{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:41:13Z","timestamp":1787013673930,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T00:00:00Z","timestamp":1506470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,12]]},"abstract":"\n Objective<\/jats:title>\n \n To assess the efficacy and safety of medical termination of pregnancy (\n MTOP<\/jats:styled-content>\n ) when no intrauterine pregnancy (\n IUP<\/jats:styled-content>\n ) is confirmed on ultrasound.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective case\u2010note review.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Two gynaecological clinics in Vienna, Austria, and Gothenburg, Sweden.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n \n All women with gestations of \u226449\u00a0days undergoing an\n MTOP<\/jats:styled-content>\n during 2004\u201314 (Vienna) and 2012\u201315 (Gothenburg).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Two study cohorts were created: women with and women without a confirmed\n IUP<\/jats:styled-content>\n . An\n IUP<\/jats:styled-content>\n was defined as the intrauterine location of a yolk sac or fetal structure visible by ultrasound. Women with an\n IUP<\/jats:styled-content>\n were selected randomly and included in the\n IUP<\/jats:styled-content>\n cohort.\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n Efficacy of\n MTOP<\/jats:styled-content>\n , defined as no continuing pregnancy and with no need of surgery for incomplete\n TOP<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After excluding 11 women diagnosed with an extra\u2010uterine or molar pregnancy, 2643 cases were included in the final analysis; 1120 (98.2%) had a successful\n TOP<\/jats:styled-content>\n in the no\u2010\n IUP<\/jats:styled-content>\n group, compared with 1458 (97.1%) in the\n IUP<\/jats:styled-content>\n group, with a risk difference of 1.09% (95% confidence interval, 95%\u00a0\n CI<\/jats:styled-content>\n , \u22120.14, 2.32%;\n P<\/jats:italic>\n \u00a0=\u00a00.077). Significantly more women with confirmed\n IUP<\/jats:styled-content>\n were diagnosed with incomplete\n TOP<\/jats:styled-content>\n , and were treated with either surgery or additional medical treatment of misoprostol [64 (4.3%) versus 21 (1.8%); risk difference \u22122.42%; 95%\u00a0\n CI<\/jats:styled-content>\n \u22123.9, \u22121.1%;\n P\u00a0<\/jats:italic>\n <\u00a00.001].\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n There was no difference between the groups in efficacy of\n MTOP<\/jats:styled-content>\n , whereas early treatment resulted in significantly fewer interventions for incomplete\n TOP<\/jats:styled-content>\n . The risk of ectopic pregnancy needs to be considered if treatment is initiated before an\n IUP<\/jats:styled-content>\n is confirmed, but with structured clinical protocols the possibility of the early detection of an ectopic pregnancy in an asymptomatic phase may increase.\n <\/jats:p>\n <\/jats:sec>\n \n Tweetable abstract<\/jats:title>\n \n MTOP<\/jats:styled-content>\n before confirmed intrauterine pregnancy is as effective as at later gestation with less incomplete\n TOP<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.14904","type":"journal-article","created":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T04:28:39Z","timestamp":1504153719000},"page":"1993-1999","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Efficacy and safety of very early medical termination of pregnancy: a cohort study"],"prefix":"10.1111","volume":"124","author":[{"given":"I","family":"Bizjak","sequence":"first","affiliation":[{"name":"Division of Obstetrics and Gynaecology Department of Women's and Children's Health Karolinska Institutet and Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Fiala","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology Department of Women's and Children's Health Karolinska Institutet and Karolinska University Hospital Stockholm Sweden"},{"name":"GynMed Clinic Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Berggren","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Sahlgrenska Academy at Gothenburg University Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Hognert","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Sahlgrenska Academy at Gothenburg University Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"S\u00e4\u00e4v","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology Department of Women's and Children's Health Karolinska Institutet and Karolinska University Hospital Stockholm Sweden"},{"name":"Department of Obstetrics and Gynaecology Norrt\u00e4lje Hospital Norrt\u00e4lje Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Bring","sequence":"additional","affiliation":[{"name":"Statisticon\u00a0AB Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Gemzell\u2010Danielsson","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology Department of Women's and Children's Health Karolinska Institutet and Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2006.03.018"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e3181a2b026"},{"key":"e_1_2_6_4_1","unstructured":"Official Statistics of Sweden Statistics on induced abortions 2014 2015.www.socialstyrelsen.se"},{"key":"e_1_2_6_5_1","volume-title":"Safe Abortion: World Health Organizatoin. Safe Abortion: Technical and Policy Guidance for Health Systems","author":"WHO","year":"2012"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(89)90051-6"},{"key":"e_1_2_6_7_1","unstructured":"Royal College of Obstetricians and Gynaecologists.The Care of Women Requesting Induced Abortion (Guideline No. 7). 2011."},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00014.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep084"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9007"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001703-199512000-00017"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1990.tb02444.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(01)00200-1"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.10.013"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2014-100924"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.09.006"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(03)00012-5"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61054-0"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2004.06.005"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deq037"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.12.009"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000130839.61098.12"}],"container-title":["BJOG: An International Journal of Obstetrics & Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.14904","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.14904","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T05:01:44Z","timestamp":1695963704000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.14904"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,27]]},"references-count":22,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/1471-0528.14904"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.14904","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.730363369.793553013","asserted-by":"object"}]},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,27]]},"assertion":[{"value":"2017-08-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-09-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}