Medical Researchers Are Warning that Viable Pregnancies ARE Being Misdiagnosed as Miscarriages

For more than ten years, we've been raising the alarm.  Too many women with viable pregnancies are being misdiagnosed as having miscarriages.  Many women have refused to end their pregnancies until they were 100% certain they were indeed going to miscarry and, as a result, many babies have been saved.

For years, doctors denied this was happening...despite the fact that we had already collected hundreds of stories at The Misdiagnosed Miscarriage.  All of that is changing.

This week, we have two new news articles on the problem of misdiagnosed miscarriages: 

Study: Viable pregnancies may be getting misdiagnosed as miscarriages

 

and

 

Early miscarriage guidelines should be improved, researchers say

 

and, of course, the study they are referencing:

 

Defining Safe Criteria to Diagnose Miscarriage:  Prospective Observational Multicentre Study

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If you are being diagnosed with a blighted ovum, here is our takeaway message:

 

- Is the gestational sac greater than 25mm? 

   

   If the sac is greater than 25mm, this may indeed be a blighted ovum.  My own gestational sac measurement 28.5mm before my daughter was found and I had had to turn down the D&C twice.  If this is your first ultrasound and there are no complications, one more ultrasound a week out might be a good idea to verify.

 

- If the gestational sac is not yet greater than 25mm, is it growing?

    

To know if the gestational sac is growing, you should space your ultrasounds out by a week to  verify growth.  As I've blogged, measurements can vary between techs but a week gives enough time to see some definitive growth.

 

- Are you more than nine weeks? 

    

We've just talked to too many women who were about nine weeks, myself included, before finding their babies.  I'm a firm believer that if a sac is growing a blighted ovum should NEVER be diagnosed before nine weeks.

 

- Is your doctor monitoring your hCG levels?

  

If so, stop!!!  Once the gestational sac is viewed, there really is no reason to monitor your levels.  Levels can go up and be normal.  Levels can plateau and be normal.  Levels can even drop and be normal.  Levels are good for confirming pregnancy and confirming this is not an ectopic pregnancy.  I can't tell you how many women I've talked with who were scared needlessly because their doctors kept monitoring their levels after the sac was viewed.

 

-  Have you seen a yolk sac?

   

If so, this is NOT a blighted ovum.  A baby is needed for a yolk sac to form.  That doesn't mean this can't end in miscarriage but it does mean this is not a blighted ovum.

And, during this time, stay monitored.  If there are any complications be seen right away.  In the meantime, space those ultrasounds out by a week each.  If you feel your doctor is pressuring you to end your pregnancy too soon, please find another doctor.  Although it is slow going, more and more doctors are accepting that they have been diagnosing miscarriages too soon. 

If you are going through this scare, ((((hugs)))) from somebody who has been there.

 

 

This Week a Misdiagnosed Miscarriage Baby Survived Misoprostol and Another One Survived a D&C -

Despite the fact that doctors tried to end two wanted pregnancies this week, two babies survived. 

I'm used to hearing about misdiagnosed miscarriages.  I hear a new story just about weekly and sometimes several in a week.  Can you imagine how many women never find The Misdiagnosed Miscarriage site and are misdiagnosed as well.  Misdiagnosed miscarriages are a big problem.  They can end a wanted baby's life. 

Even sadder, imagine how many women are incompetently diagnosed by these doctors and have their pregnancies ended?  It happens and it happens too often.

Today, I read two posts by two different women.  One woman was given Misoprostol to end her pregnancy. Her doctor scared her into a medicated miscarriage.

Note here:  if you are not 10 weeks or more and there are no obvious complications, many doctors are fine with you waiting out a miscarriage misdiagnosis. 

Anyhow, despite taking the medication, a week later, a baby with a strong heartbeat was found (for more on Anie's story:  told Miscarriage, Took Misoprostol. HB Found!!!

