Miscarriage Care and Facilities in Scotland: Scoping Report NHS Highland

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 Care 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 Highland miscarriage data is collected at all sites via BadgerNet. Raigmore Hospital and Belford Hospital reported that they also use Trakcare. Depending on the site, data is collected on the number of miscarriages, miscarriages as a proportion of pregnancies, gestation, maternal age, parity, SIMD and ethnicity. This can be seen in Table 22 below. Raigmore Hospital reported that the EPU collects data from every patient that has an ultrasound scan, while Caithness General Hospital said that data is also collected from the A&E department and by the midwife who deals with early pregnancy scans. The information collected includes date, CHI (Community Health Index), gestation by last menstrual period (LMP), gestation by ultrasound scan, diagnosis, management plan, and requirement for follow-up.

In NHS Highland, Belford Hospital is the only site that reported collecting data on miscarriages as a proportion of pregnancies. Like most sites across Scotland there is some disparity in what is counted as a miscarriage in NHS Highland. Responses varied across all sites; Raigmore Hospital said that miscarriages are recorded following a positive home pregnancy test, Dr MacKinnon Memorial Hospital reported that any miscarriages that they are made aware of either before or after the booking appointment are recorded as a miscarriage, and Caithness Hospital said that a miscarriage must be confirmed by ultrasound scan. Other sites record miscarriage once pre-booking contact has been made.