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Questionable Study Makes Women Wonder Whether They Really Miscarried

Questionable Study Makes Women Wonder Whether They Really Miscarried

Today is Pregnancy and Infant Loss Remembrance Day, and with a new son and another on the way since last year, I still find myself thinking back to the baby I found out that I lost two years before with a bit of sadness in my heart.  Although the pain isn’t fresh, it is still memorable, and I feel both for the many women who went through the same struggle with me, and the many, many more who have losses that I have never known.

Which is why a new study published yesterday in Science Daily has me absolutely livid.

Via Jezebel, a group of papers being published in the journal Ultrasound in Obstetrics and Gynecology claim that the method being used to diagnose miscarriages may not be as accurate as doctors have believed, and that in fact, many doctors may be misdiagnosing healthy pregnancies as miscarriages and having patients terminate pregnancies that haven’t actually failed at all. “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 Basky Thilaganathan, Editor-in-Chief of the journal.

According to the papers, because miscarriage is often diagnosed by a failure of the pregnancy to progress in measurement from one week to the next, by using faulty equipment there is a possibility that unreliable ultrasounds are being misread to look like there is no progression, when in fact there is actually growth.  “The final study revealed that there is up to a 20% variation in the size of gestational sacs reported when different clinicians measure the same pregnancies. If the first measurement over-estimated the sac size and the second measurement some days later underestimated it, then it would be easy to incorrectly conclude that no growth had occurred.”

But there’s a separate issue with using that reasoning to declare a misdiagnosis of miscarriages.  Most women who are thought to have had a missed miscarriage (ie: a pregnancy that is no longer progressing due to lack of development into an embryo, or the loss of a fetus that the body doesn’t recognize has died in utero) receive at least two ultrasounds, the standard week apart, if not longer.  If there is no growth between that week, yes, it is assumed that there is a likely miscarriage, but not just because of size of sac, or unchanging size of fetal growth, but lack of other signs that the pregnancy is progressing, most importantly, a heart beat.

An empty sac at six weeks is not the best sign for a pregnancy, but still has hope.  An empty sac that still has no fetal pole at seven weeks is a pretty sure sign of a blighted ovum – an unsuccessful pregnancy.  A fetus that measures near 8 weeks but doesn’t show signs of a heartbeat is alarming, but could simply be measuring behind due to date.  But a fetus that should be one week older at the next measuring and doesn’t show definite signs of growth and still shows no heartbeat is another sure sign of miscarriage, since a heartbeat should be seen in a fetus that far developed.

As for my own pregnancy, a second ultrasound wasn’t necessary to verify what we knew.  I was supposed to be nearly 12 weeks pregnant, and the fetus both measured weeks behind and showed no heartbeat, either via abdominal ultrasound or transvaginal.  There wasn’t a doubt in the world that it was a missed miscarriage that needed to be followed up on.

Many women who miscarry deal not just with grief, but an overwhelming sense that if they had done something differently, maybe they would not have lost that baby, even when it’s almost never true.  To release a study especially right before Pregnancy and Infant Loss Remembrance Day, that would make women question if they would be holding that lost baby if they had just held on to hope is absolutely cruel.

 

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100 comments

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3:27PM PDT on Oct 24, 2011

Hugs to all those who have suffered the loss of a baby!

12:32AM PDT on Oct 22, 2011

A second opinion is always a good thing. Mind you, many times, you'll automatically go into labor. I miscarried via an abruption. I went into spontaneous labor. So unless you're 150% sure that it's a miscarriage, you're better off to let it go until labor is naturally occurring.

1:47PM PDT on Oct 18, 2011

It is much more difficult to lose your teen-aged son to a murderer and have the cops completely indifferent and even rude.

12:13PM PDT on Oct 18, 2011

Thanks for the info

8:48PM PDT on Oct 17, 2011

My two miscarriages were spontaneous abortions, so there was no doubt. Most women I know who experienced fetal death and then were induced, waited a few days before going ahead with the procedure to make sure, but after reading this, I'd definitely want another test.

7:17PM PDT on Oct 17, 2011

Thank You for this article, as we are trying to conceive it is great information. Indeed, in the past depending on where one lived and one's status maternal and infant mortality could be from 1/3 to 2/3rds of the population. If the mother did not die outright from placenta previa, or bleed out, she ran the risk of septacemia/blood poisoning after giving birth. Children often died during the act of birth because of complications, or after the advent of the use of forceps, many babies just had their heads crushed during delivery. My great-great-grandmother was a Midwife, and I have seen her books - she at least had both midwife and medical books to refer to. In many cultures the mentality was that the mother could die, but the child should live, if you had a choice of saving only one. After birth, more accidents of fate occured, especially during the time when wetnurses were used -- first off because the babies did not get their mom's immunities, and secondly by malnutrition, abuse, neglect or just being slept on by the wetnurses. So, yes give me the intense prenatal care, US's every week, genetic testing, and anything to make the odds better for my potential offspring.

5:25PM PDT on Oct 17, 2011

Miscarriages happen for a reason. Hearts that are broken over a blighted embryo or a miscarriage at three months would be equally, and I'm afraid far more permanently, broken over the birth of a child who could not survive, or who survived with terrible defects.

As hard and cruel as it may seem when it happens, a miscarriage is nature's way of saving the mother's body the stressful burden of carrying a pregnancy that can't and won't lead to a normal, healthy child.

2:58PM PDT on Oct 17, 2011

I knew of a women that was pregnant with twins, she miscarried one of the babies and the other one was born full term with down-syndrome. I too believe that this is nature's way of letting us know that the baby would not have survived if he/she was to come to term. God Bless All of the families that have lost a loved one. xoxoxoxox

10:35AM PDT on Oct 17, 2011

@Marjaana V "ok, how did we all manage without the endless ultrasounds?"

We managed with more stillborns. Seriously, did people forget why we used these things in the first place? I'm all for women having natural births, births underwater, whatever they want, but let's not forget that women historically used to die in childbirth all the time, and had stillborns rather frequently. America has more preemies born today, not because of shoddier healthcare (though it could be better), but because today's preemies were yesterday's stillborn children. As the old saying goes, fixing old problems creates new problems. Sure, "endless" ultrasounds might not be a great thing, but a few should not pose significant problems. Look at how many women get ultrasounds and their children turn out just fine.

6:12AM PDT on Oct 17, 2011

This happened in Ireland. A mother went for a scan and was told the her baby was dead. She didn't believe them and went for a second opinion. Turns out that the scan machine that was being used was faulty and therefore wasn't picking up heart beats. After she broke her story other women came forward and said that they had similar experiences all over the country. Not a good week for our health minister I can tell you. I'm no doctor and I don't claim to be but the suggestion I can give is, if you are in doubt at all get a second opinion, do not get bullied into taking abortive medicine, stand your ground. You may not get the happy ending you are hoping for or maybe you will, but at the same time at least you will be sure that your baby just simply wasn't strong enough and that's not your fault either :-(

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