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Yes, it definitely can be mistaken for a viable pregnancy. An ultrasound can usually help in determining whether it is a blighted ovum or a pregnancy. If the sac is >8mm without a visible yolk sac (transvaginal ultrasound) or >16mm without a visible embryo (also transvaginally), it is considered a blighted ovum. Transabdominally, it is a blighted ovum if it measures >20mm without a visible yolk sac or >25mm without a visible embryo.

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