Feature | October 25, 2013

Radiologists Recommend Steps to Reduce Risk of Inadvertent Harm to Potentially Normal Pregnancies

New Criteria Aim to Prevent Misdiagnoses of Nonviable Pregnancies

October 25, 2013 – A panel of 15 medical experts from the fields of radiology, obstetrics-gynecology and emergency medicine, convened by the Society of Radiologists in Ultrasound (SRU), has recommended new criteria for use of ultrasonography in determining when a first trimester pregnancy is nonviable (has no chance of progressing and resulting in a live-born baby). These new diagnostic thresholds, published Oct. 10 in the New England Journal of Medicine, would help to avoid the possibility of physicians causing inadvertent harm to a potentially normal pregnancy.

“When a doctor tells a woman that her pregnancy has no chance of proceeding, he or she should be absolutely certain of being correct. Our recommendations are based on the latest medical knowledge with input from a variety of medical specialties. We urge providers to familiarize themselves with these recommendations and factor them into their clinical decision-making,” said Peter M. Doubilet, M.D., Ph.D., of Brigham and Women's Hospital and Harvard Medical School in Boston, the report's lead author.

Among the key points made by the expert panel:

  • Until recently, a pregnancy was diagnosed as nonviable if ultrasound showed an embryo measuring at least five millimeters without a heartbeat. The new standards raise that size to seven millimeters
  • The standard for nonviability based on the size of a gestational sac without an embryo should be raised from 16 to 25 millimeters
  • The commonly used "discriminatory level" of the pregnancy blood test is not reliable for excluding a viable pregnancy

 

The panel also cautioned physicians against taking any action that could damage an intrauterine pregnancy based on a single blood test, if the ultrasound findings are inconclusive and the woman is in stable condition.

Kurt T. Barnhart, M.D., MSCE, an obstetrician-gynecologist at the Perelman School of Medicine at the University of Pennsylvania and a member of the SRU Multispecialty Panel, added, "With improvement in ultrasound technology, we are able to detect and visualize pregnancies at a very early age. These guidelines represent a consensus that will balance the use of ultrasound and the time needed to ensure that an early pregnancy is not falsely diagnosed as nonviable. There should be no rush to diagnose a miscarriage; more time and more information will improve accuracy and hopefully eliminate misdiagnosis."

“These are critical guidelines and will help all physicians involved in the care of the emergency patient. They represent an up-to-date and accurate scientific compass for navigating the pathway between opposing forces felt by the emergency physician and his/her consultants who are concerned about the potential morbidity and mortality of an untreated ectopic pregnancy in a patient who may be lost to follow-up, but yet must ensure the safety of an unrecognized early normal pregnancy,” said Michael Blaivas, M.D., an emergency medicine physician affiliated with the University of South Carolina and one of the panelists.

For more information: www.acr.org

Related Content

Study Examines Characteristics of Mobile Mammography Patients
News | Mammography | October 18, 2017
Significant differences were found among women receiving mammography at a cancer center versus those visiting a mobile...
Machine Learning Identifies Breast Lesions Likely to Become Cancer
News | Artificial Intelligence | October 18, 2017
A machine learning tool can help identify which high-risk breast lesions are likely to become cancerous, according to a...
Volpara Solutions to Showcase VolparaEnterprise Live! at RSNA
News | Mammography | October 16, 2017
Volpara Solutions will introduce VolparaEnterprise Live!, a mammography quality control tool, at the 2016 Radiological...
TMIST Mammography Study Opens Enrollment
News | Mammography | October 16, 2017
The Tomosynthesis Mammographic Imaging Screening Trial (TMIST), the first randomized trial to compare two types of...
National Breast Center Founder Names Top Three Innovations in Breast Cancer Treatment
News | Women's Health | October 11, 2017
In 2017, invasive breast cancer will be diagnosed in about 252,710 women and 2,470 men in the U.S. and remains the...
News | Brachytherapy Systems | October 05, 2017
External researchers presented new clinical data supporting the use of iCAD’s Xoft Axxent Electronic Brachytherapy (eBx...
Joint Venture Partnership Opening 16 New Breast Screening Sites in Texas
News | Breast Imaging | October 04, 2017
HCA Healthcare Gulf Coast Division and Solis Mammography have entered into a joint venture agreement to make breast...
International Trial Confirms Safety, Effectiveness of High-Dose Brachytherapy Plus Pelvic Radiation for Cervical Cancer
News | Brachytherapy Systems, Women's Healthcare | October 04, 2017
Findings from a new multicenter, international clinical trial confirm the effectiveness of high-dose brachytherapy or...
Kubtec Announces Expansion of 3-D Tomosynthesis Technology
News | Digital Radiography (DR) | October 04, 2017
October 4, 2017 — Kubtec announced at the annual conference of the American Association of Pathology Assistants (AAPA
The Siemens Acuson

The Siemens Acuson

Feature | Breast Imaging | October 04, 2017 | By Melinda Taschetta-Millane
According to a new Market Study Report,1 the automated breast ultrasound system (ABUS) market will see a 21 percent...
Overlay Init