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Ten Reasons Miscarriages are Misdiagnosed

Updated on January 7, 2015
© Drpnncpp | Dreamstime.com - Ultrasound Baby Photo
© Drpnncpp | Dreamstime.com - Ultrasound Baby Photo

Not every woman diagnosed with a miscarriage will miscarry. Although miscarriages are common, they are also fairly commonly misdiagnosed. For this reason, unless you are miscarrying naturally, you need to be certain you are indeed miscarrying before letting your physician end your pregnancy.

I have put together a list of the top reasons women end up misdiagnosed by their doctors, at least the reasons seen on The Misdiagnosed Miscarriage site. If you have been diagnosed with a miscarriage and you fit into even one of these categories, you may want to seek a second opinion, or if there are no complications, wait out the diagnosis.

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A Tilted Uterus

If I had to select the most common reason for a misdiagnosed miscarriage, I'd have to say it is because a woman has a tilted uterus.

Most women don't even know they have a tilted uterus. Some studies indicate that up to 1 in 3 women have a tilted uterus. Although, to date, there have been absolutely NO studies done on the retroverted uterus, pregnancy and ultrasound measurements, there have been studies done on the retroverted uterus and fibroids that concluded measurements were smaller in a retroverted uterus (but normal when done via a trans-rectal ultrasound). No woman is going to want a rectal ultrasound so you just need to know that if you have a tilted uterus (and you'll likely have to ask during an exam if you do), ultrasound measurements are very likely to be off. By ten to twelve weeks, the uterus moves back into a more normal position but, by that time, the baby would be big enough to be seen retroverted uterus or not.

What You Need to Know:

If you have a tilted uterus, you are more likely than most to be misdiagnosed if you've had an early ultrasound. Doesn't mean this isn't a miscarriage but you need to proceed with caution. The new guidelines from the UK are terrific. Rather than focus on how many weeks you are, they focus on the size of the gestational sac. If the gestational sac is growing and there are no complications, you should wait until the sac measures 25mm and then wait one week to verify.

Want to Read More:

Tilted Uterus and Early Pregnancy

Do You Have or have you had a Tilted Uterus

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Empty-Looking Gestational Sac with High hCG Levels

So, you've told that the gestational sac is big enough that a baby should be seen? This happened to me. I was told at 7 and 8 weeks that I was miscarrying because with those measurements and those hCG levels 'a baby is ALWAYS seen'. I know my gestational sac measurement at 8 weeks was 21.5mm (I did have a tilted uterus) and that sac looked as empty as could be. I turned down the D&C at both of those appointments. The next week, with the sac measuring 28.5mm, there was my baby.

What You Need to Know:

Older ultrasound guidelines are wrong. If your gestational sac is not yet 25mm and is still growing, it is just too soon to suggest a blighted ovum. Again, I'm a fan of the UK's new guidelines which state that if there are no complications, wait until the sac is 25mm and then wait one week to verify.

Want to Read More:

High hCG Levels and No Baby Seen? Yes, There Might Still Be Hope!

Diagnosed in the Emergency Room

I think the world of ER doctors. I do. However, you need to remember, they work long shifts and they are not specialized in all medical fields. They also tend to work long hours and see a lot of patients. The ER is not the place where a physician can take his time in diagnosing you. I have talked to so many women told in the ER that they were miscarrying and they were just fine. In fact, with my first pregnancy, I was told I was miscarrying in the ER due to heavy bleeding and I carried that baby to term.

What You Need to Know:

If you are diagnosed with a miscarriage in the ER and don't need emergency surgery (i.e. ectopic), schedule an appointment with your OB-GYN.

Have you ever been misdiagnosed (any condition)?

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Gestational Sac Looking One to Two Weeks Behind

You are certain of your dates. You know when your last period was and some of you may know they exact date of conception. This happened to me as well. I told the doctor there was no way I conceived a week in a half later and, in fact, my home pregnancy test was positive by that time. This likely goes back to the tilted uterus thing but, even if you don't have a tipped uterus, just because the ultrasound tech is measuring you one or two weeks behind doesn't mean your measurements are actually behind.

What You Need to Know:

The ultrasound equipment is not as accurate as they would have you believe. Case in point, there have been studies showing that the same woman can have two ultrasounds the same day by two different techs and their measurements can be quite a bit different. I've talked to women who have been baffled because this has happened to them. Looking a week or two behind is not concerning and should not be the reason a miscarriage is suggested

Want to Read More:

Why Ultrasounds May Cause Misdiagnosed Miscarriages

Non-Doubling hCG Levels

So many women are worried unnecessarily by their hCG levels during the first trimester. Your doctor needs to make sure this is not an ectopic pregnancy. After the sac is seen, numbers will often slow down and there is a point in the first trimester where your levels can rise, plateau or even decline and still be perfectly normal. I've talked to women whose numbers rose well above 100,000 before plateauing and other women had levels that started plateauing around 30,000. Early in the first trimester, numbers do rise more quickly but research is showing that even then many women only have a 50% rise in numbers and are just fine. I've talked to quite a few women who very early on had their numbers plateau or drop temporarily and often it seemed to either be due to the loss of a twin (common occurrence) or being slightly dehydrated. Numbers usually bounced back soon afterward.

