which is thought to develop due to low hormone levels, does not recur in the next pregnancy. This situation can be prevented with hormonal treatments such as progesterone. In cases of recurrent miscarriage, it is necessary to resort to assisted reproductive methods (IVF) to rule out genetic problems. Abortion may not be necessary after every diagnosis of blighted ovum. If all the pieces are removed with bleeding and no material remains in the uterus, abortion is not required. However, if a piece remains in the uterus, it may cause infection and thus adhesion of the inner wall of the uterus. Abortion (D/C) procedure can be decided both for this reason and to reveal the cause of miscarriage by performing pathological and genetic examination of the incoming material. In some cases, medications can be used to accelerate the miscarriage event. Even two weeks after the abortion during the waiting period, it may be advisable to protect against the possibility of ovulation (ovulation) with contraceptives.
Preventing Empty Gestational Sac Formation
Blighted ovum cannot be prevented and once encountered, the probability of encountering again in future pregnancies is very low.
Although it is not always possible to prevent the formation of an empty gestational sac, prenatal care should be done regularly before pregnancy in order to prevent early miscarriage, any chronic disease should be controlled, preventable risk factors such as smoking and drinking alcohol should be avoided. Genetic research can be done in couples who have lost. In this case, it is recommended to have regular menstruation two to three times before getting pregnant again.

Kiss. Dr. Kutlugul Yuksel
Gynecology and Obstetrics Specialist
Note: Article Written Date: 24.11.2011

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