{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T19:23:02Z","timestamp":1770146582615,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T00:00:00Z","timestamp":1660608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the rate of surgical intervention for unsuccessful medical treatment in early pregnancy loss (EPL), according to gestational size by ultrasound (GS\u2010US).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study. All women who were treated with misoprostol for EPL between July 2015 and December 2020 were included. The cohort was divided according to GS\u2010US: group 1: gestational sac without an embryonic pole; group 2: an embryonic pole with crown\u2010rump length (CRL) compatible with &lt;7\u2009weeks; group 3: CRL compatible with 7<jats:sup>+0<\/jats:sup>\u20137<jats:sup>+6<\/jats:sup> weeks; group 4: CRL compatible with 8<jats:sup>+0<\/jats:sup>\u20138<jats:sup>+6<\/jats:sup> weeks; group 5: CRL compatible with \u22659\u2009weeks. We compared the rate of any surgical intervention due to treatment failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 783 patients were included: group 1, 236 (30.1%); group 2, 319 (40.7%); group 3, 115 (14.7%); group 4, 78 (10.0%); and group 5, 35 (5.0%) patients. The rate of any surgical intervention was significantly lower in groups 1\u20134 (54, 22.9%; 85, 26.6%; 28, 24.3%; and 22, 28.2%, respectively) compared with group 5 (17, 48.6%; <jats:italic>P<\/jats:italic>\u00a0=\u20090.030). On multivariant analysis, GS\u2010US greater than 9\u2009weeks was independently associated with the need for surgical intervention (adjusted odds ratio 1.23, 95% confidence interval 1.01\u20131.51; <jats:italic>P<\/jats:italic>\u00a0=\u20090.040).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When treating EPL medically, GS\u2010US greater than 9\u2009weeks increases the risk of undergoing additional surgical intervention compared with younger weeks.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14371","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T09:29:26Z","timestamp":1659000566000},"page":"933-938","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Surgical intervention after medical treatment for early pregnancy loss according to gestational size"],"prefix":"10.1002","volume":"160","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2731-6553","authenticated-orcid":false,"given":"Ohad","family":"Gluck","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology E. Wolfson Medical Center  Holon Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elad","family":"Barber","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology E. Wolfson Medical Center  Holon Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ori","family":"Tal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology E. Wolfson Medical Center  Holon Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram","family":"Kerner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology E. Wolfson Medical Center  Holon Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eran","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology E. Wolfson Medical Center  Holon Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Sagiv","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology E. Wolfson Medical Center  Holon Israel"},{"name":"Sackler School of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dex074"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.02.001"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404\u2010016\u20104179\u20106"},{"key":"e_1_2_9_5_1","first-page":"325","article-title":"Early pregnancy failure: factors affecting successful medical treatment","volume":"12","author":"Marwan O","year":"2010","journal-title":"Isr Med Assoc J"},{"issue":"4","key":"e_1_2_9_6_1","first-page":"901","article-title":"Factors related to successful misoprostol treatment for early pregnancy failure","volume":"107","author":"Mitchell CD","year":"2007","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12808"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13512"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/RUQ.0000000000000060"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.07.013"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ECLINM.2020.100716"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)31788\u20108"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMOA1715726\/SUPPL_FILE\/NEJMOA1715726_DISCLOSURES.PDF"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AJOG.2020.04.006"},{"key":"e_1_2_9_15_1","unstructured":"Recommendations|Ectopic pregnancy and miscarriage: diagnosis and initial management|Guidance|NICE. 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Accessed March 13 2022 2018.http:\/\/apps.who.int\/"},{"key":"e_1_2_9_17_1","unstructured":"The Israeli Association of Obstetrics and Gynecology.The use of misoprostol in gynecologic procedure.2017."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2005.00632.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.03.032"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31819638e6"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.14371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.14371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.14371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T04:23:53Z","timestamp":1692246233000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.14371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,16]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1002\/ijgo.14371"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.14371","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,16]]},"assertion":[{"value":"2022-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}