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14 Oct 2011 06:35 AM

Diagnosis Guidelines May Be Inadequate To Help Clinicians Detect Viable Pregnancies Thought To Be Miscarriages

Current guidelines that help clinicians decide whether a woman has had a miscarriage are inadequate and not reliable, and following them may lead to the inadvertent termination of wanted pregnancies. This is the conclusion of a series of papers published in the international journal Ultrasound in Obstetrics and Gynecology. "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," says Professor BaskyThilaganathan, Editor-in-Chief of the journal.

A miscarriage is often confirmed by using an ultrasound scan to see whether there is any sign of a pregnancy sac or embryo in the womb, and women understandably expect that when a diagnosis of miscarriage is made there is no room for error.

In four studies based at Imperial College London, UK, Queen Mary, University of London, UK, and the Katholieke Universiteit Leuven, Belgium, researchers found that current definitions used to diagnose miscarriage could lead to an incorrect diagnosis.

One piece of research showed that the data behind the current guidelines are based on old and unreliable evidence. "The majority of ultrasound standards used for diagnosis of miscarriage are based on limited evidence," says author Dr. Shakila Thangaratinam, who works in the Women's Health Research Unit at Queen Mary, University of London.

When there are suspicions that a woman has had a miscarriage, common practice is to use ultrasound to measure the size of the gestational sac and the embryo. One study shows that in some cases cut-off values to define miscarriage in these circumstances cannot be relied upon.

When there is doubt about the diagnosis of miscarriage, current guidance suggests the pregnancy sac should be re-measured seven to ten days later. If the sac does not grow, it is assumed that...
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