Blighted Ovum: A Case Report.
A blighted ovum refers to a fertilized egg that does not develop, despite the formation of a gestational sac. The most common cause of a blighted ovum is of genetic origin. Trisomies account for most first trimester miscarriages, while consanguineous marriages result in recurrent miscarriages due to a blighted ovum. Additionally, a higher percentage of deoxyribonucleic acid (DNA) damage in sperm carries a higher rate of miscarriage. Nutritional factors that may lead to a blighted ovum include low-levels of copper, prostaglandin E2, and anti-oxidative enzymes.
The case presented is of a 28-year-old female with a blighted ovum, with a focus on outpatient management. With 50% of miscarriages occurring in the first trimester, it is very likely that primary care physicians will encounter a patient with a blighted ovum and will have to properly manage the patient, whether it be expectant or a more invasive approach.
A 28-year-old African American patient, G6P2 at 11-weeks gestation by last menstrual period with a past medical history of obesity and iron deficiency anemia presented with hyperemesis, abdominal
pain, shortness of breath, urinary frequency, and passage of blood clots through the vaginal canal. A urine β-hCG conducted in the office indicated that the patient was pregnant. An ultrasound performed one-week previous by the patient’s primary care provider was unable to establish an intrauterine pregnancy. Transvaginal ultrasound indicated an anteverted uterus measuring 11.6×8.2×7.8 cm.
From an epidemiologic perspective, half of the global population has the potential to undergo a gestation. With consanguineous marriages being prevalent in certain ethnic groups, there is a likelihood of a physician having a patient with a blighted ovum. Physicians should be well-versed in how to manage a blighted ovum and the treatment modalities available.
Women Health Open J. 2020; 6(1): 3-4.doi: 10.17140/WHOJ-6-135
