Miscarriage Care and Facilities in Scotland: Scoping Report NHS Ayrshire and Arran

Data on miscarriages

Accurate assessment of the number of all miscarriages that occur in Scotland is not possible at present as only miscarriages that require hospital inpatient or day case treatment are recorded.

The Lancet series on Miscarriage Matters recommended that:

• miscarriage data are gathered and reported to facilitate comparison of rates among countries, to accelerate research, and to improve patient care and policy development; and
• every country reports annual aggregate miscarriage data, similarly to the reporting of stillbirth.

The Scottish Government is currently working with Public Health Scotland to find ways to improve miscarriage data recording and to gather a more accurate picture of the number of miscarriages in Scotland. This will be used to facilitate comparison of rates among countries, to accelerate research, and to improve patient care and policy development.

This scoping exercise found that miscarriage data is not collected in all sites or in all Health Boards in Scotland. While some data is collected in 11 of the 14 Health Boards, there is variation in what is being recorded as a miscarriage and this varies both across and within Health Boards.

Information technology used to collect miscarriage data

Across Scotland different IT systems are used by Health Boards to collect data about those accessing miscarriage care. BadgerNet Maternity is used by 11 out of 14 Health Boards to collect miscarriage data and Trakcare is used by 8 Health Boards to capture miscarriage data.

In NHS Ayrshire and Arran miscarriage data is collected via BadgerNet, Symphony (University Hospital Ayr) and through patient and paper records. Data is collected on the number of miscarriages, miscarriages as a proportion of pregnancies, gestation, maternal age, parity and ethnicity. There is currently no data collected on SIMD as detailed in Table 24.

In NHS Ayrshire and Arran data on miscarriage is presented to senior medical and maternity staff for review. However, like most sites across Scotland there is some disparity in what is counted as a miscarriage in NHS Ayrshire and Arran. Responses varied across the three sites, while all sites said that they record a miscarriage from self-report of the patient using a home pregnancy test, Arran War Memorial Hospital and University Hospital Ayr said that miscarriage would be counted as those over five-six weeks gestation by the patients last monthly period with positive pregnancy test either at home or in the hospital, while University Hospital Crosshouse stated that miscarriage is recorded from positive home pregnancy test but did not specify a gestation.