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Miscarriage and Gestational Trophoblastic Disease
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
This is defined as a nonviable intrauterine pregnancy retained within the uterine cavity. The diagnosis is usually confirmed on ultrasound with an absent fetal heartbeat. In some cases, there is a gestational sac without a detectable fetal pole, described as “blighted ovum” or “anembryonic pregnancy”; however, these terms are now avoided with the use of set ultrasound criteria to diagnose miscarriage.
Ultrasound in the First Trimester
Published in Asim Kurjak, CRC Handbook of Ultrasound in Obstetrics and Gynecology, 2019
Asim Kurjak, Vincenzo D’Addario
The incidence of chromosomal abnormalities among aborted blighted ova is high.28 In the material of 24 blighted ova examined cytogenetically, Bulic and Singer29 found 50% chromosomal abnormalities (mainly trisomy, monosomy, and tetraploidy). We have investigated 72 pregnant women with blighted ovum in actual pregnancy.28 In 26 cases (36.1%) chromosomal aberrations were found, predominantly triploidy, monoploidy X, and autosomal trisomies. It is interesting that the two most common trisomies are those also found among live-bom children, trisomy of the 18th and 21st chromosome. We were unable to show any significant difference between the obstetric histories, ages, or parity of mothers with chromosomally normal as compared to abnormal blighted ova.28 In the same studies, 23 parents having blighted ovum in actual pregnancy were analyzed cytogenetically. In 13.6% of them, identical chromosomal aberrations were found as in the aborted material of blighted ova (mainly pericentric inversion of the ninth chromosome and translocations).
Conditions
Published in Sarah Bekaert, Women's Health, 2018
A blighted ovum is a fertilised egg that has ceased development at a very early stage. On ultrasound examination there is a gestational sac in which no fetal pole can be identified. Because the egg’s supporting tissue (trophoblast) may continue to function for some time after the death of the embryo, the sac may reach a considerable size.
Treatment considerations in myasthenia gravis for the pregnant patient
Published in Expert Review of Neurotherapeutics, 2023
A registry-based, nationwide cohort study from Denmark did not find any increased frequency of pregnancy loss in MG [64]. Pregnancy loss was defined as miscarriage, blighted ovum, or missed abortion. This occurred in 59 out of 463 MG pregnancies. They listed six events with two or more pregnancy losses; also this frequency is similar to the non-MG group. Case-series from France, Italy, Turkey, and Brazil reported all together 26 miscarriages in 162 pregnancies, i.e. 16% [8]. This is similar to the general population. In a US cohort of azathioprine users in the first pregnancy trimester for either autoimmune disease or after transplantation, spontaneous abortions occurred in 105 out of 471 pregnancies, i.e. 22%, and another 8 were stillbirths [65]. That was markedly lower figures than for mycophenolate mofetil, a drug with a well-known teratogenic risk.
Medical management of first trimester missed miscarriage: the efficacy and complication rate
Published in Journal of Obstetrics and Gynaecology, 2019
Tamara Serdinšek, Milan Reljič, Vilma Kovač
A missed miscarriage and a blighted ovum represent a form of spontaneous abortion that occurs in 10–20% of the clinically recognised pregnancies (Trinder et al. 2006; Barceló et al. 2012; Murphy et al. 2012; Jurkovic et al. 2013; Neilson et al. 2013). Although a surgical evacuation of the uterus has long represented a standard treatment for a missed miscarriage, medical management now represents a well-established alternative with very high success rates (Grønlund et al. 2002; Trinder et al. 2006; Barceló et al. 2012; Neilson et al. 2013). Although it can be associated with some side effects (vomiting, diarrhoea, and hypertension), a longer duration of bleeding, and possibly a greater risk for an unplanned surgical evacuation of the uterus, it is now considered as an acceptable and safe method of miscarriage management that is also well accepted by patients (Neilson et al. 2013).
Early Pregnancy Losses: Review of Nomenclature, Histopathology, and Possible Etiologies
Published in Fetal and Pediatric Pathology, 2018
M. Halit Pinar, Karen Gibbins, Mai He, Stefan Kostadinov, Robert Silver
Once a patient has been diagnosed with a pregnancy loss, it is important to use clear and appropriate nomenclature in the medical record when naming the diagnosis. The nomenclature currently used has been criticized for lack of clarity and promoting confusion (4,27,28). Traditionally, a pregnancy loss prior to 20 weeks was called a spontaneous abortion, and a loss past 20 weeks' gestation was termed a stillbirth or an intrauterine fetal death (IUFD). This separates a 19-week loss from a 21-week IUFD arbitrarily but places that same 19-week loss in the same category as a 5-week loss. Yet, the causes of the 19- and 21-week losses are more likely to be similar, while the etiologies of the 5- and 19-week losses are likely to be different. There are some old and poorly descriptive terms, such as missed abortion and blighted ovum, which have persisted since their introduction many years ago and have not undergone revision, despite the widespread application of ultrasound for accurate clinical assessment and diagnosis.