Blighted Ovum Adalah Pdf Download
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Heterotopic pregnancies are rare in spontaneous conceptions. Nonetheless, when it does occur, the intrauterine pregnancy is usually viable. We herein present a true rarity of the coexistence of a blighted ovum and an ectopic pregnancy.
A 25 year old G2P1001 married seamstress of African ethnicity at 8 weeks of amenorrhoea presented to our health facility with a 4 day history of lower abdominal pains and vaginal bleeding for which physical examination revealed a closed cervix. Trans-abdominal ultrasound scan confirmed a diagnosis of a blighted ovum and an ectopic pregnancy. Patient was managed with surgical therapy. Evolution thereafter was uneventful.
The case presented confirms that HP can occur in the absence of predisposing factors, and that the detection of a blighted ovum should not preclude the possibility of a simultaneous ectopic pregnancy. A high index of suspicion could lead to early diagnosis, prompt management and a favourable prognosis even in a low-income setting.
Heterotopic pregnancy (HP) is often used to describe the coexistence of an intrauterine and an ectopic pregnancy . It is a seldom but yet fatal condition whose diagnosis can easily be missed. Heterotopic pregnancies are thought to be caused by multiple ovulations; the incidence is thus expected to be higher amongst women with assisted reproductive techniques [2,3,4]. The incidence of HP in the general population is estimated to be 1 in 30,000. However, incidence as high as 1% have been reported in patients with assisted reproduction; induction with clomiphene citrate, in vitro fertilization etc. [1, 3]. The ectopic component of HP could be a living or dead foetus found either in the cervix, fallopian tubes, ovaries or even intra-abdominal. Likewise, the intrauterine pregnancy could either be dead or alive in the uterine cavity [5,6,7]. However, not much has been reported on a blighted ovum as the intrauterine component of an HP.
She reported being well till 4 days prior to presentation when she started experiencing abdominal pain; the pain was mainly in her lower abdomen, dull in nature, non-radiating, mild in intensity and was initially intermittent then became constant. It was associated with mild per vagina loss of bright red blood. She had no other symptoms. This prompted her to consult at a drug store, where she was prescribed phloroglucinol tablets 80 mg/day in 2 divided doses which she took for 3 days but had no regression of the symptoms. The persistent lower abdominal pain and mild vagina bleeding prompted a second consultation at our health facility. Upon presentation she was haemodynamically stable and vaginal examination was relevant for a closed cervix. A presumptive diagnosis of threatened abortion with possible aetiology of a urinary tract infection was made. Urinalysis showed leucocyturia while obstetric echography revealed an empty gestational sac measuring 29.9 mm. Diagnoses of blighted ovum and urinary tract infection were made. She was given a short course of antibiotics and programmed for manual vacuum aspiration. Vacuum aspiration was done and the patient served a single intramuscular dose of 10 units of oxytocin. The bleeding and lower abdominal pain stopped and she was discharged the next day.
The intrauterine component of an HP could be a single or multiple gestations, live or dead, could be aborted spontaneously or progress to term safe delivery . In our extensive search of literature using Google scholar, Pubmed, African journal online (AJOL) and HINARI search engines, no case of a blighted ovum as the intrauterine component of an HP had been reported. This case is thus of particularity as it is does not only present an HP in natural conception but also describes a blighted ovum as the intrauterine component of the HP, which is a true rarity.
Tal and colleagues in a review reported that 70% of HPs are diagnosed between 5 and 8 weeks, 20% between 9th and 10th week and remaining 10% from 11th week . The case reported falls in line with the 20% of people diagnosed between 9th and 10th week. An ectopic pregnancy and a blighted ovum have similar presentations of: no symptoms, lower abdominal pain, and vagina bleeding. This was the case with our patient. The similarity in symptoms and rarity of its co-occurrence could make one to preclude the diagnosis of the other.
The case presented confirms that HP can occur in the absence of predisposing factors, and that the detection of a blighted ovum should not preclude the possibility of a simultaneous ectopic pregnancy. We therefore advocate in all pregnant women with first trimester bleeding even in the presence of a confirmed blighted ovum, a complete review of the whole pelvis including adnexa during ultrasound scan.
