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'Lack of communication' led to miscarriage confusion.


Peter Stevenson

A SERIES of misunderstandings was responsible for a pregnant woman being told by hospital staff that she had suffered a miscarriage when she hadn't, Health Minister Androulla Agrotou said yesterday.

Maria Stylianou, 26, who was in her eighth week of pregnancy, lodged a complaint recently after she believed she was told by doctors at the Makarios Hospital that she had had a miscarriage.

"She (the doctor) was absolute about what she was saying," Stylianou told Sigma television at the time. "She announced it was a miscarriage."

Stylianou said she left the hospital distraught but was later convinced to visit a private gynaecologist who ascertained there was nothing wrong with the embryo.

Agrotou yesterday revealed the results of an investigation carried out by an experienced gynaecologist.

According to the report, an ultrasound which was carried out on January 21, 2013 on the pregnant woman, showed an endometrial gestational sac without foetal elements.

As the ultrasound was unable to display foetal data or to show any heart function as expected in a seven-week pregnancy the woman was instructed to take a large amount of a chorionic hormone over the next 48 hours.

She was told to come back two days later when the effects of the hormone would give the doctors a clearer picture. The report said the doctors involved had given assurances that at no point did they recommend that the woman terminate her pregnancy despite their concerns at the ultrasound scans.

The gynaecologist who compiled the report said that although a heartbeat can be found in a six to seven week old foetus, it is often misdiagnosed, and that the absence of a heartbeat does not necessarily mean there has been a miscarriage.

In response to the question, why was a heartbeat not found at the Makarios Hospital on the same day that one was found at a private clinic, the gynaecologist answered that the private doctor the woman visited was an ultrasound specialist and had hi-tech equipment.

The report reached two conclusions. The first concluded that the doctors who examined the pregnant woman did not express themselves correctly or were not clear in their diagnosis, resulting in the patient misunderstanding the situation and becoming upset.

The report suggested they could have asked the woman to come back for testing in 48 hours without revealing their concerns.

The second conclusion stated that the doctors had little experience with ultrasound, and that the equipment used was slightly dated. The report said that the hospital does have newer equipment and the doctors could have referred the woman to a more experienced colleague.

"We express our sympathy towards the woman, and the whole issue will be examined by medical services and the public health service, which has been instructed to take measures to prevent similar incidents," Agrotou said.

"There was a miscommunication with the woman, resulting in her getting upset and although the Makarios Hospital has the capabilities to carry out an ultrasound through an experienced doctor, it didn't happen," she added. Agrotou said that the doctors would have been held responsible if the examinations they had carried out were not the appropriate ones.

"What the doctors wanted to ascertain was if the sac was empty," Georgiou said. "It's a fact that between the sixth and seventh week of pregnancy there is a possibility that a heartbeat might not be found," she concluded.

Agrotou also said she had ordered an investigation into the recent case of a dead foetus which was disposed of as medical waste at Limassol General Hospital instead of being sent to the morgue for burial.

A pregnant woman visited the hospital because she had stopped feeling her baby move. The foetus had died at 21 weeks, and the woman had an operation to have it removed. Under regulations a foetus less than 20-weeksd old would be disposed of as medical waste.

Agrotou said there were many points which needed to be cleared up. She said that an investigative officer would be assigned today at the latest.

"Based on everything that has been submitted up until now, I have seen fit to give instructions for a disciplinary investigation, the aim of which will be to clear up the incident," she said.

Health Minister Androulla Agrotou

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Publication:Cyprus Mail (Cyprus)
Article Type:Medical condition overview
Date:Feb 5, 2013
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