HSE apologises for miscarriage misdiagnoses

  • Joanne McCarthy

The HSE has apologised to women affected by a miscarriage misdiagnosis for the distress caused to them and their families.

The report into miscarriage misdiagnoses in Ireland identified 24 cases; 18 which occurred in the last five years and an additional six cases that were older.

According to the HSE, helplines in maternity hospitals around the country received over 400 phone calls from women who were concerned that they may have had a misdiagnosed miscarriage. The review found that 95% of these cases were not a misdiagnosis of miscarriage, but a total of 24 cases of miscarriage misdiagnosis did occur.

The HSE has said that the review group, which was chaired by independent obstetrician Prof William Ledger, established why the misdiagnoses occurred and has subsequently made recommendations to prevent future miscarriage misdiagnoses. The implementation of the recommendations of the review, many of which are already underway, will ensure that there are measures in place to prevent recurrence of a misdiagnosis of miscarriage, it said. 

"Miscarriage is the most common complication of early pregnancy, occurring in one in five of all pregnancies, and for many people is a source of enormous distress and grief. The misdiagnoses which were identified as part of the review will undoubtedly have amplified that distress for the women involved," said Prof Ledger. 

"This review found 24 cases of misdiagnosis, and 18 in the past five years, out of a total birth rate of approximately 375,000 live births. In this timeframe there would have been approximately 70,000 miscarriages. The 24 misdiagnoses occurred at the very early stages of pregnancy, when ultrasound diagnosis alone is unreliable, due to the risk of missing a tiny foetus or heartbeat.

“Over reliance on ultrasound to diagnose a miscarriage in very early pregnancy has been repeatedly highlighted since the introduction of the technique in the 1970s and we have made recommendations that caution against the use of ultrasound alone to detect a pregnancy before eight weeks gestation," he explained.  

The HSE said Prof Michael Turner, HSE national clinical lead for obstetrics and gynaecology, is leading a significant programme of change in maternity services nationwide. New clinical guidelines on early pregnancy loss, are in place in hospitals since earlier this year and will allow for time delays, where the woman wishes it, to confirm a miscarriage diagnosis. Decisions to make medical or surgical intervention will only be made by senior clinicians who are appropriately trained in early pregnancy care, according to the HSE.

Copies of the report were made available to each of the participating women earlier today.

 

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