A blighted ovum, also known as an anembryonic pregnancy, occurs when a fertilized egg implants and a gestational (embryonic) sac forms and grows, but the embryo fails to develop. A blighted ovum is the single leading cause of miscarriage. This activity outlines the management of blighted ovum and highlights the role of the interprofessional team in educating the patient on this condition.
Objectives:Outline the risk factors for a blighted ovum. Describe the clinical presentation of a patient with a blighted ovum.List the treatment and management options available for a patient with a blighted ovum.Employ interprofessional team strategies for improving care coordination and communication to enhance fertility rates in patients with a history of miscarriage.Access free multiple choice questions on this topic.
An anembryonic pregnancy is characterized by a gestational sac that forms and grows while an embryo fails to develop. Although the terms anembryonic pregnancy and blighted ovum are synonymous, the latter is falling out of favor for the more descriptive former term. Anembryonic pregnancy constitutes a significant but unknown proportion of miscarriages with the American Pregnancy Association estimating anembryonic pregnancy to constitute half of all first trimester miscarriages. Approximately 15% of all clinically recognized pregnancies end in first-trimester loss with live birth occurring in only 30% of all pregnancies.  A significant proportion of patients with early pregnancy loss(that include anembryonic pregnancies) are unaware of their miscarriage particularly when early pregnancy loss occurs in the early stages of pregnancy.
A Technically, when a gestational sac is present, the patient is still pregnant, so the GYN codes are inappropriate. And yes, you should assign the diagnostic code for blighted ovum (ICD-9-CM code 631).
The primary outcome was determining the relationship between serum progesterone (P4, ng/ml) and estradiol (E2, pg/ml) levels on the day of ET and live birth rate (LBR) in artificial endometrial preparation cycles. The secondary outcomes included the clinical pregnancy rate (CPR) (the number of pregnancies with presence of a gestational sac with fetal heartbeat on vaginal ultrasound per ET cycles), blighted ovum rate (the number of pregnancies per ET cycle in which the embryo fails to develop or is reabsorbed), miscarriage rates (the number of the spontaneous loss of a clinical pregnancy before week 20 per ET cycles) and LBR (the number of deliveries that resulted in at least one live born fetus per ET cycle).
Blighted ovum atau kehamilan anembrionik merupakan keadaan dimana seorang wanita hamil namun tidak terdapat janin didalam kandungannya, dikarenakan ovum yang dibuahi tidak berkembang. Hingga saat ini penyebab kejadian blighted ovum belum dapat dideteksi karena gejala yang tidak spesifik. Umumnya kejadian blighted ovum terjadi pada trimester I dan memungkinkan untuk terulang kembali pada kehamilan selanjutnya. Tujuan penelitian ini untuk mengetahui gambaran kejadian blighted ovum. Metode penelitian yang digunakan adalah Literature Review yang didapatkan dari 3 database yaitu PubMed, ResearchGate dan Google Scholar dengan kriteria inklusi jurnal terakreditasi Sinta dan Scopus. Hasil penelitian dari 5 jurnal yang telah diidentifikasi melalui proses literature review didapatkan karakteristik ibu hamil berdasarkan usia, paritas, imunologis, dan kelainan genetik ada pada ibu hamil dengan blighted ovum. Ibu hamil yang mengalami blighted ovum memiliki karakteristik usia >40 tahun dengan paritas multigravida dan grandemultigravida serta kelainan genetik.
It is clinically important to distinguish molar pregnancy from nonmolar hydropic changes because the former can cause persistent trophoblastic disease. Furthermore, the blighted ovum is a common feature in ectopic pregnancy and can easily be misinterpreted as a true hydatidiform mole .
Five biochemical (positive hCG) pregnancies were recorded in the study group (double trigger) and none in the hCG-only trigger group. Of which, 3 (37.5%) are ongoing and one resulted in a blighted ovum. However, it should be emphasized that the increased pregnancy rate in the study group (double trigger) is biased due to the study design which offered this protocol to patients who had failed a previous IVF attempt. 2b1af7f3a8