Women are in danger of terminating wanted pregnancies because of unreliable guidelines on detecting miscarriage, it has been warned.
‘These statistics are undoubtedly worrying for patients and offer yet more evidence that the NHS is struggling to cope with an inexorable rise in demand. Our members are seeing an increased number of patients requiring urgent care and this has an inevitable effect on the ability of hospitals to manage planned treatments.
Four studies based at Imperial College London, UK, Queen Mary, University of London, UK, and the Katholieke Universiteit Leuven, Belgium, found that current definitions used to diagnose miscarriage could lead to an incorrect diagnosis.
A series of papers published in the international journal Ultrasound in Obstetrics and Gynecology has concluded that improvements need to be made to minimise errors.
A study by Dr Shakila Thangaratinam, of the Women’s Health Research Unit at Queen Mary, University of London, claimed that the data behind the existing guidelines are based on “on limited evidence".
Another study, led by Professor Tom Bourne from Imperial College London, warned that measuring the pregnancy sac to determine miscarriage may also lead to unnecessary terminations.
If doctors are unable to diagnose a miscarriage straight away, current guidance suggests re-measuring the pregnancy sac seven to 10 days later to check for f any growth.
But, says Prof Bourne, who co-authored a third paper in the series, healthy pregnancies may show no measurable growth over this period of time.
“By identifying this problem we hope that guidelines will be reviewed so that inadvertent termination of wanted pregnancies cannot happen. We also hope backing will be given to even larger studies to test new guidelines prospectively," says Bourne.
The final study, by Dr Anne Pexsters of the Katholieke Universiteit Leuven, revealed discrepancies of up to 20 per cent in the size of gestational when different clinicians measure the same pregnancies, which could also result in an incorrect diagnosis of miscarriage.
“Many of us in clinical practice have been concerned for some time about possible errors relating to the diagnosis of miscarriage,” said Professor Dirk Timmerman from Katholieke Universiteit Leuven and co-author of three of the research papers.
“We are pleased that our data have identified where these errors might occur so that we can prevent mistakes happening in the future.”
Professor Basky Thilaganathan, editor-in-chief of the journal, said: “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.”
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