Transvaginal ultrasound imaging for assessment of early pregnancy.

Public concerns regarding the misdiagnosis of miscarriage 1 have identified a serious weakness in the provision of quality care to women in early pregnancy. The implementation of a clinical initiative to standardise care during early pregnancy 2 is a welcome response to these tragic outcomes. While all imaging modalities have technical limitations, the current controversy over the erroneous diagnosis of miscarriage highlights the fact that standards of ultrasound training need improvement 1 . Abdominal "external" ultrasonography can be sensitive for diagnosing presence or absence of a gestational sac, but compared to transvaginal "internal" sonography, it is less sensitive at detecting a fetal pole 3 . But a transvaginal sonogram can still render an incorrect diagnosis of miscarriage, if faulty equipment is used.