As if anxiety about potential error were not quite stressful for newly pregnant women, research published Friday shows that the current guidelines for using ultrasound to determine that a pregnancy is completed can not always be accurate.
Four new studies looked at ultrasound U.K. specifications, but when the results are extrapolated to the guidelines of the U.S., researchers suggest that 1 in 23 women diagnosed with error could still have a viable pregnancy.
That could mean for the future of such incorrectly doomed pregnancies is not known. Researchers analyzed not if women in the studies that have been informed that their pregnancies had ended then has to have surgery to remove their uterus.
But just the possibility that a pregnant woman unintentionally would end a pregnancy viable is intolerable, said Tom Bourne, Professor of Gynecology at Imperial College London and principal author of three related studies published in the journal ultrasound in obstetrics and Gynecology. "We are concerned that the current guidelines can lead to a misdiagnosis," said Bourne. "The current thresholds for error are not appropriate."
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Ultrasound is the gold standard used to determine the error. It is assumed - at least by pregnant women - exceptionally precise. Yet, studies, who analysed the existence or the size of the gestational sac, concluded that the presence or absence of a gestational sac, as well as its size, were not infallible indicators of spontaneous abortion.
The researchers followed 1,060 women who complained of slight bleeding or pain - the two potential signs that a pregnancy is distressed - between five and eight weeks of pregnancy and had an initial ultrasound. As is practical, they returned seven to ten days later for a further analysis measure the growth of the bag. Those who were still pregnant were followed again between 11 and 14 weeks.
Generally, an embryo enjoyed 6 mm with no increase in the size of the gestational sac between detectable scans or without a heartbeart is supposed to indicate the spontaneous abortion, but Bourne concluded that it is possible that a pregnancy may not grow measurable in a week. In fact, half a percentage point for women in the study - or 1 in 183 - still could be pregnant even if scanning guidelines technically would have classified their pregnancies in the end.
To the United Kingdom, ultrasounds which reveal an empty gestational sac over 20 mm in size lead to a diagnosis of spontaneous abortion. In the United States, the standard established by the American College of Radiology is 16 mm. based on the findings of researchers, 8 in 183 U.S. women - or 1 to 23 - would have a miscarriage diagnosed incorrectly.
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Another study concluded that a gestational sac can vary up to 20% according to the who made the measure; different clinicians obtain different results. Imagine, for example, that a Sonographer overstates size of CCS, and then a second ultrasound later underestimates it. The confusion which could lead to a women being falsely that she had failed.
To increase the precision, Bourne recommends ultrasound guidelines be updated and increased standards for the determination of miscarriage.
Jonathan Schaffir, Associate Professor of obstetrics and Gynecology at the Ohio State University, who was not involved in the research, said that the British studies are important, even if it is likely that most of the doctors who suspect miscarriage at early stages of pregnancy would adopt a wait-and-see approach. "It is important of Miss not even a viable pregnancy, but it is rather unusual to determine the error based on an analysis of these measures at the beginning, at the beginning," he said. "From a practical point of view, the results of these studies will not change clinical practice."
Bonnie Rochman is a journalist in time. Find him on Twitter at @ brochman. You can also continue the discussion on the time Facebook page and Twitter time @.
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