{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T15:32:49Z","timestamp":1763998369215,"version":"3.45.0"},"reference-count":34,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Medical treatment with misoprostol represents one of the main treatments for Early Pregnancy Loss (EPL). In our study, we aimed to identify clinical features associated with a successful response to this approach. Methods: A prospective single-center observational study was conducted at the EPL Clinic of the Department of Obstetrics and Gynecology, Fondazione A. Gemelli IRCCS Rome, Italy. Patients were categorized according to the type of treatment received: spontaneous delivery, elective dilatation and curettage, or medical treatment. A separate analysis was performed within the medical treatment group to distinguish women with a successful response from those with an unsuccessful one. The success of medical treatment was calculated as the response rate (number of patients who successfully responded to treatment\/total number of treated patients) with a 95% Confidence Interval (CI). For patients undergoing misoprostol treatment, a multivariable analysis was planned to identify predictors of a successful response, including variables with a p value less than 0.05 in the univariable analysis. Receiver Operating Characteristic (ROC) analysis was performed to evaluate the predictive ability of continuous obstetrics parameters for medical treatment success. The optimal cut-off value to differentiate responsive from unresponsive patients was also determined. The significance level was set at p &lt; 0.05. Results: Sixty-four patients who underwent medical treatment were analyzed. Amenorrhea age was the only parameter inversely associated with treatment success, indicating that an earlier amenorrhea age correlated with a better response to misoprostol. ROC analysis identified a cut-off of 62.5 days, with an AUC (95% CI) of 0.72 (0.55\u20130.89). An amenorrhea age of \u2264 62.5 days predicted a successful response to medical treatment with a specificity (95% CI) of 90.0% (89.8\u201390.2) and sensitivity (95% CI) of 54.9% (41.2\u201368.6). Conclusions: Amenorrhea age emerged as a potential predictor of treatment response in women with EPL undergoing misoprostol therapy. However, further studies of larger sample sizes are needed to validate and improve our model.<\/jats:p>","DOI":"10.3390\/jcm14238275","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T15:33:06Z","timestamp":1763739186000},"page":"8275","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Response to Misoprostol Treatment in Early Pregnancy Loss: A Single-Center Prospective Observational Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6160-0558","authenticated-orcid":false,"given":"Silvia","family":"D\u2019Ippolito","sequence":"first","affiliation":[{"name":"Dipartimento di Medicina e di Scienze della Salute \u201cVincenzo Tiberio\u201d (DiMeS), Universit\u00e0 degli Studi del Molise, Via Francesco De Sanctis, 86100 Campobasso, Italy"},{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2959-8571","authenticated-orcid":false,"given":"Tina","family":"Pasciuto","sequence":"additional","affiliation":[{"name":"Research Core Facility Data Collection G-STeP, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Section of Hygiene, University Department of Life Sciences and Public Health, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Granieri","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2626-9845","authenticated-orcid":false,"given":"Sara","family":"Giuliano","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greta","family":"Barbaro","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giandomenico","family":"Pianese","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmelinda","family":"Martino","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1590-3942","authenticated-orcid":false,"given":"Chiara","family":"Tersigni","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4834-0974","authenticated-orcid":false,"given":"Alessio","family":"Colalillo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, Universit\u00e0 Cattolica Del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Catena","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pantaleo","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, 44122 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2424-2691","authenticated-orcid":false,"given":"Giuseppe","family":"Vizzielli","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Udine, 33100 Udine, Italy"},{"name":"Clinic of Obstetrics and Gynecology, \u201cSanta Maria della Misericordia\u201d University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tullio","family":"Ghi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5698-7946","authenticated-orcid":false,"given":"Francesco","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina e di Scienze della Salute \u201cVincenzo Tiberio\u201d (DiMeS), Universit\u00e0 degli Studi del Molise, Via Francesco De Sanctis, 86100 Campobasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicoletta","family":"Di Simone","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"},{"name":"IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists\u2019 Committee on Practice Bulletins\u2014Gynecology (2018). 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