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Data collected included demographic, clinical, and sonographic parameters, with comparisons made between patients with successful and unsuccessful treatment outcomes. Univariable and multivariable logistic regression analyses were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 716 patients included in the study, treatment failure was observed in 29.5%. In multivariable analysis, prior CD was independently associated with an increased risk of treatment failure (aOR 1.97; 95%CI 1.25\u20133.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Additionally, advanced gestational age was also associated with an increased likelihood of failure (aOR 1.02 per day; 95%CI 1.00\u20131.03;\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.009). In subgroup analyses, patients with prior CD had higher failure rates compared with those without prior CD (43.2% vs 27.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Among patients without prior CD, gestational age\u2009&gt;\u200970\u00a0days was associated with higher failure rates compared with\u2009\u2264\u200970\u00a0days (35.2% vs 24.3%,\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.006). In this subgroup (no prior CD and gestational age\u2009\u2264\u200970\u00a0days), the presence of bleeding during treatment was associated with lower failure rates (12.5% vs 25.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prior cesarean delivery was independently associated with an increased risk of treatment failure following medical management of first-trimester spontaneous abortion. Advanced gestational age was also associated with increased failure rates. Further studies are needed to refine treatment protocols and explore approaches for patients with prior CD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08504-1","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T13:14:53Z","timestamp":1782566093000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is a history of cesarean section a predictive factor for the failure of medical management in spontaneous abortion?"],"prefix":"10.1007","volume":"313","author":[{"given":"Ravit","family":"Pertez-Machluf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Youran Kimhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rotem","family":"Yedidia Moser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nissim","family":"Arbib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair","family":"Daykan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Weitzner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Schonman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zvi","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Yagur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,27]]},"reference":[{"key":"8504_CR1","doi-asserted-by":"publisher","unstructured":"ACOG Practice bulletin no. 200: Early pregnancy loss (2018) Obstetrics and Gynecology 132. https:\/\/doi.org\/10.1097\/AOG.0000000000002899.","DOI":"10.1097\/AOG.0000000000002899"},{"key":"8504_CR2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1715726","author":"CA Schreiber","year":"2018","unstructured":"Schreiber CA, Creinin MD, Atrio J, Sonalkar S, Ratcliffe SJ, Barnhart KT (2018) Mifepristone pretreatment for the medical management of early pregnancy loss. 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