At 5w 4d, was grocery shopping and felt dizzy. Severe pain, gush of blood. The ultrasound at the ER showed a gestational sac but no fetal pole or yolk sac. Bleeding stopped and mouth of uterus was closed, so they sent me home to follow up in a few days.
They are saying it’s probably a blighted ovum, and it might be because of my hyperparathyroidism (causing high blood calcium; had surgery for this in 2011 but it’s apparently recurring). I am devastated.
Following up tomorrow with a high-risk ob/gyn. I am so afraid to hope for the best, because even if this were a viable pregnancy now, it could still be undermined by the hypercalcemia.
Has anyone had a blighted ovum/ anembryonic pregnancy? If so, how did you cope?
I am very sorry for your loss. I would say that an ultrasound showing a clear amniotic sac with trophoblast (the part that eventually develops into the placenta) but no embryo is diagnostic. As you might know, as soon as a fertilized egg reaches the handful-of-cells stage it divides into two parts: the part that becomes the placenta and membranes, and the part that becomes the fetus. Once they diverge their fates are distinct but remain interdependent, such that a serious problem with the embryo can occur but the placenta can initially remain OK. The embryo will die, but the placental part will soldier on until it ‘realizes’ there is no more embryo [i.e. no embryo sending life-sustaining chemical signals to grow, proliferate, secrete hormones, etc] and it, too, will die and slough. You as the mother will experience this as a miscarriage with bleeding.
I personally wouldn’t attribute this to high calcium levels. While it’s important to treat hyperparathyroidism if your calcium is genuinely very high (>12), a lethal insult at this very early stage of development is nearly always due to a genetic problem. It could be severe chromosomal abnormalities, a very important developmental gene that was never turned on, a mutation that occurred during early cell division causing the mistake to be propagated on down the line to every cell in the embryo… in short absolutely nothing that you did wrong, absolutely nothing that your body did wrong, just a very ugly and unfortunate ‘thing that happened.’
PS if you had conservative parathyroid surgery (assuming you had primary hyperparathyroidism with a parathyroid adenoma), do you know how many glads were removed? Often times there is a “missed adenoma” where a small secondary adenoma is hiding away. It was relatively silent when the main adenoma was pumping out all that PTH, but one the big bad gland is gone, the secondary adenoma gets its day in the sun. It’s not usually a problem unless you’re actually having hypercalcemia symptoms like bone pain, mood changes, kidney stones, osteoporosis…
Thank you for your kind words. I actually have MEN1 (found out last year via genetic testing, after subtotal parathyroidectomy) and have the benign tumors in all three glands (parathyroid, pancreas, pituitary). I’ve been fortunate to have three healthy and uneventful pregnancies (and children, one of whom is affected), but I wasn’t symptomatic for hyperpara until the end of 2010- beginning of 2011. Now that we have thought hard about the risks, decided that it’s certainly not the worst condition one can have, and that we would like to have more children (we’d thought we were done), I am in close contact with the doctors but should have talked more with my endocrine surgeon first, I think. I am anticipating that she will recommend more surgery.
The original parathyroidectomy took out two-and-a-half glands, I believe. They weren’t able to find more than that, so the thought is that some of them were “kissing”. I have family members with MEN1 who have normal calcium levels now, after having had the parathyroidectomy where some tissue is implanted in the forearm (can’t remember what it is called, though).
It’s interesting that you had three confirmed adenomas yet had 2.5 parathyroids removed? The subtotal parathyroidectomy is a nice option because usually 1/2 of a gland is preserved and implanted in the forearm; it allows a steady level of PTH to be secreted so you don’t necessarily have to be on heavy calcium supplementation.
Again, I am very sorry for your loss, but just want to reiterate that I think it was completely independent of MEN or hypercalcemia, and the odds of it recurring are the same as anyone else’s.
Thank you, [name]Blade[/name]. I hope you are right. Either way, we will probably have to wait until this is under control again.
I think the adenomas elsewhere were unconfirmed (but the pituitary one was definitely suspected) until at least a few months after the parathyroidectomy. I’ve had so much imaging I can’t even remember what’s happened/when it happened anymore.
[name]Laura[/name], I’m so sorry youre going through this. Hang in there during the waiting and know that thoughts and prayers are with you and your family as you find out more about what is going on.
Somehow, when we went in yesterday for the ultrasound, we saw a 2.5mm embryo with a heartbeat!!!
I cannot describe the shock and excitement of this. I am not what you would call an optimist. It’s still scary because I have hypercalcemia, and this can cause miscarriage at another time or problems in the newborn, to name a few things. We will just have to hope for the best, and they will probably do surgery on my parathyroids again in the second trimester.
I want to thank everyone so much for their support.
ER docs think they know how to use ultrasound, but honestly the machines in the ER are so vastly inferior to the fancy ones radiologists / sonographers have access to that you can miss so much.
As you doubtless know surgery in the second trimester, especially outside the abdomen, is quite safe.
No, I didn’t know that, [name]Blade[/name]. I assumed it was totally sketchy to have to have surgery during pregnancy at all. Maybe I will read about it (or maybe not!).
If you have to have surgery during pregnancy, the second trimester is the time its done. The first trimester is when you worry about teratogenesis (birth defects); the third is when you worry about actually precipitating labor (or, for intraabdominal surgery, maneuvering around the uterus), but the second is the sweet spot. Obviously no purely elective operations are done-- no nose jobs or joint replacements-- but plenty, plenty, plenty of pregnant women have operations. The anesthetics affect the baby the same way they affect you, but as long as you don’t deliver within an hour or so of your operation [name]Baby[/name] metabolizes them off. No harm, no foul.
Yes, you are supine on the table. Would that be a problem? There are positioning aids if so.
No, I don’t think that would be a problem. I’m just a little squeamish about being flat on my back, even early on.
The weird thing is that the surgeon is saying now (through email) that I might NOT have to have surgery at all during the pregnancy. But from what I’ve been reading, it sounds like baby and I would be much less likely to have complications if I did have the surgery! I don’t know what to be more afraid of: surgery or no surgery! Wouldn’t a [name]Ca[/name] value of 10.9 already be high enough for them to want to do the parathyroidectomy in the 2nd trimester??
Bleeding stopped and mouth of uterus was closed, so they sent me home to follow up in a few days.
That’s devastating! Thinking of you. 
Well congrats again!