How a Miscarriage can be Misdiagnosed
Is This Really a Miscarriage -or- Why You Need to Ask More Questions About Your Diagnosis.
Miscarriages can be misdiagnosed. But, before we begin, please remember that often, a miscarriage diagnosis ends in actual miscarriage. You just need to be absolutely certain before allowing your doctor to end your pregnancy.
However, some women are told they are destined to miscarry when, in fact, their babies are just fine.
Click here to read some of their stories.
When Miscarriage is suspected, many doctors push women to end their pregnancies either surgically or medically. Can you wait to end the pregnancy? Should you ask questions? Is the trans-vaginal ultrasound really THAT accurate during the first trimester? Are hCG levels really supposed to double every 48 hours? Should you get a second opinion? These are common questions and I'd like to share what I've learned.
I believe every woman deserves to have no doubt before having her pregnancy ended.
All photos and text on this page belong to Cari_Kay unless otherwise noted.
I am not a medical professional. The information I share is meant to supplement the information given you by your doctor. If you feel your doctor is not doing enough for you or not willing to listen to your concerns, I strongly encourage you to take what you've learned here and get a second opinion.
My Misdiagnosed Miscarriage Journey
and what I've learned along the way
More than four years ago, I shared the story of my two misdiagnosed miscarriages on Epinions.com. You can read my original article Can a Miscarriage be Misdiagnosed to find out more about my own misdiagnoses.
I could not have imagined then, how sharing my story would change my life as well as the lives of many other women. As a result The Misdiagnosed Miscarriage was born.
Over the coming days, I'll add more about my journey here. Really, I only have one thing I hope everybody takes away here. Do not feel pressured into ending your pregnancy too soon. If you are not 100% certain this is a miscarriage and your doctor is pushing you to end the pregnancy quickly, you can wait out the diagnosis. Studies show that having a natural miscarriage can be just as safe, if not safer than having a D&C as long as you know the signs of infection. If you have signs of infection, see your doctor immediately otherwise stay monitored and take the time you need to be certain. No woman should be rushed through treatment if she is not 100% sure she is losing the baby. Don't get me wrong, though. Often times, women wait and end up miscarrying but sometimes they wait and are rewarded with a viable and successful pregnancy. That is what makes getting the word out so important.
By sharing my story, I don't want to give false hope. I do, however, believe in hope. Reading this site or posting on the misdiagnosed site will not decrease your chance of miscarrying. However, it may prevent your doctor from ending what may turn out to be a viable pregnancy. As I look at my now four-year-old daughter, I am thankful I turned down that D&C twice. Even if my pregnancy had turned out to be non-viable, I could not have lived with the 'what ifs'. I needed to know with certainty and every woman deserves that same certainty.
To read more about my 'blighted ovum' experience you can check out my "When a Blighted Ovum is not so Blighted" article.
and, yes, many doctors believe them too.
(note, I'm in the process of adding to this. Check back often for updates)
Over the last few years of talking to women, we've seen some patterns emerge in the many stories I've heard from women.
I'd like to share a bit of what we've learned.
My doctor says my hCG levels should rise every 48 hours. Is this true?
No! In early pregnancy, levels should double more quickly but as the first trimester progresses, those levels will slow, plateau and even begin to decline.
Follow up to Question #1:
Well then, how quickly should my hCG levels rise?
According to conceivingconcepts.com levels typically look like this:
less than 1200 -- doubling time 48 to 72 hours
1200 to 6000 -- doubling time 72 to 96 hours
more than 6000 -- doubling time can be more than 96 hours.
My doctor has said that I am far enough along, the baby is always seen by this point on the ultrasound. Is that true?
I can tell you what the ultrasound literature states and what your doctor has learned:
"A pregnancy is anembryonic if a transvaginal ultrasound reveals a sac with a mean gestational sac diameter (MGD) greater than 13 mm and no yolk sac, or a MGD >18 mm with no embryo." To give you an idea, a 13 mm gestational sac is usually thought to be seen around six weeks and an 18mm sac, around seven weeks or so.
