The limitations of using gestation sac and embryonic growth as criteria to define miscarriage: a prospective observational multicentre study.

In this paper the team demonstrates that some current approaches to making a diagnosis of miscarriage are potentially not appropriate.

Ultrasound Obstet Gynecol. 2011 Aug 19. doi: 10.1002/uog.10075. [Epub ahead of print]

Abdallah Y, Daemen A, Guha S, Syed S, Naji O, Pexsters A, Kirk E, Stalder C, Gould D, Ahmed S, Bottomley C, Timmerman D, Bourne T.

In this paper the team demonstrates that some current approaches to making a diagnosis of miscarriage are potentially not appropriate. Currently if an empty gestation sac is seen – which occurs quite commonly – a repeat scan is carried out 7 to 10 days later. If there is no growth in the sac there is an assumption there must be a miscarriage. Our data show that in a small number of cases the pregnancy may be viable even if there is no significant sac growth over this time period. This is important as it means that if the current approach is used there is the possibility of false positive diagnosis of miscarriage. We also found that if the sac was empty on first scan the failure to see an embryonic structure (yolk sac or embryo) was always associated with miscarriage. This rather than growth of the sac seems a more specific indicator of miscarriage.