Routinely offering women further tests after their first miscarriage – rather than waiting until their third – could prevent more than 10,000 losses a year in the UK, a study suggests.
The additional measures are effective and can be achieved “without significant additional workload for NHS teams”, according to pregnancy and baby charity Tommy’s.
The move could also spare thousands of families each year trauma, experts said.
Currently, the NHS will run tests after a third miscarriage in most cases.
This leaves families “unsupported” with their “grief unrecognised”, a new report by Tommy’s said.
The pilot study by researchers at Tommy’s National Centre for Miscarriage Research and Birmingham Women’s Hospital trialled a so-called graded model of miscarriage care.
This involves the NHS intervening at an earlier stage, with women offered a one-to-one consultation with a specialist nurse after their first loss to discuss health before conception and during pregnancy.
The hormone progesterone may also be offered in future pregnancies if a woman has experienced early vaginal bleeding.
After two miscarriages, patients would be offered tests for anaemia and abnormal thyroid function. If they go on to have a third, women would be offered the current standard NHS care.
Professor Arri Coomarasamy, director of Tommy’s National Centre for Miscarriage Research, said: “If the graded model were implemented across the UK, our study indicates it could prevent around 10,075 miscarriages every year.
“That’s more than 10,000 families bringing their babies home instead of suffering the trauma of a pregnancy loss.”
The trial included 203 women with a history of one or more miscarriages who were given early intervention, along with 203 who had the usual care.
Of the women who had the graded model of care, 86% had one or more factors detected that could increase their risk of future miscarriages, compared to 58% in the group who had standard care.
According to the study, women treated using the graded model had a 4% lower risk of a pregnancy after miscarriage ending in another loss.
The measures could also save the NHS more than £40 million after one year, the report suggests.
Elsewhere, among women who had two losses, one in five were found to have either thyroid problems or anaemia which were picked up in blood tests they would not usually be offered at that stage.
Kath Abrahams, chief executive of Tommy’s, said: “NHS care and support for women who experience a miscarriage in the UK is inconsistent and generally involves no follow-up or tests until after a third loss.
“The three-miscarriage wait means women and families are left without early access to services that could help prevent future losses and reduce the debilitating feelings of isolation and hopelessness that we know affect so many who experience pregnancy loss.
“Our pilot study indicates that providing support after a first miscarriage, with escalating care after further losses, is not only effective but achievable without significant additional workload for NHS teams who are already working extremely hard to deliver good care.
“Put simply, it is the right thing to do.”
Tommy’s estimates there are about 250,000 miscarriages in the UK each year.
Ms Abrahams said Scotland has already embedded the new model into its miscarriage care pathway and called on policymakers in England, Wales and Northern Ireland to do the same.
She added: “We will do all we can to drive that change across the UK, so that more women and families are supported after every miscarriage.”
The Government has pledged to review miscarriage support in the new Women’s Health Strategy.
Baroness Merron, parliamentary under-secretary of state at the Department of Health and Social Care, welcomed the study and said its findings “will be carefully considered”.
She added: “Pregnancy and baby loss can have a devastating impact on women and families, who too often feel they have been left without the care and support they need.
“Research like this is crucial, and our renewed Women’s Health Strategy puts women’s voices and experiences at the heart of care.”