Now, ask me if that is true? I will tell you emphatically, "No!" At about 22mm, my gestational sac still looked empty and it was 28.5 mm before my baby was seen. Numerous women have shared similar stories on the misdiagnosed site.
My doctor said that my hCG levels are high enough that a baby is always seen. Is this true?
No. Again, found on many medical sites, "a yolk sac larger than 7 mm without evidence of a developing fetal pole suggests a nonviable pregnancy" and "The embryonic pole usually becomes evident at a level of approximately 5000 mIU/mL, and the fetal heartbeat can be seen in the vast majority of normal gestations when the hCG level reaches 10,000 mIU/mL"
Let me tell you, this panics many women. However, my own levels had long passed the 10,000 mark before anything could be seen and, again, many women report the same on the misdiagnosed site.
My doctor says I have a retroverted (AKA tilted or tipped) uterus but says that has really no bearing on the pregnancy, is this true?
This is partially true. A retroverted uterus does not cause a miscarriage. It simply means your uterus is tilting back rather than forward. This usually straightens itself out by the end of the first trimester.
However, that said, a disproportionate number of women are mistakenly misdiagnosed when they have a tilted uterus. Many of these babies stay 'hidden' longer until up to nine or even ten weeks. Also, we've found that many women who know exactly when they conceived look one to two weeks behind during the transvaginal ultrasound even when this is not possible. Then, during their second trimester ultrasound when their uterus is in a more 'normal' position and they have the abdominal ultrasound, their dates are often right on again.
I am eight weeks and we saw the baby on the ultrasound with no heartbeat. Is there no hope?
I have been told that if you ever see the baby on a first trimester ultrasound with no heartbeat, you should wait at least seven days and have a follow-up ultrasound. Sometimes the angle is wrong or sometimes the baby is just too small still. Ask for that follow-up ultrasound and give it at least a week. If the baby is still too small, you want enough time for everything to be seen if the pregnancy is indeed viable. While waiting, as with any pregnancy, if there are any complications, be seen right away.
I've been told that doctors would never misdiagnose something as important as miscarriage, is this true?
No, and that is the point of this page. We've been collecting stories from many women who were misdiagnosed. Some women were given no hope whatsoever and other women were simply told by their doctors not to get their hopes up. We are continually adding to this post: Misdiagnosed Stories. If you have a story you would like to share, please add it to that forum.
I'm in my first trimester. We saw the heartbeat last week on the ultrasound. This week there is no heartbeat. Is there any hope?
There may be hope and, for that reason, many doctors will ask to do an ultrasound one week out to verify. Yes, often miscarriage is confirmed but we've seen a number of cases on our site to know that sometimes that heartbeat is seen again. You just have to wait for that baby to get a bit bigger first.
IMPORTANT: Ultrasounds May Lead to Misdiagnosed Miscarriages!
Misdiagnosed Miscarriages are finally making the news and, more importantly, research is beginning to come out about them!
A snippet from that article:
"As if the worry over potential miscarriage weren't stressful enough for newly pregnant women, research released Friday shows that current guidelines for using ultrasound to determine that a pregnancy has ended may not always be accurate.
The four new studies looked at U.K. ultrasound specifications, but when the findings are extrapolated to U.S. guidelines, the researchers suggest 1 in 23 women diagnosed with miscarriage could still have a viable pregnancy."
On the Misdiagnosed Miscarriage site, we believe that that figure might be much higher. For women diagnosed with a blighted ovum, something like one in five may be much more accurate.
For more on the inaccuracy of ultrasounds during the first trimester, check out my blog:
Misdiagnosed Miscarriage Musings
Do you know anybody who has had a misdiagnosed miscarriage?
IMPORTANT New Guidelines for Diagnosing a Miscarriage
The UK is the first to acknowledge that misdiagnosed miscarriages are indeed a problem. The Royal College of Obstetricians and Gynaecologists has revised its guidelines. If your gestational sac is more than 25mm and/or the CRL is 7mm or more, you should wait a week to verify (if there are no complications). If the measurements are less, you are too early to diagnose. For more information (and something to take to your doctor), please, see my new page:
Need to contact the author? You may e-mail Cari_Kay at firstname.lastname@example.org