What You Need to Know:

Your hCG levels are important only up until they find the gestational sac in your uterus. After that point, they can do any number of things and still be normal.


Want to Read More?

The First Trimester and Non-Doubling hCG Levels

Unexplained Bleeding

Research seems to indicate that about 1 in 3 women will spot or bleed during their pregnancy. Some of the reasons for bleeding are internal exams or ultrasounds, sex, bowel movements and taking supplements (including progesterone). Often these pregnancies are just fine. Just from the stories women have shared with me, you are more likely to be diagnosed with a miscarriage in the ER if you are bleeding than with your OB-GYN.

What You Need to Know:

If you are bleeding, call your physician. It's easy to panic but often the cause is just one of the reasons listed above and not serious. If you are having any pain (abdominal, chest, neck or shoulder), feeling faint, passing tissue or large clots, have signs of infection or pain while urinating, be seen right away.

Want to Read More:

Bleeding During the First Trimester - Don't Panic!

IVF

I think diagnosed miscarriages after IVF are the most frustrating. Doctors were there. They know when you conceived. Despite research telling them that about 1 in 3 women undergoing IVF will look behind schedule, they are very quick to diagnose these pregnancies as miscarriages and even quicker to want to end them.

What You Need to Know:

I'm going to bring up the UK's new guidelines because that is the BEST way to convince your doctor to wait a bit longer before diagnosing you. If there are no complications, wait until the gestational sac reaches 25mm (if it is growing) and then wait one week to verify.

Want to Read More:

Misdiagnosed Miscarriage After IVF

A Doctor or Nurse Did Your Ultrasound

Consider for a moment the amount of training your physician has had with that ultrasound machine vs. the amount of time an ultrasound technician has trained. Often ultrasound techs will have two to four years of schooling in obtaining their certificates or degrees. Compare this to the amount of time your OB-GYN has trained with that equipment. Many women with misdiagnosed miscarriages have reported that their OB-GYN was the one doing the ultrasound.

What You Need to Know:

An ultrasound technician has quite a bit more training with the ultrasound equipment than your physician. If your physician is performing his own ultrasounds, there is a better chance of being misdiagnosed. Proceed carefully before having your pregnancy ended.

Enlarged Yolk Sac

When I first started hearing from women who were misdiagnosed, everything I read said that an enlarged yolk sac meant inevitable miscarriage or deformities. A newer study came out this year that said roughly 1 in 3 women with an enlarged yolk sac will miscarry. Keep in mind, that same statistic says that with an enlarged yolk sac 2 in 3 women will NOT miscarry. Since that time, I've talked to women diagnosed with an enlarged yolk sac and their babies were perfectly normal.

What You Need to Know:

An enlarged yolk sac does not mean you'll miscarry. Yes, it may indicate problems with the pregnancy or the baby but you also have to factor in ultrasound measuring errors. It is possible to see one tech who says the sac is too big and then see another who measures it within normal range. That happens. Even if the yolk sac is indeed a bit bigger, women have gone on to have their babies.


Want to Read More:

Enlarged Yolk Sac During the First Trimester?

Missing Gestational Sac

And, this is the trickiest misdiagnosis. If you are being diagnosed with an ectopic, your future fertility and even your life could be at risk. However, recent reports indicate that up to 40% of pregnancies diagnosed as ectopic may be wrong! (see Baby Born Deformed After Misdiagnosed Ectopic Pregnancy).

What You Need to Know:

A 40% risk of an ectopic pregnancy being misdiagnosed is truly worrisome. I've read that approximately 80% of true ectopic cases resolve on their own. It's the other 20% that need intervention. If we break that down, out of 100 women diagnosed with ectopic pregnancies, about 40 of this women actually have viable pregnancies. About 48 women will actually have their ectopic pregnancy resolve on their own. That leaves 12 women who need intervention. Stay closely monitored and make sure to ask your physician why they are so certain this is an ectopic pregnancy.

Want to Read More:

Is This Really an Ectopic Pregnancy?

Have you been misdiagnosed or are you going through a miscarriage scare? I'd love to hear from you.

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    • Cari Kay 11 profile image
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      Kay 13 months ago

      It is so common to look one to two weeks behind. That really isn't worrisome. Generally, they'll do another ultrasound one week after the baby is viewed if there is no heartbeat. If the pregnancy is viable, a week gives the little one enough time enough to grow so more is seen. Really, hCG levels won't tell you much at this point because they can go up, plateau or decline and be fine. Please, keep us updated. I do hope you get better news.