While continuing to read posts, another woman reported that her doctor diagnosed an ectopic, performed laporoscopic surgery, did not find evidence of an ectopic pregnancy so performed a D&C.  Imagine this mom's surprise when an ultrasound a few days later found a gestational sac complete with yolk sac (perfectly normal this early in a pregnancy  (for more on Beksmel's story:  Confused - Pregnant or not after laparoscopy and D&C for ectopic

There are no guarantees on these babies.  We've seen some babies survive these procedures and are just fine while others go on to miscarry later. 

I am just a firm believer that if there is no immediate need for a D&C before ten weeks, a woman should stay closely monitored and take a watch and wait approach.  If she feels pushed into ending her pregnancy before she is ready, she should seek out a second opinion.  Yes, some women will miscarry naturally during that time but others may end up finding their babies. 

Please, pray for these two women and their babies.  My hope is that they go on to have uneventful pregnancies.

Is a D&C Necessary When You've Been Told You are Going to Miscarry?

It's the first trimester and you've been told you are going to miscarry.  Your doctor is telling you that you need to have a D&C as soon as possible and you are wondering if it is really necessary.

First things first, are you certain you are miscarrying?  Why is your doctor so sure you are miscarrying?  Is it because there is an empty sac?  If so, my first question is whether or not your gestational sac is growing and if it is more that 25mm (see New Blighted Ovum Guidelines! Chances Are You ARE Being Diagnosed Too Soon!).

If there are serious complications, ending your pregnancy right away may be necessary (i.e. infection setting in, ectopic, molar pregnancy, etc...).  If your doctor does believe there is a serious complication but you are not convinced, you may decide to seek a second opinion but, please, do it right away.

Serious complications aside, do you need to have the D&C right away?  Let's see what the American Pregnancy Association says:

"About 50% of women who miscarry do not undergo a D&C procedure. Women can safely miscarry on their own, with few problems in pregnancies that end before 10 weeks. After 10 weeks, the miscarriage is more likely to be incomplete, requiring a D&C procedure to be performed. Choosing whether to miscarry naturally (called expectant management) or to have a D&C procedure is often a personal choice, best decided after talking with your health care provider."

Please take note:

"Women can safely miscarry on their own, with few problems in pregnancies that end before 10 weeks."

The takeaway is this:  If you are not 100% certain of your miscarriage diagnosis and there are no complications -or- even if you are certain and would prefer to miscarry on your own, waiting for a natural miscarriage is an option many women choose.   You should not feel pressured to have a D&C if you do not want one.  You can always choose to have the D&C at a later point.  You should not feel rushed.

After ten weeks, miscarriages may become more complicated and a D&C may be the safest way to go.  Talk to your doctor and the two of you can determine your best course of treatment.

As always, seek a second opinion if you are at concerned that your diagnosis might not be an accurate one.  This isn't false hope.  This is just being 100% certain before you end your pregnancy.

Do Doctors Try to Scare Women into Ending Their Pregnancies Early?

Yesterday Michelle posted on The Misdiagnosed Miscarriage site about her misdiagnosed miscarriage.  Her doctor had been trying to convince her to end her pregnancy for weeks before she pulled out her trump card.  She told her the pregnancy was likely molar and she needed to end it now. Michelle refused, got a second opinion, and saw her baby with a strong heartbeat.

If you'd like to read Michelle's story, here is the link:
Chelle31 - Diagnosed Molar, Told to Have D&C - MISDIAGNOSED!

So, you've been diagnosed with a molar or ectopic pregnancy, what do you do?  Both these types of pregnancies can have very serious consequences including death.  You have to take this sort of diagnosis seriously but you also want to know that is correct, right?

And, so, I wonder if *some* doctors pull the ectopic or molar card because they have made up their minds and are likely slighted bugged that you aren't in total agreement. 

But, on the other hand, ectopic and molar pregnancies are fairly common.

What is a mom to do?

My doctor did try to convince me, strongly convince me for two weeks to have a D&C with my daughter.  Thank goodness I knew two people who had serious complications from D&C and could no longer conceive.  I declined.

