For most women who miscarry, the following pregnancy is fraught with worry, especially the first trimester. You analyze every twinge, pain, streak of blood and pregnancy symptom, wondering if you are about to lose a second pregnancy in a row.
Now, they may have a way to tell if some threatened miscarriages will result in a miscarriage or a birth, which could make those weeks of waiting a little easier.
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.
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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**.
The PVI index, although it wouldn’t help those of us who had missed miscarriages who showed no signs of bleeding before loss, would be of great comfort to others who have more experience with the traditional miscarriage. And considering the number of ultrasounds, beta tests and early monitoring many do on their subsequent pregnancies, this could offer a huge break in unneeded, expensive medical interventions.