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Births followed D&C procedures
[Posted: Tue 19/04/2011 by Niall Hunter, Editor www.irishhealth.com]
Four live births took place in women who had had a surgical procedure to remove what were believed to be unviable pregnancies, it has emerged in HSE's miscarriage misdiagnosis repoirt.
In two other cases, women who had had these procedures subsequently had miscarriages.
The Chairman of the review team, Prof William Ledger of the University of Sheffleid, said he had been shocked when he read of these cases in the review.
According to the miscarriage misdiagnosis report, surgical procedures known as an ERCP or D&C, used to remove fetal tissue from the womb following a diagnosis of miscarriage, was carried out in six of the 24 cases covered in the review.
Three of the women were believed to have had an incomplete miscarriage, two had suspected ectopic pregnancies and one a suspected molar pregnancy.
The report said of the six women that had the surgical procedures, there were four live births and two subsequent miscarriages. However the report does not state which of these outcomes were realted to which of the above conditions.
Asked to explain these cases, the HSE's Clinical Lead for Obstetrics/Gynaecology Prof Michael Turner said while it was not a common occurerence, it was possible to have a D&C and subsequently go on to deliver a baby.
Prof Turner said it was possible to put an instrument into the uterus and not disturb an unborn pregnancy, leaving the fetus intact.
Prof Ledger said the two miscarriages concerned would have veen viable pregnancies as ultrasound was carried out after the surgical procedure that showed there was still a heartbeat.
"What you cannot say is whether or not the procedure precipitated the later miscarriage. If the procedure was likely to have caused the miscarriage it would have happened almost immediately (when the procedure was carried out)."
Prof Ledger said these were likely to have been cases where time passed after the surgery, then the pregnancy turned out to be viable and then the pregnancy was lost later on. He said it could not be stated for certain that the surgical procedures caused the miscarriages.
He said in the four cases where women had live births after the surgery, the pregnancy had previously been diagnosed as a miscarriage although the fetus was still alive, and the attempt to remove the miscarried tissue was not carried out properly, so tissue remained which turned out to be a viable pregnancy.
Prof Ledger said he was shocked by those cases when he read about them.
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