ANALYSIS:MISCARRIAGE IS the most common complication of early pregnancy, occurring in one in five of all pregnancies.
Not surprisingly then there was huge concern last year when it emerged some women had been scheduled for surgery or prescribed drugs to remove their “dead” foetuses at hospitals across the State only for it to transpire later, sometimes after they were fortunate enough to insist on second ultrasound scans, that their pregnancies were in fact viable.
In the first case to come to public attention Melissa Redmond from Donabate, Co Dublin, revealed she was prescribed an abortifacient after an initial scan at Our Lady of Lourdes Hospital, Drogheda, in July 2009 showed no foetal heartbeat. Following her own gut instinct, she sought another scan from her GP, who discovered the baby was alive and she now has a healthy toddler. An internal hospital review of her case found the ultrasound scanner used produced images that “were grainy and of poor resolution”.
However, it was human error rather than machines which was to blame for most misdiagnosed miscarriages that occurred over the past five years, according to the report of an independent review group set up by the HSE after the baby scan scandal broke.
The review group found some scanners were more than five years old but they were well maintained. It was a lack of training in early pregnancy ultrasound that was a key problem across hospitals.
Many will be in disbelief that such a lack of training exists at a time when more than 70,000 babies are born every year and many others are lost to miscarriage. But Prof Michael Turner, an obstetrician at the Coombe who is now leading the HSE’s programme to improve maternity care, says we are only a few years behind the UK in introducing formal training in this area. Training is starting now.
After the controversy broke last June helplines received more than 400 calls from worried women. In the end 25 cases fitted within the terms of reference of the national review group. The group analysed 24 of them but, disappointingly, the State Claims Agency refused to provide anonmyised data on the 25th case because the woman in that case is taking legal action.
It is remarkable that of the 24 women whose cases were examined, 22 went on to have healthy babies. Even more remarkably, six of the 24 women who had surgical procedures performed to evacuate the contents of their uterus after a suspected miscarriage or ectopic pregnancy continued to be pregnant afterwards. But subsequently two of these six miscarried.
Many women who did not speak up to ask for second scans will now wonder if their silence resulted in them losing a baby that was just too tiny to exhibit a heartbeat. In truth they will never know, but Prof Turner says he is confident “that almost without exception the right thing was done” so women should not torture themselves.
The report makes a host of recommendations including setting out clearly when second ultrasound scans should be offered. If these are followed it should minimise the chances of the mistakes which did occur being repeated.