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Missed abortion - misdiagnosis?

  1. #1
    Dancer is offline Registered User
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    Missed abortion - misdiagnosis?

    At 6 weeks and 3 days pregnant, my obgyn gave me the devastating diagnosis "missed abortion". I was shattered. This is my first pregnancy.

    Only the gestational sac was visible on the US but no fetus. The sac measured 6x14mm. I have a retroverted uterus. I never had any bleedings, cramps, not even morning sickness. The only symptoms I had were sore and swollen breasts.

    After that devastating news I have been doing my own research on the internet and asked friends who had past experiences with miscarriages. The shocking news is that there are many stories on the net of misdiagnosis in early pregnancy of "missed abortion", either because the fetus was not visible, or the heartbeat couldn't be found. Especially with retroverted uteruses the scan sometimes can't pick up the fetus or the heartbeat, as the location may be unusual. Some doctors would send their patients to have a curettage right away after the first diagnosis without questioning it.

    One anecdotal example: http://www.misdiagnosedmiscarriage.c...pic.php?t=9336

    For a more scientific approach, I found a reference to a study (unfortunately it's only in German):
    Missed Abortion: Abwarten und Tee trinken - DocCheck News
    It says in 8.3% of known cases where the heartbeat wasn't found the pregnancy still went on. In 2.6% it still went on after no fetus was detected. The earlier in the pregnancy and the smaller the sac, the more probable that it was a misdiagnosis. Mind you, these numbers seem small but it's only of the known cases, which means it doesn't count those who were killed before it was effectively known if it was a right diagnosis or not!

    Having said that, I am very upset at my obgyn. Even if he is right, and even if he didn't push me to do a curettage right away, he should have pointed out to the chance that it may be a misdiagnosis at this early stage. But he just sent me away with some painkillers and said if I don't miscarry in 2 weeks, I should call him for a curettage. I am not going to post his name now but I will go for a 2nd opinion next week with another doctor who was recommended to me through a friend. Should I be lucky and it was indeed a misdiagnosis, I will post the obgyn's name who made that mistake since I don't want anyone else to ever go to him and the same happens and in the worst case you kill a baby that was still alive!

    I don't know what my chances are, but given my sac was small, I am early in the pregnancy and have a retroverted uterus, never had any bleedings or cramps, I just can't believe I lost the baby. Maybe I am just holding on to false hope after reading all this on the internet, maybe it is gone as it is nature's will and I will continue to grief, but even if so, the doctor should have pointed out to the possibility that it may still be alive and have another check at a later stage!

    I will keep everyone posted, please keep your fingers crossed for me!
    Hugs!

  2. #2
    TNJ
    TNJ is offline Registered User
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    Oh no, thats awful news!

    A lot of doctors in HK are so 'to the point' that they forget we have feelings! A little compassion and understanding would be nice sometimes!

    I had an ultrasound at 9 weeks 5 days because I was clueless to how far along I was.. My baby was so small - so conisdering how small she looked then and how fast they grow it wouldnt surprise me if you have a baby and he/she is just simply too small to see!

    Definitely get a second opinion but maybe wait 2-3 weeks so the baby will be big enough to see. Or if your really eager to find out asking an OBGYN for a transvaginal ultrasound may be a good idea, so you can hear the babys heart beat.

    Please keep us posted, I will keep my fingers crossed for you!!!! x

  3. #3
    Aquarian is offline Registered User
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    Obviously your obgyn had a reason for that diagnosis....but...

    6 weeks is VERY early to call it missed abortion. Unless you're certain of your dates, you could have ovulated later which would mean you could still be only 5 weeks. Also, if I remember correctly the sac should be 1mm per week, so 6mm for a 6 week pregnancy would be about right - so I'm surprised he said it was small. (But I might have misunderstood)

    Yes it's a concern that they couldn't see a fetus at this point, but 6 weeks is definitely early - many places won't even scan until 8 weeks for this very reason, so you should definitely get a second opinion.

    Good luck!

  4. #4
    Aquarian is offline Registered User
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    ...and just checking, your OB did do a transvag US? If he diagnosed this based on an abdominal US then he doesn't have a clue what he's doing.

  5. #5
    Dancer is offline Registered User
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    Many thanks for your kind words and comments. If a transvaginal US is the one that goes into your uterus via the vagina then that's what I got. I had the feeling though that the machine wasn't the latest one you can get in the market.
    Yes there is uncertainty of how far I am along, I can remember the day of my last period but my cycle can vary quite widely, so we just assumed 28 days. The obgyn didn't state the sac was too small. I just meant in absolute terms, the study stated the smaller the sac, the more probable was a misdiagnosis. And 6×14mm is in the range where misdiagnoses were probable.
    I'll go for a 2nd opinion and will also ask for a hcg test. Even if the chances are small that the baby is alive, for such a life-changing decision I want to be 100% certain.

  6. #6
    Aquarian is offline Registered User
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    Yep that's a transvag U/S. But if you're not sure of dates he shouldn't have been advising you to do anything at this point other than book in for another scan in a couple of weeks.

    I hope you get good news next week.

  7. #7
    TNJ
    TNJ is offline Registered User
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    I hope all goes well at your 2nd opinion!

  8. #8
    Loveisgood is offline Registered User
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    Hope everything worked out for you!!
    Take care

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