"However, at present we have no way of predicting which threatened miscarriages will result in the end of the pregnancy and so we are unable to target attempts to rescue the pregnancy at the right women or to offer them counselling," she said. "This has led to wasteful and potentially harmful interventions, including unnecessary blood tests, ultrasound scans, hospital admissions for bed rest, sexual abstinence, low dose aspirin and progesterone supplementation."
Between 2009-2010, Dr Adam and her colleagues followed 112 women with threatened miscarriages, who were between six and ten weeks pregnant. During the five weeks the women were in the study they had ultrasound scans, weekly charting of pain and bleeding and weekly tests to check the levels of progesterone and the pregnancy hormone, human chorionic gonadotrophin (hCG). After analysing data on the outcomes of these pregnancies, Dr Adam found there were six factors that had the most impact on the risk of miscarriage: a history of subfertility, levels of progesterone, levels of hCG, the length of the foetus, how much bleeding had occurred, and the gestational age of the baby.
Individually, these factors were unable to predict accurately the risk of miscarriage, but when the researchers combined two of these factors the amount of bleeding and levels of hCG to create a "Pregnancy Viability Index" (PVI), they found that this provided a consistently reliable means of predicting which pregnancies would miscarry.
"By the end of the study period, the PVI was able to accurately predict the pregnancy outcome in 94% of women who had ongoing pregnancies (its positive predictive value), and also predicted the outcome in 77% of women whose pregnancy ended in miscarriage (its negative predictive value)," said Dr Adam**.
"This research has, for the first time, offered us a robust tool to begin to attempt to rescue pregnancies threatening to miscarry, when, currently, all we can do is fold ou
|Contact: Hanna Hanssen|
European Society of Human Reproduction and Embryology