Blighted Ovum

I've had two blighted ova since June. What causes this and what can be done about it? Should I be concerned? I am getting very upset and depressed.

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

The term blighted ovum has come to be synonymous with miscarriage, but generally it refers to the absence of fetal tissue detected in the pathology exam of any specimen following a miscarriage. Most of the time, the fetal tissue has already been passed or may have deteriorated.

Chromosomal abnormalities are responsible for about half of the miscarriages that occur before 12 weeks. Fetal death almost always precedes miscarriage, and the death may be related to many different things: abnormal development, uterine or hormonal problems, infection, thyroid problems, diabetes, progesterone deficiency and environmental factors. The list just goes on and on. Usually, we just don't know why women miscarry.

Some providers do not feel it is cost effective to do a work-up until a woman has miscarried twice or even three times. This is due to studies which show that most women will retain the third pregnancy (or fourth) just as successfully whether an investigation is made or not.

I feel that other factors must be considered, however, and age is one of them. Fifty to 60 percent of all early spontaneous abortions are associated with a chromosomal abnormality, but without an obvious, strong family history, as genetic testing is not usually done after one or two miscarriages. However, a study for antiphospholipid antibodies, including the lupus anticoagulant and anticardiolipin antibodies, could be done now.

Rarely, a lack of progesterone from the corpus luteum (where the egg ruptures) can cause miscarriage. Measuring progesterone and doing an endometrial biopsy following ovulation can sometimes diagnose this problem.

From a nutritional and environmental perspective, unless deprivation or exposure is extreme, these are rarely causes of recurrent miscarriage. Coffee consumption in excess of four cups per day has been associated with miscarriage in some studies and, of course, smoking and alcohol consumption have been implicated as well. I would just eat a well balanced diet.

The following are some books available on the subject:

"How To Prevent Miscarriage And Other Crises Of Pregnancy"
Stefan Semchyshyn and Carol Colman; foreword by Frederick P. Zuspan.
New York: Macmillan, 1989

"Miscarriage: a Shattered Dream"
By Sherokee Ilse and Linda Hammer Burns
Wintergreen Press, 1985

"Preventing Miscarriage: The Good News"
Jonathan Scher, Carol Dix.
New York: Harper & Row, 1990

I am sorry that this has happened and I hope you are getting lots of support.

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