July 5, 2011 – Dr Kaltum Adam, an honorary clinical research fellow at St Mary’s Hospital in Manchester, UK and her colleagues have developed a reliable way of predicting the outcome of pregnancies that are threatening to miscarry.
“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 counseling. 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,” says Adam.
The study, which took place between 2009-2010, followed 112 women who had been diagnosed with threatened miscarriages and were between 6-10 weeks pregnant. During those five weeks the women were given ultrasound scans and weekly charting of pain and bleeding and were given weekly tests to check the levels of progesterone and hCG.
When analyzing the data on the pregnancies Dr Adam and her team found that six factors had the most impact on the risk of miscarriage: level of progesterone, level of hCG, history of sub-fertility, length of fetus, how much bleeding there was and the gestational age of the baby.
Individually, these factors were unable to accurately predict 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 way of predicting which of the threatened pregnancies would end in miscarriage.
“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 our hands and hope for the best.”
Dr Adam and her team are currently seeking funding in hopes to continue the study with a larger research trial of 1000 women who have been diagnosed with a threatening miscarriage.