Pitfalls in the diagnosis of miscarriage and ectopic pregnancy

Early pregnancy complications such as miscarriage and ectopic pregnancy (EP) are very common and associated with significant physical and emotional morbidity for the patient and her family. Transvaginal ultrasonography (TVS) is the diagnostic cornerstone of the management of women with early pregnancy complications, with high sensitivity of 87-99%, specificity of 94-99% and it is the investigative modality of choice. The challenge in the diagnosis of miscarriage is in making sure that it is correct, so as to not risk inadvertently terminating an ongoing pregnancy. Misdiagnosis of miscarriage should be a ‘never’ event. To quote the 1995 report on the misdiagnosis of miscarriage by Campbell and colleagues, “the death of an embryo should be regarded as of equal significance to that occurring at a later stage.”

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