British criteria for diagnosing miscarriage should be reconsidered, researchers say today.
The latest guidelines, introduced in 2011, still leave a possibility that the problem could be misdiagnosed – leading to the termination of a healthy pregnancy, according to a study at Imperial College, London.
Currently the guidelines say that if a second ultrasound scan is needed it can take place after seven days.
The researchers say it is safer to wait 14 days for the second scan.
The prospective multicentre observational trial, reported in The BMJ, involved 2,558 women attending pregnancy clinics across London, reporting possible symptoms of miscarriage. When there was uncertainty, women were being asked to return at intervals of between seven and 14 days.
The researchers say there was a false positive rate of nearly 2% among women who returned after seven days.
Researcher Professor Tom Bourne said: "Women should be able to rely on a diagnosis of miscarriage. It’s an area of medicine where the highest levels of caution are warranted.
"Although we have shown some aspects of the current guidelines are very good, our new study provides us with better data to guide clinicians and improve diagnostic accuracy."
He added: "We would also like to see updated guidelines complemented by improved patient information so that women know that being told they need a second scan is not a reflection of the quality of the first scan, but a necessary failsafe to ensure misdiagnosis cannot occur."
Bourne et al. Defining safe criteria to diagnose miscarriage: prospective observational multicentre study. BMJ 24 September 2015 [abstract]
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