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Missed Miscarriage, Blighted Ovum, and Chemical Pregnancy

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Because the placenta begins to develop and secrete human chorionic gonadotropin (hCG) in a blighted ovum, a pregnancy test will come back positive, even though no embryo is forming. The woman may also have some symptoms of a normal pregnancy early on, including fatigue, nausea, and sore breasts; however, hormone levels eventually begin to taper off causing the symptoms to subside and the woman to possibly notice some reddish-brown vaginal discharge, cramping, or bleeding.

The gestational sac and accumulated tissue is usually expelled by the end of the first trimester, if not earlier. However, the process of expelling the tissue completely can take weeks and many women opt to have a D&C once they find out their pregnancy has ended.

Chromosomal abnormalities usually cause a blighted ovum, and having one blighted ovum does not increase the risk of having another, and experts don't consider it a sign that there is anything wrong with either partner. However, if you have several consecutive miscarriages, your doctor may suggest testing to determine if there is something wrong.

Chemical Pregnancy

A chemical pregnancy is thought to occur when an egg is fertilized, but dies soon after implantation. A chemical pregnancy will cause a pregnancy test to come back positive, but only faintly so, and a blood test normally shows very low hCG levels that don't increase over time.

This type of early miscarriage is called a chemical pregnancy because a pregnancy is not considered "clinical" until it is confirmed with an ultrasound, usually around 5 or 6 weeks. A chemical pregnancy is similar to a blighted ovum and would become one if the pregnancy developed for several more weeks and a sac formed without the embryo.

Chemical pregnancies are thought to be fairly common, involving as many as half of all pregnancies, but an accurate number is hard to determine because most women who experience a chemical pregnancy never even realize they are pregnant unless they are trying to conceive and testing regularly and early. Most women assume their period was just a few days late and is unusually heavy; and they may also notice some small blood clots and unusual cramping. Many chemical pregnancies are discovered today that would otherwise have gone undetected due to the ultra sensitive pregnancy tests on the market, which make it easier to get a positive result 3 or 4 days before a woman's period is due.

Women who were aware that they were pregnant before the miscarriage should be monitored to ensure their hCG levels go down to pre-pregnancy levels. There is the possibility of an ectopic pregnancy, so it is necessary to ensure that a full miscarriage has occurred (all the fetal tissue is expelled), even if the woman has had a period.

Most chemical pregnancies are due to chromosomal problems in the developing fetus. Other possible causes include inadequate uterine lining, uterine abnormalities, low hormone levels, luteal phase defect, or certain infections. There is no way to prevent chemical pregnancies; however, your doctor may suggest you take vitamin B6 and baby aspirin, and apply progesterone cream, all of which can help lower the risk. If your doctor determines that an infection caused the chemical pregnancy, he or she may prescribe antibiotics to clear the infection and reduce the likelihood of another such miscarriage.

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