GPs' failure to diagnose pregnancies a cause for 'concern'

UCD report: The Medical Council has expressed concern at reports that three GPs failed to diagnose women attending them for …

UCD report: The Medical Council has expressed concern at reports that three GPs failed to diagnose women attending them for illness over a prolonged period as being simply pregnant.

The details of the cases were outlined in a report, entitled Concealed Pregnancy: A case-study approach from an Irish setting, published last week.

The report, compiled by University College Dublin (UCD) researcher Catherine Conlon, found that 51 births in two hospitals in the Republic - one in Dublin and one in the west - over an 18-month period between July 2003 and December 2004 had been concealed by women.

In some cases the pregnancies were not reported because the women did not know they were pregnant. These included three women who said they were attending their GPs for months but their doctors did not detect that they were pregnant.

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The president of the Medical Council, Dr John Hillery, told The Irish Times the report was "obviously of concern" to the council. "We need to look at that report," he said.

The report, commissioned by the Crisis Pregnancy Agency and the HSE West, included in-depth interviews with 13 of the 51 women involved in the study.

These included a young woman who said she had attended her GP 28 times because she was feeling unwell but he did not determine what was wrong with her. He suspected cystitis first and gave her antibiotics. When her stomach was getting bloated, he gave the woman, who was on the contraceptive injection, anti-inflammatory tablets.

The woman eventually sought a referral to the gynaecological unit of her local hospital where she was immediately diagnosed as nine months' pregnant. Neither she nor her GP suspected she could be pregnant because she was using contraception.

Another woman told how when she was feeling unwell she went to her GP three times before a pregnancy test was carried out. At this stage she was 30 weeks' pregnant. She said the GP tested her for diabetes and other conditions. She was panicking that she had a lump growing inside her and believed she could not be pregnant as her partner believed he was infertile. She had conveyed this belief to her GP.

The third woman claimed she was attending her GP for six months because she wasn't feeling right and her pregnancy went undetected. She said a pregnancy test proved negative. It was only when she was sent into hospital for tests that her pregnancy of 36 weeks was uncovered. When she told her GP "he was gob-smacked", she said.

The ages of these three women are not given in the report but the average age of the 51 women in the study was 21 years. Overall, the group ranged in age from 16-44.

The report set out to determine the extent of concealed pregnancy and consulted women, on a confidential basis, who had been through the experience. The views of the GPs who they attended are not known.

The report recommended GPs should be more proactive in the administration of pregnancy tests and adopt a principle of testing to screen for pregnancy rather than testing to confirm a pregnancy. The HSE should resource GPs to screen for pregnancy, it added.