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      Faye 13 months ago

      I had my second ultrasound yesterday at what I thought was 8 weeks according to my LMP of 1/7. Baby only measured at 6w5d. No heartbeat was detected. I will undergo blood testing every 48 hrs starting tomorrow to see my hcg levels. Otherwise I'll go in for another ultrasound in one week. My practioner said at this point she does not want to rule out the possibility of the pregnancy still being viable. At my first ultrasound two weeks ago, nothing could be detected at all. I had it because I was bleeding. It turned out to be a sub chorionic hemmorage which had no effect on the embryo. I want to keep up hope but am preparing for the worst. Thoughts? Could a heartbeat be detected if I wait a little longer? I don't understand measuring smaller if I know for certain my LMP date of 1/7 would put me at 8 wks. It seems like that indicates the baby stopped growing. But like I said, my practitioner is not ruling out the possibility of the pregnancy still being viable. I will just have to wait and see this week which will be torture! Thank you in advance for any thoughts you can provide.

    • Cari Kay 11 profile image
      Author

      Kay 14 months ago

      (((hugs))) to you. Please, let us know what you found out.

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      Asa 14 months ago

      I had my first US at 5w+ 4 days after some heavy cramping and bleeding (incl. passing a few clots). At this time a gestational sac and yolk sac was seen. Was told to come back 2 weeks later for another scan and this was last Tuesday (going by the first day of my last period this would've made me 7w+6 days at the time). Things had grown and they could see a Gest. Sac measuring 25mm and fetal pole 5mm. No heartbeat was detected. I was told that I'm borderline in my measurements for seeing a heartbeat and that it is 50/50 that I will miscarry. I have had no more cramps or bleeding/spotting and I've been suffering on and off with bad morning sickness and fatigue. I would have thought that a heartbeat should be detectable at almost 8 weeks?? As much as I'm trying to cling on to the positive side of the 50/50, I'm really worried that I've miscarried. Although I'm still very tired, im not sick at all today. I'm due back for another US in 3 days (7 days after last scan) and then I'll know for sure.

    • Cari Kay 11 profile image
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      Kay 15 months ago

      Hi Lillie, hopefully they have an ultrasound scheduled a week out for you. In the meantime, if there are any complications, be seen right away. Please, keep us updated.

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      lillie 15 months ago

      I went for my first transvaginal ultrsound yesterday. they could not find a heart beat but she also said there didnt seem to any blood flow from the umbilical cord to the baby. I have not had any pregnancy symptoms except sore breast. is there a change I could be misdiagnosed? I am 8 weeks now according to the ultrasound tech but i was unsure of my last period so I feel like they could be wrong. and i have no symptoms of miscarriage no major cramps bleeding etc.

    • Cari Kay 11 profile image
      Author

      Kay 2 years ago

      If they didn't see a gestational sac, you are at serious risk with an ectopic pregnancy. If they saw the gestational sac, this is just too early to diagnose.

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      FromDenmark 2 years ago

      Hey.

      My Last period started january 16th. Ovulation february 5th. Tested positive february 16th. Went to a scan february 27th. There was nothing to be seen. It was empty. Went to the doctor, HCG was 18.300 the day of the scan. The ultra Sound lady told me, that it most likely would end in a miscarrige, because nothing showed, and the HCG was so high.

      What do you think?

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      jenn1981 2 years ago

      Thank you very much. Things are going good and we plan to try again in a month or two.

    • Cari Kay 11 profile image
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      Kay 2 years ago

      I am so very sorry :(

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      jenn1981 2 years ago

      Had my D&C this morning and everything went well.

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      Jenn1981 2 years ago

      Well I just found out that it is a missed miscarriage and I am waiting for them to schedule a D&C

    • profile image

      jenn1981 2 years ago

      Thank you very much. I was able to get an appt scheduled with a different doc who is at a high risk office and they have a high resolution ultrasound machine. A better one than the other doc I had seen. So hopefully they can give me peace of mind and let me know for sure which way things are going. My appt is for the 16th in the afternoon. I will let you know what they tell me. Once again thanks for your support it really does help to have someone to talk to with the knowledge and experience that you have.

    • Cari Kay 11 profile image
      Author

      Kay 2 years ago

      And it may end up that you miscarry. You just deserve to know for sure before having your pregnancy ended. Praying for you!

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      jenn1981 2 years ago

      Yes I definitely have. I requested a second opinion and my doc looked at me like in was crazy and asked if I was questioning the ultrasound and I said yes because how can the baby grow if she claims it has died. I am waiting for a call from a high risk office in another town to see if the doc there will see me and give me his opinion. I have prepared myself for the worst and I can accept it I just want to know 100% that the baby is gone or alive before I make any decisions.

