{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:22:30Z","timestamp":1789230150779,"version":"build-2803163510"},"reference-count":10,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>In Japan, dilatation and curettage (D&amp;C) is a common procedure for spontaneous miscarriage and induced abortion, and its safety has long been an issue. Electric vacuum aspiration (EVA) is also common, but manual vacuum aspiration (MVA) was introduced recently, with medical abortions using mifepristone or misoprostol which are not yet legally accepted. This nationwide retrospective study surveyed the surgical methods and complications associated with spontaneous miscarriage and induced abortion at less than 12\u2009weeks of gestation in Japan to assess their safety, in comparison with a similar survey for induced abortions in 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Questionnaires were sent to 4176 facilities with a license for induced abortion surgeries in 2019. The questions included were the methods used, number of spontaneous miscarriages and induced abortions, and number of complications (uterine perforation, incomplete abortion, and gross bleeding requiring blood transfusion).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responses were received from 1706 facilities (40.9%). Although EVA with sharp curettage was the most common surgical method, which was used for 11\u2009953 spontaneous miscarriages (28.9%) and 24\u2009045 induced abortions (37.3%), the most common surgical method per facility was D&amp;C, and the rates of D&amp;C for spontaneous miscarriages (38.4%) and induced abortions (44.7%) performed in general hospitals were significantly higher than those in clinics (24.1% and 22.0%, respectively). There was no significant difference in the complication incidence rate among surgical methods for spontaneous miscarriages. However, in induced abortion surgery, the total complication and incomplete abortion incidence rates for D&amp;C were significantly higher than those for EVA without sharp curettage (47\/15\u2009162 [0.31%] vs. 29\/18\u2009693 [0.16%], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.00362, 45\/15\u2009162 [0.30%] vs. 27\/18\u2009693 [0.14%], <jats:italic>p<\/jats:italic>\u00a0=\u20090.00285, respectively). There was no significant difference in the complication incidence rate between MVA and other surgical methods for each abortion surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In Japan, especially in general hospitals, D&amp;C is still widely used for miscarriage and induced abortion surgery. Its complication\u2010incidence rates significantly decreased compared with that of the nationwide survey in 2012, but were still significantly higher than EVA without sharp curettage. Few facilities used MVA, but its complication rate was comparable with those of other surgical methods.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.15014","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T23:44:49Z","timestamp":1632786289000},"page":"4158-4163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Survey on spontaneous miscarriage and induced abortion surgery safety at less than 12\u2009weeks of gestation in Japan"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7820-5557","authenticated-orcid":false,"given":"Eishin","family":"Nakamura","sequence":"first","affiliation":[{"name":"Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Asahi General Hospital  Chiba Japan"},{"name":"Education Committee of the Japan Association of Obstetricians and Gynecologists (JAOG)  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Sekizawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Showa University School of Medicine  Tokyo Japan"},{"name":"Medical Safety and Education Committee of the Japan Association of Obstetricians and Gynecologists (JAOG)  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Education Committee of the Japan Association of Obstetricians and Gynecologists (JAOG)  Tokyo Japan"},{"name":"Department of Obstetrics and Gynecology Nara Medical University  Kashihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Takai","sequence":"additional","affiliation":[{"name":"Education Committee of the Japan Association of Obstetricians and Gynecologists (JAOG)  Tokyo Japan"},{"name":"Department of Obstetrics and Gynecology, Saitama Medical Center Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Medical Safety and Education Committee of the Japan Association of Obstetricians and Gynecologists (JAOG), Tokyo, Japan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,27]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"World Health Organization Department of Reproductive Health and Research. Safe abortion: technical and policy guidance for health systems. Second edition 2012."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.09.032"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2003.09.042"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625180701746461"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmz002"},{"issue":"4","key":"e_1_2_7_7_1","article-title":"Surgical methods for first trimester termination of pregnancy","volume":"2001","author":"Kulier R","year":"2001","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000109147.23082.25"},{"key":"e_1_2_7_9_1","first-page":"13","article-title":"Suction v. conventional curettage in incomplete abortion. A randomised controlled trial","volume":"83","author":"Verkuyl DA","year":"1993","journal-title":"S Afr Med J"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03362-4"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30413-8"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.15014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.15014","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.15014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T02:56:13Z","timestamp":1693191373000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.15014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,27]]},"references-count":10,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/jog.15014"],"URL":"https:\/\/doi.org\/10.1111\/jog.15014","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,27]]},"assertion":[{"value":"2021-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}