Flawed miscarriage diagnosis criteria may lead to abortion of healthy babies: study
LONDON, UK, October 17, 2011 (LifeSiteNews.com) - According to a report published in the international journal Ultrasound in Obstetrics and Gynecology, current ultrasound scan guidelines used to determine if a women has had a miscarriage are inadequate and unreliable, and following these guidelines may result in healthy and wanted pregnancies being aborted.
“This research shows that the current guidance on how to use ultrasound scans to detect a miscarriage may lead to a wrong diagnosis in some cases. Health professionals need clearer evidence-based guidance to prevent this happening,” said Professor Basky Thilaganathan, editor-in-chief of Ultrasound in Obstetrics and Gynecology.
Currently, when a miscarriage is suspected, the standard test is an ultrasound scan to measure the size of the gestational sac and look for the presence of an embryo.
When there is doubt about the diagnosis of miscarriage, current guidelines suggest the gestational sac should be re-measured seven to ten days later. If the sac has not grown, it is assumed that a miscarriage has occurred.
However, the study led by Professor Tom Bourne from Imperial College London found that perfectly healthy pregnancies may show no measurable growth over this period of time. Moreover, the study revealed a variation of up to 20% in the reported size of gestational sacs when different clinicians measure the same women, showing that an incorrect first measurement compounded by an error in the second measurement could easily lead to the misdiagnosis that a miscarriage had occurred when in fact a healthy child was living in the mother’s womb.
If a miscarriage is diagnosed a mother may be advised to wait and let the miscarriage progress naturally, or choose to speed up the process by a surgical intervention, such as dilatation and curettage where the lining of the womb is scraped with a curette, which could lead to the death of a healthy child if miscarriage is misdiagnosed.
“Currently there is a risk that some women seeking reassurance with pain or bleeding in early pregnancy may be told they have had a miscarriage, and choose to undergo surgical or medical treatment when the pregnancy is in fact healthy,” said Professor Bourne.
“By identifying this problem we hope that guidelines will be reviewed so that inadvertent termination of wanted pregnancies cannot happen.”
Researcher Dr Shakila Thangaratinam, Senior Clinical Lecturer at Queen Mary, University of London said there is an urgent need to conduct a large-scale study to be confident that diagnosis of miscarriage is correct in every case using the ultrasound measurements.
“When we’re testing to see if someone has a healthy pregnancy or not, we want to be absolutely confident that the test is reliable to avoid making a misdiagnosis. Our paper raises concerns about the gaps in evidence,” said Dr Thangaratinam.
The full text of the study titled “Accuracy of first-trimester ultrasound in the diagnosis of early embryonic demise: a systematic review” is available here.