Monday, October 27, 2014

When Good Pregnancies are Misdiagnosed as Molar Pregnancies

Every so often on The Misdiagnosed Miscarriage, women share that their doctors have diagnosed a molar pregnancy and are pushing for a quick D&C.

Now, a molar or partial molar pregnancy is quite serious.   A molar pregnancy is when the mother's chromosomes are somehow 'lost' and the father's chromosomes are duplicated.  In a partial molar pregnancy, the father's chromosomes are duplicated again but the mother's remain as well.  This can happen with duplication or if two sperm fertilize the egg.

According to the Mayo Clinic, about 20% of women who have had a molar pregnancy will develop gestational trophoblastic disease.  This happens when the tissue remains and continues to grow.  You'll see hCG levels rise as well.  When this happens, chemotherapy may be needed.  Very rarely this will turn into cancer.  Generally, a complete molar pregnancy can be detected by about nine weeks. 

As you can see, you should take a molar pregnancy but I was reminded today of how frequently good miscarriages are misdiagnosed as being molar as in Gabrielly's story.  We've been emailing back and forth.  She was being misdiagnosed too soon with a molar pregnancy.  We've had other similar stories as well, such as Heather's story and Dani's story. 

I have a suspicion that some doctors *may* use the molar diagnosis to pressure women into having a quick D&C.   Very few pregnancies have ended up being molar in my years on the site.  Those women seemed to have really high hCG levels (over 100,000) or other signs (i.e. grapelike clusters, pain, bleeding, etc...).  Reading through online literature and it sounds like partial molar and molar pregnancies are often caught at the end of the first trimester and into the second trimester. 

How early can a molar pregnancy be caught?  This is what I've really been wondering since so many women who are being misdiagnosed with a molar pregnancy seem to be between 6-8 weeks.

I found this study:

A prospective study of ultrasound screening for molar pregnancies in missed miscarriages.

"The diagnosis of both complete (CHM) and partial (PHM) hydatidiform moles in first-trimester miscarriages is difficult. hCG is significantly higher in both CHM and PHM and, in conjunction with transvaginal ultrasound, could provide the screening test required to enable clinicians to counsel women more confidently towards non-surgical methods of management of their miscarriage, where histopathological examination is not available."

For this reason, if there is any reason to suspect your doctor is wrong in their diagnosis, you really might want to consider a second opinion especially during the first trimester.  Stay monitored though.

As always (((hugs))) if you are going through this scare.

Thursday, October 23, 2014

Misdiagnosed Miscarriages in the ER - A Real Problem

According to, misdiagnosed cases in the ER or ICU range from 20% to 40%.  These numbers are huge.

I have been very thankful for ER doctors in the past but, please remember, they are treating everybody no matter what their specialties might be.  They don't have a lot of time with each patient either.  They are going from one room with a car accident victim to the next were somebody has cut his finger with a saw to the room with the toddler with a 104 temperature to the room where a pregnant women is bleeding.

Is it any wonder they don't get it all correct?

A woman just shared her daughter in law's experience.  At just shy of seven weeks, she went to the Emergency Room due to serious cramping.  No baby was visible.  They diagnosed a miscarriage.  Thankfully her DIL did not give up and they insisted on another appointment to verify.  At that appointment, they found the baby.

You may read her story here: 

Gmvallejo's DIL Story: Misdiagnosed in the ER

 I am sharing her story today because we have been seeing these stories for years.  Indeed, I was misdiagnosed in the ER as well and have shared that story.

Misdiagnosed at 12 Weeks

Our site is filled with stories of women misdiagnosed in the ER.  This doesn't mean that every woman that goes in there is misdiagnosed but it could mean that, at the very least, 1 in 4 may be.  This is important because you need to know there may be hope and you may need a second opinion.

I know I keep going on about the new UK guidelines:

Misdiagnosed Miscarriage? The UK Has Changed their Guidelines. Your Doctor Needs to Take Note.

but if your gestational sac is not yet 25mm, you should not be diagnosed with a blighted ovum.  The new guidelines are good ones and would prevent the vast majority of misdiagnosed miscarriages.  If there are no complications, wait until the sac is 25mm (if it is growing) and then wait one week to verify.  For most women, this will bring them to at least the nine week range before they can be diagnosed.  My gestational sac with my daughter was 28.5mm before my daughter could be seen and at only 21.5mm, it still looked empty.
As always, if you are going through this scare right now (((hugs)))  Feel free to visit the Misdiagnosed site or leave me a message here.