    • Cari Kay 11 profile image
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      Kay 2 years ago

      Have you considered a second opinion?

    • profile image

      jenn1981 2 years ago

      Well the tech said that the baby has grown which surprised everyone including myself but she still couldn't get a heartbeat. Is it possible for the baby to continue to grow if I did miscarry around last Monday or before like they were trying to say? I am confused cuz I assumed that the baby would shrink or deteriorate if it had passed away. I still have all my pregnancy symptoms that I've had and still no signs of bleeding or cramping.

    • Cari Kay 11 profile image
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      Kay 2 years ago

      Has the baby been growing?

    • profile image

      jenn1981 2 years ago

      Had another ultrasound today and still no change really. Still couldn't get a heartbeat but the baby is still measuring good. I don't see how this can be. Once again the doc asked me if I wanted a d&c and I said no because all the things I've read that this pregnancy could still be viable. I had my ultrasounds a week apart and the baby has not gotten any smaller and there are still no signs of miscarriage or bleeding. I asked for a second opinion with a better ultrasound machine at a high risk office but they said that doctor may not agree to see me and do another ultrasound. How is it that a doctor can deny someone of a second opinion? Isn't that against medical ethics and medical standards? And my doc told me she didn't really see a point in a second opinion cuz she didn't think they would find a different conclusion than hers. I don't think it's right of her to say that. When someone asks for a second opinion they are supposed to get it. So I'm sitting and waiting again and I don't know what I should do. Any advice or help would be greatly appreciated.

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      jenn1981 2 years ago

      Yes I have another ultrasound scheduled for tomorrow morning so I assume I will have a more definitive answer by then. I will post What they say after I have the ultrasound. I hate the waiting part and I don't like feeling confused about everything.

    • Cari Kay 11 profile image
      Author

      Kay 2 years ago

      Are you having another ultrasound done this week?

    • profile image

      jenn1981 2 years ago

      Well I got the call about my blood work just a few minutes ago and they said my levels went up drastically. Now they are more confused from what the nurse said. She said Monday when I come back in they are going to do another ultrasound and see what they can see. She said something about the doc being worried about a tubal pregnancy or possible molar pregnancy. When they did the ultrasound on Monday the baby was in the uterus you could plainly see that so I don't see how it could be a tubal pregnancy. And I don't know what a molar pregnancy is. She didn't give me exact number of what my levels were but she said they went up drastically. In your opinion what could that mean? Still no loss of symptoms and no cramping or bleeding which she said is a good thing. Any input would be helpful. Thanks again

    • Cari Kay 11 profile image
      Author

      Kay 2 years ago

      Jenn, I am so sorry you are going through this worry. Yes, this may end in miscarriage but, generally when the baby is seen without a heartbeat, they'll wait one week and do a follow-up ultrasound to verify (if there are no complications). Sometimes that little heart was just still too small to really be seen. (((hugs))) and please keep us updated.

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      jenn 2 years ago

      Was told yesterday at 8 weeks 4 days (according to my LMP) that they couldn't find the heartbeat on the abdominal or vaginal ultrasound. They said the baby is measuring 9 weeks and still connected to the uterine wall. Can see the baby, head body arms and legs. They said I am miscarrying but I have no spotting and no bleeding or cramping. I still feel pregnant with all the normal symptoms of bloating, feeling sick breasts sore and tender. I even told them I have strange periods, for last 3 years I have a period every 14 to 21 days and my partner and I have not used any form of birth control the 4 years we have been together and this is the first time we have conceived. I have had ovary issues few years ago as well with cysts so I don't ovulate normally. I took a home pregnancy digital test (along with my others) on Dec 28th and the digital said "pregnant 1 to 2 weeks" so that would only put me around 6 weeks give or a take several days not 8 weeks 5 days as of today. Could it be possible that they could see the baby but not be able to see the heartbeat yet? All the things I've read and the fact that I know my LMP but also know what the digital test said as well lead me to believe that it may be too early for them to see the heart beat. Am I giving myself false hope or could it be possible? I know you are not a doctor but I've also ready many things you have wrote on more than just this site and I wanted to tell you my situation and see what your thoughts are. I go back tomorrow for more blood work and they are going to compare It to yesterday's and I go back Monday for another ultrasound. Does the fact that I'm not bleeding or cramping mean there is hope that they will find the heartbeat at the next ultrasound?

    • Cari Kay 11 profile image
      Author

      Kay 2 years ago

      Could you tell me more about your pregnancy? When was your LMP? Do you have an idea of when you conceived? Have they told you the measurement of the gestational sac? How many ultrasounds have you had? What have your hCG levels been? Just a few questions that help you figure out what is happening. (((hugs)))

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      dawn 2 years ago

      i have been told my baby has no heartbeat but no signs of miscarriage?

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