Let me pause a moment to say that while I turned down the D&C, D&Cs do have their place.  If there is an emergency or you are more than 10 weeks along, a D&C may well be needed and your best hope.  For me, though, I was fine.  There were no complications and I was still less than 10 weeks.  For more on my story:  When a Blighted Ovum is Not a Blighted Ovum

To give my doctor credit, I don't think he was trying to scare me because he was tired of seeing me and wanted to move on.  He was a newer doctor who had just come out of med school and honestly believed the textbooks on blighted ova were correct (they're not). 

However, I've talked to more women than I can count over the years who have shared how rude some physicians have gotten when they've questioned the diagnosis.  With everything still looking normal, they've been told they need surgery immediately.  I have no doubt many women end up having the surgery.  I hear from the ones who do not and some have found their babies. 

I once asked a doctor why other doctors are so quick to push the D&C or medicated miscarriage.  His response?  Because doctors really do believe they are correct and they don't want to be called in the middle of the night to meet you in the ER or answer questions about your pregnancy. 

Because an ectopic or molar pregnancy can have serious complications, just waiting it out may not be an option.  Your best bet is to get a second opinion as soon as possible especially if you feel your doctor is overly pushy or rude.  You may end up needing that surgery but I do believe a woman deserves to know with 100% certainty that her pregnancy is failed before having that surgery.  Find a physician who will really listen to your concerns.

If you are going through a miscarriage scare right now, I don't know how this will end.  Just stay monitored and get a second opinion if you think one is warranted.

Ten Years of Misdiagnosed Miscarriages

I realized recently that I began The Misdiagnosed Miscarriage in 2005.  That was ten years ago!

I had actually shared my own misdiagnosed blighted ovum story a year or two before I started the site.  Slowly messages started popping up.  Women were wondering if they could have a misdiagnosed miscarriage as well.  At that time, a Google search of 'misdiagnosed miscarriage' turned up absolutely nothing related to misdiagnosed miscarriages.  That's right, nothing!   I scoured the web for help.  It certainly could not be found on pregnancy/miscarriage forums.  General consensus was to get a D&C and move on. 

With the advent of the site, I also was surprised by the backlash.  Women were upset that I believed I was misdiagnosed.  I was assured by many including one woman who ran a website for women going through miscarriages, that my story was a fluke and doctors would never ever EVER misdiagnose a miscarriage.

Ten years later, and Google results show tens of thousands of pages when you search for 'misdiagnosed miscarriage'.  Our site has nearly 700 misdiagnosed miscarriage stories.  In fact, there are probably more because women will discover they are misdiagnosed and with the sheer number of posts, their story never gets moved to the Misdiagnosed forum.  Looking at my gmail account, I have probably received about 10,000 emails from women about the possibility of a misdiagnosed miscarriage.  A number of those women have been misdiagnosed.  I can do that Google search and find stories all over the web by women who were also misdiagnosed.

What a difference ten years makes!

And, your stories matter!  Ten years ago, doctors were constantly telling women miscarriages are never misdiagnosed.  Now, the UK has recognized this is a real problem and has changed their guidelines in diagnosing a miscarriage.  If they stick to these guidelines, I'd guess they'll eliminate at least 90% of misdiagnosed miscarriage cases.  I hope the United States and other countries are not far behind. 

What can we conclude?  Miscarriages can be and are misdiagnosed.   Every story shared helps so many people and gets the word out there.  Each of you sharing a story is making a difference and saving lives.

Thank you!

Enlarged Yolk Sac? Might Not Be Enlarged After All

Ten years ago, Stacy posted on The Misdiagnosed Miscarriage.  Her doctor had given her no hope due to an enlarged yolk sac and told her to expect a miscarriage.  Her doctor was wrong.  Stacy went on to have her baby boy and he was perfect in every way.

