Home pregnancy test
Thanks to ultra-sensitive home pregnancy testing kits, more than 200 women who discover they are expecting are having their pregnancies ended by mistake because hospital scans cannot pick up the earliest signs of life, doctors warn.
Modern home pregnancy tests, which detect hormonal changes, are so effective that women are going to hospital earlier than ever, fearing they have miscarried.
Doctors are carrying out ultrasound scans, finding no heartbeat, and consequently removing the early fetus, a health watchdog warns.
Up to 400 women may be losing their babies every year due to mistaken diagnosis of miscarriage. More than half are triggered by the problem of home pregnancy testing, according to an expert.
New guidance published by the National Institute for Health and Clinical Excellence (Nice), urges doctors not to operate to remove a fetus so quickly in the early weeks of pregnancy.
The guidance also says that women should be advised that they might still be carrying a healthy baby, even if an early scan finds no positive signs.
Mary Ann Lumsden, professor of gynaecology at Glasgow University, who helped draw up the guidance, said she had “seen mistakes made” by doctors who had acted too soon.
She said the problem of “making an incorrect diagnosis too early in pregnancy” was nowadays partly the result of what she described as “patients with sensitive pregnancy tests”.
Some tests are so sensitive that women could find out they were pregnant before even missing a period.
“They may come along at a stage when it is impossible to make a final diagnosis,” she said.
“Sometimes this leads to women having surgical intervention early on. Women are told that the pregnancy is unviable at a very early stage.”
“Sometimes I have seen mistakes made because one has tried to deal with things too early and not just waited.”
Doctors needed to better explain that early scans could not always confirm if a woman had miscarried or not, she said.
“If people understand why we are saying it would better to wait, they will be sure of what we are doing.”
The problem of mistaken terminations of healthy pregnancies is only one matter covered by the guidance, which aims to improve care for women suffering suspected miscarriages or ectopic pregnancies in England and Wales.
They also call for an end to a postcode lottery in standards of treatment, by making available seven-day-a-week care for women in the first 13 weeks of pregnancy as well as a 24-hour telephone helpline for those experiencing possible complications.
Nice has also recommended training for doctors and nurses in how to “communicate sensitively” with the 168,000 women suffering miscarriages every year.
Hospitals should spare women who have suffered from miscarriage the anxiety of being treated in wards where they can hear mothers giving birth nearby.
Prof Lumsden said: “It actually doesn’t cost a great deal to be sympathetic. It is something that happens to a lot of women. But for each woman it is a unique event. We must recognize people’s distress.”
The guidelines relate to women suffering suspected miscarriages and ectopic pregnancy in the first trimester, or 13 weeks.
Approximately one in five pregnancies miscarry every year, roughly 168,000, including 143,000 in the first trimester.
Between 2006 and 2008 there were 35,495 confirmed ectopic pregnancies, of which six women died in their first trimester as a direct result.