**Question:** A 28 years old female with a history of 8 wks amenorrhoea complains of vaginal bleeding and lower abdominal pain. On USG examination there is gestational sac with absent fetal parts. The diagnosis is:

A. Ectopic pregnancy
B. Molar pregnancy
C. Abnormal placental implantation
D. Blighted ovum

**Correct Answer:** D. Blighted ovum

**Core Concept:** A blighted ovum, also known as a molar pregnancy, is a type of ectopic pregnancy characterized by the presence of a gestational sac with fetal parts missing or morphologically abnormal. This typically results from a chromosomal abnormality during fertilization, leading to a non-viable pregnancy.

**Why the Correct Answer is Right:** The correct answer (D) is a blighted ovum, as it aligns with the given clinical scenario. In this case, the patient presents with a gestational sac and absent fetal parts. This indicates that although a fertilized egg implanted in the uterus (ectopic pregnancy), the pregnancy is non-viable due to chromosomal abnormalities during fertilization (molar pregnancy).

**Why Each Wrong Option is Incorrect:**

A. Ectopic pregnancy: While the patient has an ectopic pregnancy (option A), the absence of fetal parts makes the diagnosis of a non-viable pregnancy (blighted ovum) more likely.

B. Molar pregnancy: Although molar pregnancy (option B) is a type of ectopic pregnancy, the presence of a gestational sac with absent fetal parts makes a blighted ovum (option D) a more accurate diagnosis.

C. Abnormal placental implantation: This option is too vague and does not specifically address the absence of fetal parts, making option D (blighted ovum) a more suitable diagnosis.

**Clinical Pearl:** Blighted ovum is a rare but serious condition that requires appropriate management to prevent complications such as hemorrhage, uterine rupture, or perforation. If diagnosed early, these patients may be managed conservatively with expectant care, but in severe cases, surgical intervention may be necessary. Timely diagnosis helps prevent life-threatening complications.