You can read her post here:
An Update About an Enlarged Sac

Since Stacy's posts, I have talked to so many women who have been given little to no hope because of an enlarged yolk sac.  I will say up front that, yes, some have gone to miscarry but, then again, many women without an enlarged yolk sac have gone on to miscarry.  I've talked to a number of women who continued their pregnancies and went on to have babies who were just fine.

Could the problem be that the tech is making an error with measurements?  I believe that answer is a yes.  Why do I believe that is a possibility?  I've written a series of blog posts on the unreliability of ultrasound measurements:

Ultrasound Measurements in the First Trimester Are Not as Accurate As You Might Believe and Lead to Misdiagnosing Miscarriages!

And, Even More on the Unreliability of Ultrasound Measurements During the First Trimester

And, yesterday, Fletch3 shared her story of being given no hope with an enlarged yolk sac which got me thinking about all of this:

Fletch3's Story - There IS HOPE with a Large Yolk Sac

If studies are showing that ultrasound measurements can vary 8mm with different ultrasound techs, women with 'enlarged' yolk sacs need to take note.   Could your tech be wrong?  Absolutely.  That 8mm sac might only be 5mm.   On the other hand, could your yolk sac be enlarged?  Sure but there are numerous stories from women who went on to have their babies.

Enlarged yolk sac?  Don't give up hope just because your doctor has and, please, really think about the D&C you are being offered before you have it.  If there are serious complications, then yes, that D&C may be needed but if it is just because of an 'enlarged' yolk sac, it may be time to find another doctor. 

Another Misdiagnosed Blighted Ovum Because Of High hCG Levels and No Baby Seen

I really do believe high hCG levels with no baby seen is the most common reason for a viable pregnancy ends up misdiagnosed as a miscarriage. 

Today I'd like to share Korin's story.  You can find the original post here:

Korin's Story - Diagnosed Blighted ovum 5wks 6days - UPDATE!! MISDIAGNOSED!

At about six weeks, Korin had an ultrasound.  Because they saw an empty gestational sac, the midwife told her she believed it to be a blighted ovum and wanted to check her hCG levels.

A comment from me about this:  Most doctors will not check hCG levels once the gestational sac is seen.  Your numbers could be high or low and be normal.  They could rise, plateau or even fall and be normal.  All hCG levels do with a diagnosis of suspected blighted ovum is to worry Mom unnecessarily.

Korin's hCG levels came back in the 20,000s which is perfectly normal but the midwife diagnosed a blighted ovum because there was nothing seen in the sac.  Korin did not want a D&C and chose to wait. 

Two weeks later, Korin saw the heart of her little one beating away.

I know I blog about this topic a lot but hCG numbers should NOT play a role in a blighted ovum diagnosis.  I've talked to women who had numbers much higher who did not see their babies until later.  The diagnosis of a blighted ovum should be based on the size of the gestational sac if the sac is growing.  You'll want to see the sac grow to at least 25mm before a blighted ovum should even be suggested.

In fact, that reminds me of another recent story on the site.  Rachel shared how her doctor felt her hCG numbers were too low and with no baby seen yet, she needed a D&C. Thankfully Rachel's husband demanded another ultrasound two hours before the procedure and, you guessed it, they found their baby. You can read her story here:

Rachel's Story - My Ob/Gyn Almost Murdered My Son

This is why I strongly believe a blighted ovum should NOT be even suggested before the gestational sac reaches at least 25mm.  Had that doctor just said, "It's still too early, come back in a couple weeks,"  Rachel would not have been so upset.  In fact, with my first pregnancy, most doctors would have likely suggested a blighted ovum like they did with my second pregnancy.  When they couldn't see my baby, the just said that it was too early and to come back in a couple weeks.  I was probably between eight to nine weeks when they found him.  Because of how they approached it, I figured all was normal and didn't even worry about not seeing him. 

If your gestational sac is growing and still smaller than 25mm and there are no complications, take a deep breath.  This pregnancy is still too early to diagnose as a blighted ovum.  Everything may still be normal.  Hang in there and leave a message.  I'd love to hear from you.  (((Hugs)))