Is miscarriage being diagnosed correctly?

The following article appeared in the Sydney Morning Herald recently and raises some questions about the ultrasound diagnosis of early pregnancy miscarriage.

http://www.smh.com.au/national/health/miscarriage-mistakes-endanger-foetuses-20121228-2bz9v.html

There are a couple of points worth making in regard to the article and this issue. As Prof Condous and Dr Ramsay point out, whenever there is any doubt about the ultrasound findings a repeat ultrasound ought to be undertaken before any definitive decision is made.

However an important point which was not raised in the article relates to the context in which the ultrasound is done. For example the timing of the last menstrual period or pregnancy test results along with all the other relevant information in regard to each individual woman and her pregnancy. The ultrasound should rarely be viewed in isolation from this other information. It is after all only one part of the assessment of early pregnancy.

I would agree with Prof Permezel, misdiagnosis of miscarriage in Australia is likely to be very uncommon.

Some key points:
– ensure your ultrasound is done by a good quality ultrasound provider (not all ultrasound providers are equal – discuss with your GP)
– make sure the ultrasound result is reviewed in the context of your pregnancy and its progress so far
– if in doubt about the findings seek specialist advice and/or defer making a definitive decision until the scan is repeated
– be patient in early pregnancy – ultrasound diagnosis of miscarriage is often not reliable at gestations of less than 7 weeks – better to wait a bit longer for your ultrasound and get a more accurate and reliable result

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